Abstract
This study is one of the first systematic attempts to examine the possibility of a common treatment facility (CTF) to treat infectious healthcare waste (HCW) in Nepal. First, the survey was conducted in 14 healthcare facilities (HFs) ranging from health posts to large hospitals selected from 120 total HFs in Nepalgunj sub-metropolitan city (SMC), a rapidly urbanising city of Nepal to investigate the current practices of HCW management (HCWM) and to estimate the waste generation and characteristics in the different HFs. The result shows that the average unit waste generation rate for health posts, clinics, urban health centres, and hospitals was estimated at 1.397 kg day-1, 1.608 kg day-1, 0.178 kg day-1 and 1.818 kg bed-1 day-1, respectively. Of the total 1242 kg day-1 HCW generated in Nepalgunj SMC, 73% is infected in the current situation, but if fully sorted at source, only 32% of the waste will be infected. Based on these HCW generation data and fraction of infectious waste, including waste management practices, three different scenarios are proposed for the capacity assessment and designing implementation modality of the CTF to treat infectious waste from all HFs of Nepalgunj SMC as a case study where an integrated solid waste management facility including material recovery facility and sanitary landfill site for municipal solid waste management is already in operation. The different implementation analyses are discussed, and the best implementation arrangement has been recommended for the sustainability of the project. This approach can be replicated in other cities alone or regions with many neighbouring cities of Nepal and explores a workable solution for HCWM in the rapidly urbanising cities of developing countries to help them improve their condition.
Highlights
Healthcare waste (HCW) is posing a growing problem, quickly in developing countries, like Nepal
The result shows that the average unit waste generation rate for health posts, clinics, urban health centres and the veterinary hospital was estimated at 1.397 kg day−1, 1.608 kg day−1, 0.178 kg day−1 and 0.321 kg day−1 respectively, whereas 0.99 kg bed−1 day−1 and 1.818 kg bed−1 day−1 in Bheri Hospital and other hospitals, respectively
As an integrated solid waste management (ISWM) system is already in an operational stage in Nepalgunj sub-metropolitan city (SMC), the integration of HCW into the MSWM system by constructing common treatment facility (CTF) will be a practical and sustainable solution. Once this approach is successfully implemented in the Nepalgunj SMC, the ultimate target should be the establishment of CTF in other regions of the country and its operation in PPP model
Summary
Healthcare waste (HCW) is posing a growing problem, quickly in developing countries, like Nepal. In healthcare facilities (HFs) of many cities, especially in rapidly urbanising cities of Nepal, the amount of solid waste being generated is increasing rapidly as healthcare services are expanded. There are many potential hazards associated with handling HCW, posing risks to the patients and healthcare workers and to the community and the environment (World Health Organization (WHO), 2005). HFs generate large amounts of diverse waste, which require proper treatment and disposal to protect the person’s handling it and the environment. An integrated HCWM approach, including waste minimisation, segregation, collection, transportation, treatment, storage and disposal of infectious and hazardous waste in each HF, is required to reduce the risks to human health and the environment. HCWM is considered one of the essential components of good infection prevention practices as an early recovery of the patient and health of clinical staff directly depends on the infection prevention practices used in HFs (Ministry of Health and Population (MoHP), 2020)
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