Abstract
Increased awareness about inadequate management of solid medical waste (SMW) has led to increased independent surveys in African countries and yet published data remain scanty on the subject in Africa as compared to the rest of the world. To evaluate the overall compliance with World Health Organization (WHO)’s ten recommendations on SMW practices in Africa through a literature review, we conducted literature search using search terms as “medical waste OR clinical waste OR biomedical waste OR hospital waste OR healthcare waste OR hazardous waste AND Africa” in PubMed, African Journals Online, Web of Science, Proquest, Embase, Google scholar and Scopus. Additional articles were included from open google search. Articles were selected for inclusion if they described SMW management activities such as waste segregation, collection, transport (on-site and/or off-site), temporary storage, treatment and final disposal; were located in an African country and were written in English; or if written in a different language, had an English abstract with the relevant information. Evaluations were based on fifty eight (58) full text articles which were pooled together. The fifty eight (58) full text articles represented research undertaken in 20 countries. Overall, six countries (30%) broadly met half of the WHO’s 10 recommendations. Based on the reviewed articles, the greatest compliance was shown with “daily collection of waste from the service areas” (100%). Areas of least compliance were “appropriate use of color codes” (18%) for labeling waste bins, “off-site conveyance” (16%) and “periodic training” (18%). In spite of growing awareness, SMW management in most African countries was sub-standard. Appropriate use of color codes, periodic training and off-site conveyance need to be addressed in terms of reporting and practice. Common challenges and unremarkable progress in SMW management in Africa raise a question about whether a unified approach should replace independent country efforts. Key words: Africa, hospital waste, solid medical wastes, waste management.
Highlights
Solid medical waste has been referred to as any discarded solid material generated from activities involving health protection, medical diagnosis, treatment, scientific research, dental and veterinary services (US CongressOffice of Technology Assessment, 1988; Rao, 2008; Coker et al, 2009; Hossain et al, 2011)
Available evidence from the 58 journal articles from across 20 countries in sub-Sahara Africa in the period 1997 to 2014 indicates that SMW management still face many challenges and that South Africa appears to meet best practice according to the WHO-2014 recommendations on solid medical waste management practices
This review provides an overview of solid medical waste management practices in Africa as evident in published literature
Summary
Office of Technology Assessment, 1988; Rao, 2008; Coker et al, 2009; Hossain et al, 2011). This type of waste has been considered potentially harmful to humans and requires special treatment. Non-hazardous waste from health-care facilities is comparable to domestic waste and often ends up in the municipal solid waste stream discarded in landfills (Pruss et al, 1999). Solid medical waste has remained a source of concern because of the potential to transmit diseases, contaminate soil, surface and ground water with pathogenic microbes, toxic and heavy metals often present in it (Pruss et al, 1999). Inadequate handling and disposal of medical waste has consequences for patients, relatives or carers, healthcare workers, waste workers, scavengers, the public and the environment (Abor, 2007; Coker et al, 2009; Mesdaghinia et al, 2009)
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