Assessment of Waste Management Services in Public and Private Facilities at the Three Levels of Healthcare Delivery, in Enugu State

Background: Improper and uncoordinated healthcare waste management (HCWM) practice exposes the healthcare worker, patients and surrounding communities to several morbidities and mortality from nosocomial infections.

Objectives: This study aims at assessing waste management services in public and private healthcare facilities at the three levels of healthcare delivery in Enugu State.

Methods: A cross-sectional study using quantitative and qualitative data collection methods involving healthcare workers and healthcare facilities (public and private) at the three levels of care in Enugu state. The study comprised of a total of 23 health facilities and 362 health workers drawn from the three levels of healthcare for private and public facilities.

Data were analyzed using Statistical Package for Social Sciences (SPSS) version 16.0. Chi-square test was used to compare the proportion of healthcare workers with adequate knowledge of HCWM. A significance level of p < 0.05 was used for statistical calculations. Results: One hundred and eighty (47.5%) of the respondents knew the correct steps for HCWM. Most respondents 355(93.7%) admitted that there is associated risk in handling waste. About 147 (38.8%) sustained injury while they had contact with waste out of which 57(38.8%) have had this injury more than three times. The presence of written strategy was higher in public facilities compared to private facilities (x2 = 1.446; p = 0.485), The access to it was highest in the unit (x2 = 1.027; p = 0.311). The frequency of waste collection was highest on a daily basis in both private and public facilities. Waste measurement and segregation were also observed to be higher in public than private facilities (x2 = 1.434; p = 0.488 and x2 = 1.644; p = 0.440 respectively). More public facilities segregated their waste at source compared to private facilities and this was statistically significant (x2 = 13.875; p = 0.008).

Conclusion: The frequency of waste collection was highest on a daily basis in both private and public facilities. However, waste measurement and segregation were observed to be higher in public than private facilities. More public facilities segregated their waste at source compared to private facilities. There seems to be a gap in communication among those involve in health management waste. The health personnel despite level of education and cadre, have poor knowledge of the risk associated with healthcare waste.