Process evaluation in compliance with the national medical waste control guidelines among healthcare staff at Mwananyamala region referral hospital, Kinondoni, Dar es salaam

Abstract

ABSTRACT Background: Healthcare services are among the largest sources of waste globally and produce the second most harmful waste after radiation waste. Hospitals are major primary sources of healthcare waste. Nearly 15-25% of healthcare waste generated in hospitals is hazardous and a potential source of infectious diseases (1). Healthcare waste is a major potential risk factor for fatal infectious diseases worldwide, such as hepatitis C virus (HCV), human immunodeficiency virus (HIV), and hepatitis B virus (HBV) (2). Healthcare workers play a crucial role in effective healthcare waste management if they comply with healthcare waste management standards. However, in Tanzania, healthcare waste management indicators show unsatisfactory waste management practices in hospitals. Objective: To appraise the level of compliance with the National Medical Waste Control Guidelines among healthcare staff at the Mwananyamala Regional Referral Hospital in Kinondoni Dare-es-Salaam. Methodology: Analytical cross-sectional study design was employed. The sample size of the respondents in a study were 171 healthcare workers from Mwananyamala Regional Referral Hospital. Structured questions and observations used as the major data collection methods. descriptive analysis was employed using Stata version 18. Results: The study revealed that used gloves were mostly (19.33%) generated daily compared to other types of healthcare waste. Also, there was no compliance (62%) with medical waste management practices from collection to final disposal. Majority reported that there was no compliance of healthcare waste generation at Mwananyamala Hospital (61.4%). Also, the study participant reported, there was no compliance on waste segregation (76%). Additionally, the study revealed that there was compliance with the practices on HCW storage (62.6%), while 63.2% noted that there was no compliance with on onsite transport of HCW. Moreover, the majority reported that there was no compliance with practices of HCW treatment (71.9%). It was revealed that compliance level is associated with training whereby majority of participants with no training showed non-compliance (71.2%) and also motivation to staff in issues related to HCWM, those with no motivation (75%) showed non-compliance. Conclusion: Following the implementation of National Medical Waste Control Guidelines among healthcare workers at Mwananyamala regional referral hospital, the study found non-compliance with medical waste management practices. This was associated with age, lack of training, and motivation among healthcare staff. Recommendation: The government through the office of the region medical officer should improve supervision to the regional referral hospitals regarding healthcare waste management through Region health management team (RHMT). There should be an Infection and prevention focal person who has training in waste management. Also, there should be motivation as part of recognition by introducing competition among departments for 5S kaizen for infection, prevention and control within the hospital. Moreover, regular training on healthcare waste management should be put in place.