TABLE OF CONTENTS
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study
1.2 Statement of the Problem
1.3. Objective of the Study
1.4 Research Questions
1.5 Hypothesis
1.6 Scope of the Study
1.7 Justification for the Study
1.8 Operational definition of terms
CHAPTER TWO: REVIEW OF LITERATURE
2.0 Introduction
2.1 Nature of healthcare waste
2.1.1 Sharps waste
2.1.2 Infectious waste
2.1.3 Pathological waste
2.1.4 Pharmaceutical waste
2.1.5 Chemical waste
2.1.6 Radioactive waste
2.2 Healthcare waste management
2.3 Healthcare waste generation
2.3.1 Healthcare waste generation in developing countries
2.3.2 Healthcare waste generation in developed countries
2.4 Healthcare waste management practices
2.4.1 Segregation
2.4.2 Handling and collection
2.4.3 Storage
2.4.4 Transportation
2.4.5 Treatment and disposal
2.4.6 Training and education
2.5 Health waste management practices in developed countries
2.6 Healthcare waste management practices in developing countries
2.7 Potential impacts associated with healthcare waste
2.8 Acts and legislation on healthcare waste management
2.9 Theoretical Framework
2.10 Concept adopted for the study
2.10.1 Concept of cleanliness
CHAPTER THREE: METHODOLOGY
3.0 Introduction
3.1 Research Design
3.2 Population
3.3 Sample size and sampling Technique
3.4 Research Instruments
3.5.1 Questionnaire
3.5.2 Field Observation
3.5.3 Validity and Reliability of Instrument
3.6 Method of Data Collection
3.6.1 Method of Data Analysis
3.7.1 Inclusion criteria
Content
3.7.2 Exclusion criteria
3.8 Ethical Consideration
3.8.1 Permission for the study
3.8.2 Post research benefits
CHAPTER FOUR: DATA ANALYSIS, RESULTS AND
DISCUSSION OF FINDINGS
4.1 Results
4.2 Discussion
CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATIONS
5.1 Summary
5.2 Conclusion
5.3 Recommendations
5.4 Limitation of the Study
5.5 Suggestion for further Studies
REFERENCES
APPENDICES
CHAPTER ONE
INTRODUCTION
1.0 Background to the Study
Healthcare
waste threatens the public health due to its contagious nature. Most healthcare
facilities are located in the heart of the cities and therefore, healthcare
waste that are not correctly managed can cause dangerous infection and pose
potential threat to the nearby environment, health workers, patients and to the
public (WHO, 2014). Dehghani, Azam, Changani and Fard (2008) noted
that Healthcare Waste (HCW) if not appropriately managed can be a serious
threat to human health due to their infectious attributes. Nigeria,
one of developing countries, has health issues that are competing for limited
resources; it is not amazing that healthcare waste management receives less
attention and precedence than it merits (Stephen, & Elijah, 2011).
Therefore, there is a serious challenge in developing countries, where there
are no Institutional provisions for healthcare waste management. Clinical
wastes are disposed openly in the dumpsite along with municipal waste and the
practice make the members of the community gain access to it which may lead to
outbreak of infectious diseases (Alagoz, Kocasay, Abah, & Ohimain,
2010) . Cheng, Sung, Yang, Lo, Chung and Li (2009) noted that as small as
healthcare waste is in proportion to the total community waste, its management
is considered an important issue worldwide. World Health Organization (2014)
reported that 15% of total waste generated in the healthcare facility is
hazardous and must be properly segregated at the point of generation to prevent
the whole healthcare waste becoming 100% hazardous. The World Health
Organization estimates that each year there are about 8 to 16 million new cases
of Hepatitis B virus (HBV), 2.3 to 4.7 million cases of Hepatitis C virus (HCV)
and 80,000 to 160,000 cases of human immune deficiency virus (HIV) due to
unsafe injections disposal and mostly due to very poor waste management
systems.
Across
the globe, the risk associated with Healthcare Waste (HCW) and its management
has gained tremendous attention from health practitioners and non
practitioners. If healthcare facilities know the types and quantities of
clinical waste generated, it will help them in planning, budgeting adequate
revenue for the management of hazardous waste (Bongayi, 2013). A study
conducted by Olubukola (2009) in two General hospitals at Lagos reported that
due to lack of quantification of healthcare waste, there was no waste reduction
plan in the hospitals.
This
lack of plan for healthcare waste management eventually leads to inadequate
waste segregation at point of use, collection, storage and final disposal. This
poor healthcare waste management practice creates health hazards for health
workers, patients and the environment. Identified gaps like lack of colour code
bags for segregation of healthcare waste at point of use, lack of guidelines on
segregation and disposal for health workers lead to poor healthcare waste
management in hospitals. The mismanagement of healthcare waste by healthcare
facilities does not pose health hazard to health workers and patients alone but
also to patients’ visitors and the community where they are improperly disposed
by contaminating the soil, air and water. Healthcare facilities are supposed to
protect the health of people in their environment, not to be a creator of
potential health hazard for them.
Furthermore,
increase in patient turned-out has increase the generation of healthcare waste.
Mboguwe, Mimereki and Magashula(2008) also reported that increase in population
results to increase in healthcare facilities that lead to increased healthcare
waste generation. It is expected that because of this increase, more attention
should be paid to and priority given to proper healthcare waste management in
Abeokuta South Local Government (ASLG). Management of healthcare waste
continues to present an array of challenges especially as economic situation of
the country deepen daily therefore, healthcare waste management has become a
concern.
So
many studies have been conducted on healthcare waste management but little or
no work has been done concerning segregation of clinical waste which is a vital
aspect in healthcare waste management (Coker, Sangodoyin, Sridhar, Booth, Olomolaiye,
2009). Segregation of waste is crucial in healthcare waste management because
it is the first step in clinical waste management. Segregation of healthcare
waste helps in reduction of the quantity of waste that is hazardous. Once
healthcare waste are segregated, collection will be easy, proper storage will
be done and disposal of infectious waste carried out in the way that it
will not pose any harm to health workers, patients and the environment (WHO,
2014). Proper management of healthcare waste depends on good organization,
sufficient funding and active participation of trained personnel. It was
observed that healthcare facilities were not spending resources on clinical
waste management Healthcare facility must allocate resources for colour coded
bags and training of generator of healthcare waste for proper segregation and
disposal for its sustainability. The intention of this study is to assess
healthcare waste management practices at health facilities in Abeokuta South
Local Government.
1.2
Statement of the Problem
Indiscriminate
dumping of untreated hospital waste in Municipal bins increases the
chances of survival and mutation of pathogenic microorganism population in
the municipal waste, which can lead to disease epidemics and increased incidence
of communicable disease in the community. The prevalence of infectious
disease like Hepatitis B, C, Measles, Acquired immunodeficiency syndrome,
Tuberculosis, Chickenpox, Cholera and others has also been traced to the
inappropriate segregation and disposal of hospital waste (Sreejith, 2008).In
Ogun State, the researcher observed that the healthcare facilities neglected
healthcare waste management in the area of segregation and disposal. Materials
required for segregation and disposal of these hospital wastes are not provided
by the constituted authority, thus these pose a serious threat to the health
workers, patients, environments and the community at large. There has been
recent cases of hospital acquired infectious diseases among health workers which
has been traced to contamination from healthcare waste, leading to untimely
death of some of these health workers.
The
indiscriminate dumping of hospital waste among domestic waste make the
community members easily access it. A tour of these health facilities shows the
absence of waste management facilities such as incinerators, autoclave,
and microwave. Therefore, it is most likely that medical wastes are dumped at
municipal site; this practice may lead to outbreak of communicable diseases. It
is in the light of these problems identified above that the researcher developed
interest in assessing healthcare waste management practices among health
workers in Enugu metropolis. The result of this study will be used to improve the
healthcare waste management in health facilities in Enugu metropolis. It will
also provide empirical data to policy makers, researchers and other concern
bodies to develop effective healthcare waste management policy in Enugu
metropolis and the country as a whole.
1.2 PURPOSE OF THE STUDY
The
purpose of this study is to
(i)
To determine
the composition of solid waste in selected healthcare facilities in Enugu
(ii)
To examine
the different management strategies being adopted in solid waste management by
the healthcare centers
(iii)
To identify
problem militating against solid waste management in selected healthcare
facilities Enugu Institute of Management and Technology.
(iv)
To suggest
appropriate and effective measures that will ensure efficient solid waste
management in selected healthcare facilities in Enugu
1.3 RESEARCH QUESTIONS
In an attempt to identify the
approaches and problems of solid waste management in selected healthcare
facilities with a view of finding appropriate management strategies, the
following research questions were formulated:
(i)
What are the
major components of solid waste generated in selected healthcare facilities.
(ii)
To what
extent does the composition of waste influence
the management practices?
(iii)
What are the
reasons for the inadequate as well as inefficient collection and disposal of
solid waste by health workers?
(iv)
What measure
are likely to improve the existing situation constraints or management
techniques?
(v)
What is the
level of public awareness of poor solid waste management?
1.4 HYPOTHESIS
In order to ascertain the opinion
of the public on the major constraints of solid waste management in. selected
healthcare facilities the following hypothesis are formulated.
Null Hypothesis
HO The
opinion of health workers and the
general public indicate and lack of management personnel that militate against
proper solid waste management in healthcare facilities.
Alternative Hypothesis
Hi The
opinion of health workers and the
general public indicate that it is the problem of equipment, fund and lack of
management personnel that militate against proper solid waste management in healthcare
facilities.
1.5 SIGNIFICANCE OF THE STUDY
The finding of this study will be
of great significance to both the students and staff and indeed, every body
that has a stake in the affairs and proceedings in selected healthcare
facilities.
This is because the recommendation of this study will prefer sustainable
solid waste management strategies. Moreover, the study will go along ways in
revealing to industrialists, the practical ways to minimize waste recycling.
Finally, the out come of this research will be an asset to environmental
researcher and planners for effective planning and management of solid waste.
1.6 SCOPE OF THE STUDY
The consequences and various types
of waste are of global significance but the research decided to limit the study
to.
(i)
The nature
of solid waste generation and problems in selected healthcare facilities in Enugu.
(ii)
Testing the
level of awareness and review of the activities of the (ENSEPA) in solving the
problem of solid waste in healthcare facilities.
(iii)
The possible
measures to improve the management techniques in the area.
1.7 LIMITATION OF THE STUDY
This study is constrained by
limited time and financial resources. Other limitation includes lack of
immediate reply to, the research questionnaire, but all these were soon
overcome with perseverance.