Evaluation of biomedical waste management practices in public and private sector of health care facilities in India.

Abstract

Proper management of biomedical waste (BMW) is required to avoid environmental and human health risks. The current study evaluated the BWM practices in public and private health care facilities of Fatehgarh Sahib District in Punjab, India. The study was conducted, using a modified World Health Organization (WHO) tool in 120 health care facilities randomly selected from rural and urban areas. At primary health care level, BMW management guidelines were followed in 67.2% of the public sector and 40.4% of the private sector facilities, whereas in secondary health care sectors both private and public sector follows 100% compliance. Health facilities were graded into different categories according to median score, i.e., scores less than < 2.5 was categorized as red (no credible BMW management system in place), scores between 2.5 to 7.5 as yellow (system present but needs major improvement) and scores > 7.5 as green (good system in place for BMW). It was observed that among primary health care facilities, 85% of the public sector and 64% of private sector facilities falls in the red category, whereas for secondary health care facilities only 8% fall in the red category. Logistic regression helped to identify the major factors that affect the performance of the health care facility, and it shows that regular training on BMW and improved infrastructure can improve the BMW management practices. Further, proper management of BMW requires multi-sectoral coordination, which can be better addressed through policies and by providing periodical training to all stakeholders.