Samuel et al, 2015

NIGERIAN JOURNAL OF HEALTH

AND ALLIED RESEARCH
NJHAR
Available online at: www.njhar.org
ISSN: 2488-8710 Nig J Health All Res,2(1):1-6,July,2015
ORIGINAL RESEARCH ARTICLE

HEALTH CARE WASTE MANAGEMENT: A CASE STUDY OF HEALTH

CARE FACILITIES IN BAYELSA STATE, NIGERIA
Samuel NK1*, Ephraim-Emmanuel BC2, Elegen E3, Apiakise EW4, Efeke G5, Stanley O6
1,3,5,6
Department of Environmental Health Sciences, College of Health Technology, Otuogidi-Ogbia, Bayelsa State, Nigeria.
2
Department of Dental Health Science, College of Health Technology, Otuogidi-Ogbia, Bayelsa State, Nigeria.
4
Department of Community Health Sciences, College of Health Technology, Ogbia, Bayelsa State, Nigeria.
*
Corresponding Author Contact details: Department of Environmental Health Sciences, School of Public Health
Sciences, College of Health Technology, P.M.B 131, Bayelsa State, Nigeria. Tel:+234-8036142660
INFORMATION ABSTRACT:
ABOUT ARTICLE Background and Objectives: Generation of health care waste has rapidly increased and
ARTICLE has become so complex to manage due to the nature of waste and the attitude of the
HISTORY: workers including lack of adequate waste management technology. This study therefore
Article Received: assessed the practice of health care waste management in selected health care facilities in
8/04/2015 the study area with the view of prevention of the transmission of nosocomial infections.
Article Accepted: Materials and Methods: A structured questionnaire was used in obtaining the views on the
25/06/2015 practice of health care waste management among 80 health care workers working in 25
Article Published: health care facilities that were involved in this study.
7/07/2015 Results: Materials provided and used for management of waste in these health facilities
included the use of cartons, safety boxes and other waste disposal materials. Methods of
waste disposal carried out included open dumping, disposal into water bodies, and open
burning. Majority 62(77.5%) of the respondents were however of the view that waste was
managed poorly in the health facilities assessed.
Keywords: Conclusion: Waste management is a public health problem that needs urgent attention in
Health Care, health facilities located in Bayelsa State, Nigeria. Increased education on waste
Waste Management, management, provision of proper waste disposal equipments and materials as well as
Primary Health improved monitoring and enforcement of environmental health laws and policies by
Centers environmental health agencies were however advocated.

TO REFERENCE THIS ARTICLE: Samuel NK, Ephraim-Emmanuel, Elegen E, Apiakise EW, Efeke G & Stanley O. (2015).
Health Care Waste Management: A Case Study of Health Care Facilities in Bayelsa State, Nigeria. Nig. J. Health All.
Res;2(1):1-6. ISSN: 2488-8710. Available online at: www.njhar.org

1. INTRODUCTION
undertaken in the home; dialysis, insulin injections
All around the globe, the emergence of health care
etc(1,2).
wastes which are considered to be hazardous in
Health care Waste Management (HCWM) is a
nature and capable of transmitting diseases has been
major public health concern with a huge
of utmost concern. Healthcare waste includes all the (3)
environmental threat, globally . Inadequate and
waste generated by health care establishments,
inappropriate handling of health care waste has
research facilities, and laboratories. It also includes
serious public health implication and a significant
waste originating from minor or scattered sources
impact on the environment. The increased
such as those produced in the course of health care
generation of waste arises due to the increasing
2(1) Nig. J. Health All. Res. |Page |1
Samuel et al, 2015
number of health care facilities established and the 2. MATERIALS AND METHODS
recognition of its significance to the health of the This study was carried out in selected health care
public. Health care waste materials contain toxic establishments in Bayelsa State in the year 2011.
metals, toxic chemicals, pathogenic viruses, fungi, Bayelsa State is one of the southern states in the oil
(4,5).
bacteria etc Health care waste have been known rich Niger Delta region of Nigeria. Its capital is
to be disposed into community dustbins, water Yenagoa. The study area has a humid, semi-
bodies, buried in inadequate shallow pits, burned in equatorial climate and guinea mangrove forest with
the facilities and emitting toxic fumes e.g. CO, an average rain-fall of 2000mm due mainly to its
furan and dioxin.(1). Health care waste are capable proximity to the Atlantic Ocean. Its ground water
of transmitting all kind of diseases including table is very high, usually in the wet season with
measles, typhoid fever, tuberculosis, hepatitis B and seasonal flooding from July to November. A sample
C, cholera etc. In the year 2000, WHO reports that, size of 25 health care facilities in three Local
injections with contaminated syringes accounted for Government Areas viz: Southern Ijaw, Sagbama,
21 million hepatitis B virus (HBV) infections (30% and Ekeremor LGAs were used for this study. The
of all new infections), 2 million hepatitis C virus health facilities cut across primary and secondary
(HCV) infections (40% of all new cases of health care in the public sector. They included
infections) and 260,000 HIV infections 5% of all clinics, comprehensive health centers and cottage
new infections. Health care waste has diverse hospitals. The instrument used for data collection in
ramifications as it does not only affect the health of this study was a well structured questionnaire
patients, but also healthcare workers (doctors, containing 17 items that contained issues bordering
nurses, sanitary staff etc), care-givers, on the availability of an outfit responsible for
(6,7).
neighborhoods, and the general public management of health care waste, materials
Health care waste management deals with the provided for management of waste, and the level of
coordinated approach of waste collection, effectiveness of the unit. Eighty questionnaires were
segregation, storage, transportation, treatment and voluntarily administered among the staff of health
final disposal resulting from medical or related centers, and all were retrieved. Data was presented
activities utilizing appropriate technologies, in in frequency tables and percentages.
accordance with laid down principles, guidelines,
plans, policies, legislations (national and 3. RESULTS
international) and in such ways that does not The total number of health care facilities was 25,out
negatively impact on the health of staff of the of this number 10(40%) were clinics, 7(28%) were
facility, patients, visitors, care givers, the comprehensive health care facilities and 8(32%)
(1,8).
neighborhood and the environment This study were cottage hospitals as shown in Table 1.The total
was therefore aimed assessing the methods of waste number of respondents were 80,out of this number
management in the health care facilities in the study 32(40%) from clinics, 22(28%) from the
area with a view to prevent transmission of comprehensive health centers, and 26(33%) from
nosocomial diseases and environmental the cottage hospitals as shown in Table 2.
contamination.
2(1) Nig. J. Health All. Res. |Page |2
Samuel et al, 2015
Table 1: Type of Facility
Facility Frequency Percentage
Clinics 10 40%
Comprehensive 7 28%
Health centers
Cottage hospitals 8 32%
Total 25 100%

Table 2: Availability of Waste Management Outfit

Facility Agree Disagree % Undecided Total
Clinics - 32 (100%) - 32
Comprehensive - 22 (100%) - 22
Health centers
Cottage hospitals - 26 (100%) - 26
Total Nil 80 Nil 80

Table 3 shows materials provided and used for information on methods of waste disposal.
management of waste in these health facilities Responses from the clinics indicated that, open
including the use of cartons, safety boxes and other dumping, disposal into water bodies, and open
waste disposal materials. Table 4 shows burning were the usually applied methods.
Table 3: Materials for Collection of Waste
Type of facility Materials Total
Safety boxes Cartons Others
Clinics - 30(37.5%) 2(2.50%) 32
Comprehensive 4(5.00%) 16(20.0%) 2(2.50%) 22
Health Centre
Cottage hospital 7(8.75%) 18(22.5%) 1(1.25%) 26
Total 11(13.75%) 64(80.0%) 5(6.25%) 80

Table 4: Methods of Waste Disposal

Facility Method of disposal of waste
Clinics Open burning, disposal into water bodies, Open burning.
Comprehensive Open burning, disinfection, disposal into community
Health centers dumpsite, burial in the ground.
Cottage Open burning, disinfection, burial in the ground.
hospitals

Table 5: Effectiveness of Waste Management

Facility Good Fair Poor Total
Clinics - 3 (3.75%) 29 (36.1%) 32
Comprehensive - 5 (6.25%) 17 (21.3%) 22
Health centers
Cottage hospitals 3 (3.75%) 7 (8.75%) 16 (20.0%) 26
Total 3(3.75%) 15(18.8%) 62(77.5%) 80

2(1) Nig. J. Health All. Res. |Page |3

Samuel et al, 2015

As shown in the table, the methods available with The use of safety boxes for sharp waste materials,
the comprehensive health centers were, open cartons and some other means of waste collection
burning, disinfection, disposal into community show that to some extent, waste collection and
dumpsite and earth burial. While the methods segregation is of concern when health care wastes
available with the cottage hospitals were open are generated in our study areas. Effective waste
burning, disinfection and earth burial. On the segregation either at the point of generation or at the
effectiveness of waste management, majority point of temporary storage is vital in ensuring that
62(77.5%) of the respondents were of the view that the waste materials are effectively disposed using
waste was managed poorly in the health facilities. appropriate methods, thus reducing any potential
This is shown in Table 5. hazards that may occur as a result of improper
disposal. The practice of waste segregation is also
4. DISCUSSION reported in other studies, although the need for
Our study showed that the effective health care improvement of these segregation methods have
waste management was grossly lacking in the health been advocated in order to ensure an alignment with
facilities involved in our study. Adequate materials international best practices as regards waste
based on the World Health Organization standards management. The provision of waste disposal
for collection, segregation, treatment as well as vehicles as well as personal protective devices for
disposal of wastes were not provided. Poor waste personnel involved in waste disposal are also key in
management in these health facilities have resulted effective waste management, thus resulting in
in waste litters forming nuisances at the reduced rates of infection spread as reported by
surroundings of the health facilities, waste handlers authors in the past. (3,10-13).
carrying health care waste materials on their The World Health Organization has in the past
shoulders and heads for disposal thereby creating provided stipulated guidelines for effective waste
exposure to vector-borne diseases and numerous disposal which on the contrary have been poorly
occupational hazards. Even children had access to practiced. These guidelines including the use of
blood bags and syringes and used them as toys. This chemical disinfection, microwave irradiation,
improper management of waste in these facilities encapsulation, wet thermal treatment, specialized
has also been associated with the incidence of incinerating equipments, safe burial on hospital
disease transmission such as measles, cholera, premises amongst others have not been adhered to
typhoid fever, HIV, hepatitis C and B amongst by the health facilities whose waste management
others within the areas of study. Improper waste systems were assessed in this study. Considering
management is not just a problem in our study area the methods of waste disposal practiced in these
but is a menace that is present in various parts of health facilities which include open air burning,
Nigeria as reported by previous authors which has disposal into water bodies and community refuse
contributed immensely to infection spread as well dumpsites, disinfection as well as burial in the
as the occurrence of nosocomial infections within ground, it can be seen that there still needs to be an
health care facilities. (2,3,9). improvement of how the hospital waste materials in
2(1) Nig. J. Health All. Res. |Page |4
Samuel et al, 2015
our study areas are disposed especially in cases which are below the recommended standards given
where waste materials buried within the ground are by the World Health Organization.
not buried deep enough due to use of shallow pits;
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