ENFORCEMENT OF PROPER MEDICAL WASTE MANAGEMENT PRACTICE IN GOVERNMENT HOSPITAL
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TABLE OF CONTENT
Table of content
1.1 Background of the study
1.2 Statement of problem
1.3 Research questions
1.4 Objective of the study
1.5 Significance of the study
1.6 Scope of the study
1.7 Definition of terms
2.2 conceptual review
2.3 empirical review
3.0 Research methodology
3.1 sources of data collection
3.3 Population of the study
3.4 Sampling and sampling distribution
3.5 Validation of research instrument
3.6 Method of data analysis
DATA PRESENTATION AND ANALYSIS AND INTERPRETATION
4.2 Data analysis
Medical waste management (MWM) can be generated in hospitals, clinics, medical laboratories and places where diagnosis and treatment are conducted. The management of these wastes is an issue of great concern and importance in view of potential public health risks associated with such wastes. The study assessed the medical waste management practices in selected hospitals and also determined the impact of Delta state Waste Management Authority (DSWMA) intervention programs. A descriptive cross-sectional survey method was used for the study. A population of 200 staff of the selected hospitals in Udu local government area of Delta state was randomly selected by the researcher as the population of the study. SPSS statistics was employed to analyzed the data obtained from a well-structured questionnaire and interpretation of the data was done critically and conclusion drawn.
1.1 Background of the study
Background Medical waste management (MWM) has become a critical issue as it poses potential health risks and damage to the environment (Adnane MI Et al 2013). It is also of greater importance due to its potential environmental hazards and public health risks with high propensity to result into epidemics (Dehghani MH 2008). It continues to be a major challenge, particularly, in most healthcare facilities of the developing countries where it is hampered by technological, economical, social difficulties and inadequate training of staff responsible for handling of the waste (Alagoz AZ, Kocasoy G 2008). Poor conduct and inappropriate management and disposal methods exercised during handling and disposal of medical waste (MW) is an increasing significant health hazards and environmental pollution/hazards due to the infectious nature and unpleasant smell of the waste. (Hossain MS Et al 2011). Despite the fact that current medical waste management (MWM) practices vary from hospital to hospital, the problematic areas are similar for all healthcare units and at all stages of management (Tsakona M Et al 2007). In Nigeria, a typical developing African nation, not many people are aware that medical waste contributes substantially to environmental pollution and hazards. This is reflected by lack of awareness and specific policy to address the menace of healthcare facility (HCF) waste, some of which is deemed hazardous (Akinwale C Et al 2009). It is important to note that healthcare wastes, if not properly managed, could pose an even greater threat and hazards than the original diseases. It is the duty of hospital and healthcare centers to take care of public health issues such as MW. Specific approaches that may be employed include patient care and enlightenment, ensure clean and healthy environment for workers/community (Patil GV, Pokhre K 2005). Carefree handling and disposal of MW impacts both directly and indirectly on staff, patient and environment. This is because the hospitals represent a unique environment, providing healthcare to patients and work environment for medical and other staff. In the process of healthcare delivery, medical waste is generated, which includes sharps, human tissues or body parts and other infectious materials (Baveja G, Muralidhar S, Aggarwal P 2000). Interestingly, there are reasonable ranges of technologies available for the treatment of healthcare wastes that may be appropriate for use in the third world countries. The World Health Organization (WHO) estimates that each year there are about 8 to 16 million new cases of Hepatitis B virus (HBV), 2.3–4.7 million cases of Hepatitis C virus (HCV) and 80,000–160,000 cases of Human Immunodeficiency Virus (HIV) due to unsafe injections disposal and mostly due to very poor waste management systems (WHO 1999). Contaminated injection equipment may be scavenged from waste areas and dump site either to be reused or sold to be used again. The negative health and environmental impacts of MW includes transmission of diseases by virus and microorganism, defacing the aesthetics’ of the environment, as well as contamination of underground water tables by untreated MW in landfills (Chua T, Puziah AL, Subramaniam AK 2012). Good medical waste management in hospital depends on a dedicated waste management team, good administration, careful planning, sound organization, underpinning legislation, adequate financing and full participation by trained staff (WHO 2005). However, it is pertinent that before any of these options is adopted, hospitals and medical facilities will need to assess the problems and put forward a management strategy that is suitable to their economic circumstances and also sustainable for use, based on local technology (Manyele SV 2004, Stephen Obekpa A, Elijah Ige O. 2011). Paradoxically, health-care activities which are meant to protect health, cure patients and save lives have been known to also generate waste. About 20 % of these wastes pose high risk, either of infection and chemical or radiation exposure (ICRC 2011). Health-care activities generate significant amounts of hazardous waste such as mercury and expired pharmaceuticals, as well as large amounts of general waste. As a matter of fact, the management of health-care waste is an integral part of a national health-care system. A holistic approach to health-care waste management should include a clear delineation of responsibilities, occupational health and safety programs, waste minimization and segregation, development, adoption of safe and environmentally sound technologies, and capacity building. Recognizing the urgency of this problem, a growing number of countries have taken initial steps to respond to this need. These include the establishment of regulatory frameworks, development of national plans and the demonstration of innovative approaches. However, funding of health-care waste management remains very inadequate (WHO 2007). This is an issue taking central place in the national health policies of many countries however, in most urban areas in Nigeria there are often no systematic approaches to MWM and it has not received sufficient attention. This may be because very often, health issues compete with other sectors of the economy for the very limited resources available. Also, in many countries, medical wastes are still handled and disposed together with domestic wastes, posing a great health risk to municipal workers, the public and the environment (Alagoz AZ, Kocasoy G 2008). Medical waste must be separated from municipal waste, but in many parts of Africa it tends to be collected along with the rest of the waste stream (Bdour A Et al 2007). Furthermore, hospital wastes are still mixed with the municipal waste in collecting bins at roadsides and disposed of similarly (Al-Emad AA 2011). The sustainable management of Healthcare Waste (HCW) has continued to generate increasing public interest due to the health problems associated with exposure of human beings to potentially hazardous wastes arising from healthcare (Tudor et al., 2005; Ferreira, 2003; Da Silver et al., 2005). Presently considerable gap exist with regard to the assessment of healthcare waste management practices particularly in Nigeria and in several other countries in sub – Saharan Africa. The nature and quantity of healthcare waste generated as well as institutional practices with regards to sustainable methods of healthcare waste management including waste segregation and waste recycling are often poorly examined and documented in several countries of the world despite the health risks posed by the improper handling of HCW (Farzadika et al., 2009; Oke, 2005). It is also of serious concern that the level of awareness, particularly of health workers regarding healthcare waste has not been adequately documented. HCW are a special category of waste because they often contain materials that may be harmful and can cause ill health to those exposed to it. A number of studies have indicated that the inappropriate handling and disposal of healthcare waste poses health risks to health workers who may be directly exposed and to people near health facilities, particularly children and scavengers who may become exposed to infectious wastes and a higher risk of diseases like hepatitis and HIV/AIDS (Adegbita et al., 2010; Coker et al., 2009, PATH, 2009; Oke, 2008; WHO, 2002, 1999). 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 and mostly due to very poor waste management systems (WHO, 1999; Townend and Cheeseman, 2005). In developing countries like Nigeria, where many health concerns are competing for limited resources, it is not surprising that the management of healthcare wastes has received less attention and the priority it deserves
1.2 STATEMENT OF THE PROBLEM
The mismanagement of healthcare waste poses health risks to people and the environment by contaminating the air, soil and water resources. Hospitals and healthcare units are supposed to safeguard the health of the community. However, healthcare wastes if not properly managed can pose an even greater threat than the original diseases themselves (PATH, 2009). There are a reasonable range of treatment technologies available for healthcare wastes that may be appropriate for third world countries, however, it is pertinent that before any of these options are adopted, hospitals and medical facilities will need to assess the problem and put forward a management strategy that is suitable to their economic circumstances and that can be sustained based on local technology. It is in view of this that this study becomes pertinent to examine the avenues for proper waste management practice in government.
1.3 OBJECTIVE OF THE STUDY
The study has one objective which is further divided into general and specific objective; the general objective is to examine avenues for the enforcement of proper medical waste management practice in government hospitals in Udu local government area of Delta state; the specific objectives are:
- i) To examine the effect of improper medical waste management practice on the health of Udu local government area
- ii) To examine if there is any relationship between medical waste management practice and Delta state waste management agency practice
iii) to examine the awareness level of medical personnel on the appropriate medical waste management disposal practice
- iv) To proffer suggested solution to the identified problem
1.4 RESEARCH QUESTION
The following research questions were formulated by the researcher to aid the completion of the study
- i) Is there any effect of improper medical waste management practice on the health of Udu local government area?
- ii) Is there any significant relationship between medical waste management practice and Delta state waste management agency practice?
iii) Are medical personnel properly and appropriate inform on medical waste management disposal practice?
1.5 RESEARCH HYPOTHESES
The following research hypotheses were formulated by the researcher to aid the completion of the study;
H0: there is no significant relationship between medical waste management practice and Delta state waste management agency practice
H1: there is a significant relationship between medical waste management practice and Delta state waste management agency practice
1.6 SIGNIFICANCE OF THE STUDY
It is believed that at the completion of the study, the findings will be of great importance to the medical practitioner as the study seek to explore the dangers of improper medical waste disposal to the health of the patience and the medical personnel, the study will also be of great importance to Delta state waste management agency in Udu local government area of Delta state as the study seek to recommend the need for proper medical waste management practice in hospitals, the study will also be of importance to researchers who intend to embark on a study in a similar topic as the study will serve as a reference point to further studies. Finally the study will be of great importance to student, teachers, academia’s and the general public as the study will contribute to the pool of existing literature and also add to knowledge on the subject matter.
1.7 SCOPE AND LIMITATION OF THE STUDY
The scope of the study covers enforcement of proper medical waste management practice in government hospitals in Udu local government area of Delta state. But in the course of the study, there are some factors that limit the scope of the study;
AVAILABILITY OF RESEARCH MATERIAL: The research material available to the researcher is insufficient, thereby limiting the study
TIME: The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.
FINANCE: The finance available for the research work does not allow for wider coverage as resources are very limited as the researcher has other academic bills to cover.
1.8 OPERATIONAL DEFINITION OF TERMS
Waste are unwanted or unusable materials. Waste is any substance which is discarded after primary use, or is worthless, defective and of no use
Medical waste is any kind of waste that contains infectious material (or material that’s potentially infectious). This definition includes waste generated by healthcare facilities like physician’s offices, hospitals, dental practices, laboratories, medical research facilities, and veterinary clinics
Waste management are the activities and actions required to manage waste from its inception to its final disposal. This includes the collection, transport, treatment and disposal of waste, together with monitoring and regulation of the waste management process.
Waste management practice
Waste management refers to the practice of collecting, transporting, processing or disposing of, managing and monitoring various waste materials
A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment
1.9 ORGANIZATION OF THE STUDY
This research work is organized in five chapters, for easy understanding, as follows
Chapter one is concern with the introduction, which consist of the (overview, of the study), statement of problem, objectives of the study, research question, significance or the study, research methodology, definition of terms and historical background of the study. Chapter two highlight the theoretical framework on which the study its based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding. Chapter five gives summary, conclusion, and recommendations made of the study.