Healthcare Waste Generation Rate Research Articles

Healthcare waste generation and quantification in public health centres in Addis Ababa, Ethiopia.

Healthcare waste produced in healthcare activities entails higher risk of infection and injuries than municipal waste. In developing countries healthcare waste has not received much attention and has been disposed of together with municipal wastes. Modern method of disposal of healthcare waste have been introduced to most healthcare institutions mismanagement and increased in production in public health centres in Ethiopia is important issues. The aim of the study was to assess the type of healthcare waste generation and quantification in selected public health centres in Addis Ababa, Ethiopia. An institution based cross-sectional study were conducted from January to February 2018. Fifteen health centres in Addis Ababa City Administration were selected for this study. Data were collected by using by different color plastic bags (Black plastic bags for non-hazardous wastes, Yellow plastic bags for hazardous wastes and Yellow safety box for needles and Red bags for pharmaceutical wastes and toxic wastes). The collected wastes were measured by weighing scale and were written to data entry sheet. To assure the data quality calibration of weighing scale was made by the standard weight every morning. EPI INFO TM7 and IBM SPSS were used for data entry, cleaning and analysis. The mean healthcare waste generation was 10.64+5.79Kg/day of which 37.26% (3.96+2.20Kg/day) was general waste and 62.74% (6.68+4.29) was hazardous waste from the studies health centres. Total hazardous waste; sharps, infectious, pathological and pharmaceutical wastes constitutes mean (±SD) 0.97 ±1.03, 3.23 ± 2.60, 2.17±1.92 and 0.25 ±0.34 kg/day respectively. Healthcare waste 29.93% and 0.32% were generated from delivery and post-natal case team and nutrition and growth monitoring case team respectively. The annual mean+ SD of healthcare waste generation rate per health centres were 3807.53+ 2109.84 Kg/year. The finding in this study showed there was an increased in hazardous healthcare waste in amount as compared to the WHO standard 85% non-hazardous waste and 10% hazardous waste and 5% toxic wastes. The healthcare waste management practices about segregation, collection, transportation and disposal at the source is crucial to decrease in quantity. Generally unselective handling and disposal of healthcare wastes is a concern.

Medical waste generation rate and management practices among government hospitals in Eastern Ethiopia. A descriptive survey.

Healthcare facilities generate medical waste, also known as healthcare waste or health facility waste, during the healthcare delivery process, which is improperly managed as a result of underfunded healthcare systems, poor training, and lack of awareness of policies and legislation on handling medical waste as well as do not have national guidelines in place to adhere to the correct disposal of such wastage in developing countries like Ethiopia. To estimate the healthcare waste generation rate among selected public hospitals in eastern Ethiopia. A cross-sectional study design was conducted in eight public in eastern Ethiopia from 1st June 2023 to 30th July 2023. The "Bed-Patient-healthcare wastes" model was used to estimate the healthcare waste generation rate based on WHO and empirical evidence. HCW generation rate = No of (Inpatients (Inpts) + Outpatients (Outpts))/day*0.53 kg/day. Meanwhile, general (GW), infectious (IW), pharmaceutical (PW), sharps (SW), and pathological (PtW) are computed as follows: GW = No. of (Inpt + Oupt)/day*0.53 kg/day and IW, PW, SW, and PtW = No. of Inpts/day*0.53 kg/day. In contrast, for hazardous and non-hazardous healthcare wastes, No of HCWs/day*0.8 and no. of HCWs/day*0.2 were utilized, and Key informant interviews and field observational were also applied. Descriptive analysis such as percentage, mean, and standard deviation were presented. According to the current assessment, 105.1-142.8 kg/day healthcare waste was generated from outpatient and 167.3-244.2 kg/day from inpatients of public hospitals. From these, the Mean ± SD of daily healthcare waste generation rate estimated by non-hazardous and hazardous waste were 164.6 ± 80.9 kg/patients/day and 41.2 ± 20.2 kg/patients/day, respectively. In daily generation, the mean and standard deviations (Mean ± SD) of general wastes, infections waste, pharmaceutical wastes, sharp wastes, and pathological waste/patient were 62% (521.9), 23% (194.8), 4% (35.4), 2% (17.7), and 9% (70.9), respectively. The current assessment concluded that a large volume of healthcare waste is generated from selected public hospitals, which were not effectively segregated, separated at the source, and haven't conventional or standard treatment. As a result, the study advised that regional and global collaboration in hospital waste and wastewater management be encouraged.

Quantitative analysis of healthcare waste generation and composition in Antalya, Turkey.

Health-care waste (HCW) may pose a risk to human health and the environment because of its infectious and/or toxic properties. This study was conducted to evaluate the quantity and composition of all the HCW generated by different producers in Antalya, Turkey, using data obtained from two online systems. Accordingly, this study explored the trends in healthcare waste generation (HCWG) between 2010 and 2020 and the impact of COVID-19 on HCWG by comparing the post- and pre-COVID-19 patterns based on the data obtained from 2,029 different producers. The collected data were based on the waste codes reported by the European Commission, were characterised based on the definition of the World Health Organization, and were further analysed according to the healthcare types defined by the Turkish Ministry of Health to characterize HCW. The findings indicate that the main HCW contributor was infectious waste (94.62%), most of which was generated by hospitals (80%). This is due to the inclusion of only HCW fractions in this study and to the definition of infectious waste considered. This study indicates that the categorisation into the type of HCSs may be a good option to assess the increase of HCW quantities, in accordance with the service type, size, and the effects of COVID-19. The correlation results for hospitals offering primary HCS revealed a strong relationship between the HCWG rate and the population per year. This approach may help estimate future trends to promote better HCW management practices for the specific cases considered, and it can even be applied to other cities.

Estimation of Persistent Organic Pollutants releases and emission levels from Healthcare Waste in Mwananyamala and Temeke Regional Hospitals in Tanzania

This study estimated the amount of polychlorinated dibenzodioxin (PCDDs) and polychlorinated dibenzofurans (PCDFs) from healthcare wastes generated in Mwananyamala and Temeke regional hospitals located in Dar es Salaam using Standardized Toolkit for sources of persistent organic pollutant (POPs) developed by UNEP. Healthcare wastes were collected in different categories and measured for fourteen (14) consecutive days. By using a weighing scale machine, the assessment of the healthcare waste generation rate in each hospital was measured. The average amount of healthcare waste were 67.12 Tons/year and 105.34 Tons/year at Mwananyamala and Temeke hospitals respectively. The recommended tolerable daily intake (TDI) of dioxin/furans for an adult is 1.75 x 10-10 g I-TEQ/day. The value obtained in this study (2.38 x 10-4 g 1-TEQ/day) at Mwananyamala hospital and 3.62 x 10-4 g 1- TEQ/day at Temeke is about 1.36 x 106 and 2.07 x 106 times higher than the recommended value for adults respectively. It is hereby recommended the emission of dioxin/furan from hospitals must be controlled and if possible, reduced to below the recommended limit. More detailed studies and the permanent monitoring of air quality around different healthcare facilities would be appropriate.

Healthcare waste generation in hospitals per continent: a systematic review.

There are increasing worldwide concerns about the negative impacts of healthcare waste generated in hospitals, especially in low- and middle-income countries. Hazardous type of waste can contribute to adverse effects both in human populations and the environment because of its physical, chemical, and biological characteristics. A comprehensive view on increasing waste in the world has not been conducted to understand the breadth of the issue; thus, this paper sought to provide an analysis of hospitals' healthcare waste generation rate. Comparisons were made with Wilcoxon and Kruskal-Wallis tests for simple and multiple comparisons, to analyze nonparametric data, with post hoc by Nemenyi test. Median values indicated that hospital waste was the highest in North and South America (4.42, 1.64kg/bed/day, respectively) and was almost nonexistent in Oceania (0.19kg/bed/day), while the median rates for hazardous waste were the highest in Oceania (0.77kg/bed/day). Africa was almost the lowest producer of waste in each category (0.19 and 0.39kg/bed/day for hospital and hazardous waste, respectively). Over time, linear regression indicated that hazardous waste in Asia and Europe has increased, while in Oceania, the total waste also increased. Interestingly, in North America, it was observed a reduction in the generation for both total and hazardous waste. This information highlights the importance of understanding continent-specific characteristics and rates, which can be used to create a more individualized approach to addressing healthcare waste in the world.

English

In this study, healthcare waste (HCW) generated in four referral hospitals in Tanzania namely: Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Center (KCMC), Bugando Medical Center (BMC) and Tumbi Regional Referral Hospital (TRRH) was characterized to establish its feasibility for energy recovery. The HCW collected and loaded into the incinerators was weighed and its composition determined (as highly infectious, infectious, sharps and non–infectious waste). To achieve effective energy recovery, waste segregation and color coding system were assessed. The moisture content and heating values of the waste were determined experimentally, ranging from 9.3 to 9.9 MJ/kg. Using interviews, direct observations and field measurements, the HCW generation rates, number of patients per day, number of beds and incineration rates in each health care facility were determined. Results indicated that the HCW generated were 2345, 789, 807 and 232 kg/day at MNH, KCMC, BMC and TRRH, corresponding to 1.34, 1.02, 1.1 and 0.76 kg/capital/day, respectively. The major component of the waste stream was infectious waste (which ranged from 34 to 76%). The moisture content ranged from 16 to 72% with the mean value of 43%. Further analysis on the characteristics of HCW indicated high potential for energy recovery from waste incineration.   Key words: Waste characterization, waste generation rate, waste segregation, moisture content, calorific value of waste, composition of healthcare waste, incineration, heat recovery.

Impact of COVID-19 pandemic on medical waste management in Lebanon.

Worldwide, there is a growing concern about the negative effects of infectious medical waste produced during the COVID-19 pandemic and the contamination risks associated with waste management. Therefore, measures to ensure that medical waste is managed safely and in an environmentally sound manner will avoid negative health and environmental effects from such waste, thus protecting the health of patients, health workers and the public in general. Despite that infectious medical waste generation rate is important for management planning and policy development, there is a limitation on national data availability and its accuracy, particularly in developing economies. This study analyses the infectious healthcare waste generation rates and management patterns in Lebanon before and after the COVID-19 pandemic. The estimated average of COVID-19-related infectious healthcare waste generation in this study is 39,035 kg per month or 1.3 tonnes per day, which constitute between 5% and 20% of total infectious healthcare waste in Lebanon. This study illuminates on the impact of COVID-19 on the existing challenges of waste management in Lebanon. It highlights the need for proper management and disposal of the amounts of medical waste generated to reduce contamination risks or related environmental threats, particularly during the pandemic. It also shows that Lebanon has a defective system for monitoring of waste from healthcare institutions and gaps in waste statistics. Finally, the study summarizes recommendations related to medical waste management, which can provide valuable insight for policymakers.

English

This paper assessed healthcare facilities location and medical waste generation and handling in Nigeria. Analysis such as descriptive statistics, correlation and factor analysis was carried out to identify gaps in healthcare facilities location and medical waste management in Nigeria. The population-to-healthcare provider ratio and healthcare waste generation rates in Nigeria were also analysed. The north central geo-political zone of Nigeria has over 9,000 healthcare facilities while the south-south zone has less than 5,000. Public primary health facilities are the most evenly located health institutions in Nigeria. Seventeen states in Nigeria are under served with regards to healthcare providers in facilities and can be classified as healthcare provider shortage areas. About 19,864.03 kg/day of waste is generated in Nigeria with the north central and north east accounting for the highest rates. Standard incineration facilities for effective medical waste management existed in 22% of all health facilities surveyed. Tertiary health facilities had adequate capacity (over 70%) to incinerate medical waste while significant gaps existed at the secondary and primary healthcare levels. Pearson’s correlation of employee capacities and waste management practices was significant. Factor analysis of variables on employee capacities and waste management practices showed that the first two components extracted accounted for 70.43% of the variance. The components matrix revealed that improving the availability of appropriate waste management equipment and control procedures is required. Healthcare policy makers in developing countries and Nigeria should strive towards equitable location of healthcare infrastructure and trained medical personnel, provision of appropriate waste management technologies, and building capacity of healthcare staff involved with the utilization, handling, and disposal of infectious and hazardous medical waste items. Key words: Healthcare, developing countries, medical waste, infectious waste, Lassa, HIV, hepatitis. &nbsp

Estimation of Different Categories of Healthcare Waste Generated at Two Different Hospital Categories in Four Hospitals in Dar es Salaam City

This study aims to estimate the quantity of healthcare waste categorically generated in four different healthcare in Dar es Salaam city namely, Muhimbili National Hospital, Mwananyamala Regional Referral Hospital, Temeke Regional Referral Hospital and Ilala Regional Referral Hospital to evaluate the quantities of medical waste generated based on their level and capacity. Waste was collected in different categories of non-infectious, sharps, infectious, infectious plastics, and pathological waste which were measured daily for fourteen (14) consecutive days in all hospitals by using a weighting scale and observational checklist to document related waste management information and the assessment of the healthcare waste generation in each hospital. The average general healthcare waste generation rate per healthcare ranges from 298.9 kg/day to 1554.4 kg/day. The high fluctuation in general medical waste was established to be attributed to specialization difference between one hospital to the other, and the large number of in-patients and out patients between hospitals. The overall average sharps waste generation rate was established to range from 8.5 ± 2.7 - 13.9 ± 1.8 kg/day. Higher values of sharps waste generated observed at Muhimbili hospital are due to emergency cases referred to from other hospitals located within the city and from the surrounding districts and other regions of the country. The results from this study, raise alarm to hospital administrators, and other health stakeholders working in related fields to give special attention and priority in setting a related share in their budgets for proper management of medical waste in their health facilities.

Medical waste management at three hospitals in Jenin district, Palestine.

Medical wastes are considered hazardous because they may possess infectious agents and can cause unsafe effects on the environment and human health. This study is to analyze and evaluate the current status of medical waste management at Jenin's district in light of medical waste control regulations recommended by the World Health Organization. The results demonstrated that the average hazardous healthcare waste generation rate ranges from 0.54 to 1.82kg/bed/day with a weighted average of 0.78kg/bed/day. There was no established waste segregation of healthcare waste types in all hospitals, and these wastes were finally disposed of in a centralized municipal sanitary landfill, namely Zahrat Al-Finjan. The results suggest that there is a need for activation and enforcement of medical waste laws. This can be achieved through cooperation among key actors: Ministry of Health, Environmental Quality Authority, Ministry of Local Government, and Non-Governmental Organizations working in related fields. Additional remediation measures proposed to tackle the problematic areas of medical waste management in Jenin's district hospitals are addressed. Some recommendations to minimize potential health and environmental risks of medical waste are also introduced.

Describing health care waste generation rates using regression modeling and principal component analysis

This work examined the dependence of the health care waste generation rates (HCWGR) from economic factors (gross domestic product per capita, health expenditure per capita), social and health-related factors (human development index, life expectancy at birth, mean years of schooling, deaths due to tuberculosis, under-five mortality rate, hospital beds, improved sanitation facilities, physicians, nurses and midwives, diabetes prevalence, deaths due to cancer, deaths due to asthma, deaths due to influenza and pneumonia), and one environmental sustainability factor (carbon dioxide emissions) from 41 countries using multiple linear regression modeling and principal component analysis (PCA). In addition, the Pearson correlation coefficients were calculated for all pairwise comparisons and a geographical grouping of the HCWGR was performed. The examined HCWGR included both the hazardous and the municipal fraction of health care waste (HCW). Results showed that the CO2 emissions and the life expectancy at birth positively correlated to the HCWGR (kg/bed/d) and can be used as adequate statistical predictors. The resulting best reduced model explained 84.7% of the variability. The hospital beds and the deaths due to cancer were not correlated to any principal component due to their low loadings. Only the diabetes prevalence was correlated to the F2 principal component. The other fourteen variables were correlated to the F1, which was the most significant principal component. Thus, the HCWGR and the other thirteen variables that were grouped to the F1 component have strong autocorrelation and can be treated as one variable.

Determining the Hazardous Medical Waste Generation Rates of Private Health Care Facilities-Case Study from Dhaka City of Bangladesh

Many developing countries are lagging behind the developed countries to properly manage their hazardous healthcare waste. These waste pose a significant epidemiological risks to the general people. To estimate the epidemiological risks and to establish parameters of any waste management plan, quantitative estimation of healthcare waste generation is essential. Most researches on quantitative estimation of healthcare wastes to date, have not addressed the differences in waste generation trends between the government and private healthcare sectors. This study was carried out to estimate the hazardous healthcare waste generation from private healthcare sector of Bangladesh; with a future aim do the same for government healthcare sector. A total of 50 privates healthcare facilities of different categories from Dhaka North City Corporation (DNCC) and Dhaka South City Corporation (DSCC) were selected for this study following a random sampling technique. Secondary data was obtained from PRISM Bangladesh (PRISM Bangladesh Foundation is a non-profit voluntary development organization established in 1989. In the context of environmental management, PRISM Bangladesh operates in different areas of Bangladesh with the assistance and support of UN organizations such as UNDP, UNICEF, UNDRO and UNCDF.) for these 50 healthcare facilities and personal visits to waste treatment sites were made. The estimated the hazardous healthcare waste generation rate for the private healthcare sector was found to be 0.17 kg bed-1 day-1 on per patient per day basis and an overall of 6796 kg daily. The estimated waste quantity and the proportion of hazardous healthcare waste to total healthcare waste was found to vary significantly due to different parameters related to the type and size of healthcare facility, seasonal variation etc. Based on the findings of this research, more accurate strategic planning of waste management systems for developing countries can be established by governments and municipal authorities to reduce the epidemiological risks.

Assessment of healthcare waste generation rate and its management system in health centers of Bench Maji Zone

It is known that the basic role of healthcare system is to preserve the health of patients and protect the public from diseases. However, in the process of performing these activities, health facilities generate hazardous waste that could be potentially harmful to healthcare workers, the public and the environment if there is insufficient handling, treatment and disposal of those wastes. Unfortunately, healthcare waste management is, in many regions, not yet carried out with a satisfactory degree of safety. Therefore, the aim of this study was to assess healthcare waste generation rate and its management system in health centers of Bench Maji Zone. A cross-sectional study was conducted from February to August, 2016. Observational checklist, key informant interview guide and weight scale were used to assess healthcare waste generation rate and its management system in selected health centers. Training, pre-test, instrument calibration and daily meeting were used to improve data quality. The Data was entered, compiled and analyzed using EpiData version 3.1 and SPSS version 21. The results on waste management system were reported using different descriptive statistics. Out of the total HCW generated in health centers, more than half (57.9%) was general or non-risk HCW, and the remaining 42.1% was hazardous healthcare waste. The amount of HCW generated in the studied health centers was different from WHO's norm which may be attributed to different factors such as economy, patient flow, difference in services provided, poor waste segregation practice, available waste management system and seasonal factors. HCW was not adequately managed which is characterized by lack of HCW segregation at source of generation and inadequate facilities to manage HCW. Therefore, it is important to develop a HCW management plan for keeping human health as well environmental sustainability.

Assessment of Health Care Waste Generation Rate and Evaluation of its Management System in Mizan Tepi University Teaching Hospital (MTUTH), Bench Maji Zone, South West Ethiopia

Assessment of Health Care Waste Generation Rate and Evaluation of its Management System in Mizan Tepi University Teaching Hospital (MTUTH), Bench Maji Zone, South West Ethiopia

Analyzing composition and generation rates of biomedical waste in selected hospitals of Uttarakhand, India

In India, a few studies have been conducted for analyzing the generation rates and composition of medical waste (MW). Inadequate information about the amount and composition of MW results in ineffective management practices. The present study seeks to evaluate healthcare waste (HCW) generation rates by healthcare facilities (HCFs) available in Uttarakhand, a northern state of India. Study also focuses on modeling the quantity of different types of MW generated at various HCFs and determining significant factors contributing towards MW generation. Seasonal variation in amount of MW generated from various HCFs has also been considered. To achieve these objectives, cross-sectional as well as longitudinal data have been collected from various HCFs in Uttarakhand, India. The survey revealed that around 36% of the total HCFs did not segregate their MW as per policy guidelines. Cross-sectional data for May 2015 were collected from 75 HCFs to analyze and model the composition and quantity of HCW generated. Multiple Linear Regression and Artificial Neural Network techniques were applied to model cross-sectional data. In the composition of the overall MW, ‘yellow waste’ carries the maximum share, followed by ‘red waste’ and then the ‘blue waste’. In addition, the ‘type of HCF’ and ‘bed occupancy’ have been modeled as the important factors, contributing towards the MW generations rates. Longitudinal data for 2 years (2013 and 2014) were collected to examine seasonal variation in HCW generation rates using polynomial regression analysis. Result shows that MW quantity also varies with the change in the season. Findings of the study will help hospitals and waste treatment facilities to predict amount of waste that may be generated, and plan resources towards efficient handling and disposal of MW.

Healthcare Waste Management: The Current Issue in Menellik II Referral Hospital, Ethiopia

Healthcare wastes generated in Hospitals from medical activities have not given sufficient attention. In developing countries, healthcare wastes are still handled and disposed indiscriminately creating an immense threat to the public health and the environment. This situation is much worse in Ethiopia where there is paucity of convincing evidence about healthcare waste generation rate and management system. A crossectional study was conducted in Menellik II hospital to evaluate the healthcare waste management system. Primary data on the healthcare waste management system was collected using observational checklist. Key informant interview guide was also employed on 11 selected informants to assess waste management practice and analyzed by thematic framework. The results revealed that there was no segregation of healthcare waste by type at the point of generation and disinfection of infectious waste before disposal. The main HCW treatment and disposal mechanism was incineration using low temperature, single chamber incinerator; open burning; burring in to amputation pit and open dumping on municipal dumping site as well as on the hospital back yard. Furthermore, there was negligence, attitudinal problem and low level of awareness about safe healthcare waste management. To diminish the risk of healthcare waste on public health and environment, a cost effective interventions include providing better medical waste management facilities, adherence to national regulatory and rising awareness of all concerned need to adopt in the hospital.

Healthcare Waste Generation Worldwide and Its Dependence on Socio-Economic and Environmental Factors

This paper examines the dependence of the healthcare waste (HCW) generation rate on several social-economic and environmental parameters. Correlations were calculated between the quantities of healthcare waste generated (expressed in kg/bed/day) versus economic indices (GDP, healthcare expenditure per capita), social indices (HDI, IHDI, MPI, life expectancy, mean years of schooling, HIV prevalence, deaths due to tuberculosis and malaria, and under five mortality rate), and an environmental sustainability index (total CO2 emissions) from 42 countries worldwide. The statistical analysis included the examination of the normality of the data and the formation of linear multiple regression models to further investigate the correlation between those indices and HCW generation rates. Pearson and Spearman correlation coefficients were also calculated for all pairwise comparisons. Results showed that the life expectancy, the HDI, the mean years of schooling and the CO2 emissions positively affect the HCW generation rates and can be used as statistical predictors of those rates. The resulting best reduced regression model included the life expectancy and the CO2 emissions and explained 85% of the variability of the response.

Healthcare Waste Composition and Generation Rate in Menellik II Referral Hospital, Addis Ababa, Ethiopia: A Cross Sectional Study

Healthcare facilities generate tremendous amount of infectious waste from healthcare activities. Despite the great potential for environmental hazards and public health risks of healthcare waste, its proper handling and management is significantly undermined in many developing countries where the actual amount of healthcare waste generated and its composition in Ethiopia is not well defined. Thus it is important to determine the existing generation rate in the hospital. Across-sectional study design was employed to assess the waste composition and determine generation rate in Menellik II hospital. A calibrated sensitive weight scale was used to quantify the generation rate of health care waste for seven days. Data was entered, arranged and analyzed using MS office excel sversion 2007and SPS Sversion 20. Correlation and regression analysis were computed to know the relationships between magnitude of waste generated and other variables. The results showed that the mean waste generation rate was found to be 1.94Kg/bed/day±0.335, comprised of 40.9% (130.20Kg/day±38.22) general and 59.1% (187.89Kg/day±38.85) hazardous wastes. The amount of waste generated was positively correlated with patients treated per day (r=0.835, p<0.05). The waste generation rate and proportion was also significantly varies between inpatients and outpatients (t=4.353, P<0.01) and there was a statistical significance difference among case teams (X2=56.558, p<0.0001). The mean generation rate in the hospital was comparable to other studies in Ethiopia but higher than Sub Saharan African countries. The proportion of hazardous waste (59.1%) was above the threshold set by the WHO (10-25%). This is because of malpractices of healthcare waste segregation. Therefore providing safe waste management technologies, adherence to national policy and awareness rising of all concerned needs to adopt in the hospital.

Healthcare Waste Generation and Management in Public Healthcare Facilities in Adama, Ethiopia.

Over the past few years there has been rising production of hazardous byproducts, including dioxins, furans, and mercury from indiscriminate handling and treatment of healthcare waste. This situation is worse in developing countries where there is a serious lack of reliable data on factors such as generation and characteristics of healthcare waste. To investigate healthcare waste generation and current management practices of public healthcare facilities in Adama, Ethiopia. All departments and sections in studied healthcare facilities (one referral hospital and four health centers) were examined for the characterization and determination of healthcare waste generation based on World Health Organization (WHO) guidelines. Wastes were collected and measured daily for seven consecutive days. Plastic buckets and bags of different colors were used for different types of wastes. Plastic bags were removed every morning and their weights were measured every day at 8 am using a scale. The average daily generation of healthcare waste from studied health centers ranged from 0.02 to 0.03 kg/patient/day, and the average daily waste generation of Adama referral hospital was 1.23 kg/bed/day. The healthcare waste generation rate was statistically different across the health service delivery sectors (p < 0.001). The proportion of hazardous healthcare waste generated in Adama referral hospital and health centers was 34.9% and 75%, respectively. There was no segregation of healthcare waste by type at the point of generation or pre-treatment of infectious waste in the studied healthcare facilities. Open pit burning and single chamber incinerators were the most utilized final treatment methods. Furthermore, there was a low level of awareness about safe healthcare waste management. The overall findings of this study indicate that the proportion of hazardous healthcare waste generated from the studied healthcare facilities was above the threshold set by the WHO. There is a lack of proper waste management systems in all public healthcare facilities in Adama, Ethiopia. Awareness raising activities on proper healthcare waste management should be undertaken targeting all healthcare workers.

Developing models for the prediction of hospital healthcare waste generation rate

An increase in the number of health institutions, along with frequent use of disposable medical products, has contributed to the increase of healthcare waste generation rate. For proper handling of healthcare waste, it is crucial to predict the amount of waste generation beforehand. Predictive models can help to optimise healthcare waste management systems, set guidelines and evaluate the prevailing strategies for healthcare waste handling and disposal. However, there is no mathematical model developed for Ethiopian hospitals to predict healthcare waste generation rate. Therefore, the objective of this research was to develop models for the prediction of a healthcare waste generation rate. A longitudinal study design was used to generate long-term data on solid healthcare waste composition, generation rate and develop predictive models. The results revealed that the healthcare waste generation rate has a strong linear correlation with the number of inpatients (R(2) = 0.965), and a weak one with the number of outpatients (R(2) = 0.424). Statistical analysis was carried out to develop models for the prediction of the quantity of waste generated at each hospital (public, teaching and private). In these models, the number of inpatients and outpatients were revealed to be significant factors on the quantity of waste generated. The influence of the number of inpatients and outpatients treated varies at different hospitals. Therefore, different models were developed based on the types of hospitals.