FACTORS INFLUENCING PROPER HEALTHCARE WASTE MANAGEMENT PRACTICES AMONG HEALTHCARE WORKERS

ABSTRACT

The study was carried out to investigate the Factors Influencing Proper Healthcare Waste Management Practices Among Healthcare Workers in Health Centers. Investigation revealed that 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 research design used in this report is descriptive design, utilizing questionnaire method to obtain information from the respondents for this project. A total of 300 (three hundred) respondents were selected for this study to represent the entire population of the study. Primary data were collected from the primary source which questionnaire was used as an instrument of data collection while secondary data were sources from textbooks, journals, newspapers and the internet were employed. The data were presented on a frequency distribution table and analyzed using simple percentage, while hypothesis was tested using chi-square test. The outcome of this research will help keep health care providers abreast with effective waste management practices to reduce the risk of infections and injuries to workers and the general public. Based on the findings, it is recommended that Hospital Management Board ensure uniformity in healthcare waste management practices in all hospitals, especially the private ones with practices different from the Government hospitals. Also, providing adequate numbers of waste bins, regular training and supervision on healthcare waste management are also recommended to improve the problems of poor management of healthcare wastes.

CHAPTER ONE

1.1 Introduction

Health care waste is a by-product of health care activities (WHO, 2008). It is also a product generated from hospitals or healthcare related facilities and is considered a major source of environmental contamination because it is made up of potentially harmful substances. According to Sharma et al., (2013), many hospitals in Nigeria may not practice incineration of HCW probably because the incinerator releases different pollutants into the atmosphere resulting in health deterioration and environmental pollution (Sharma et al., 2013). Health care waste management inadequacies are increasingly compounding adverse environment and public health conditions in many developing world cities. In addition, medical waste includes expired, unused, split and contaminated pharmaceutical products, drugs, vaccines, and sera that need to be disposed appropriately.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.

1.2 Background of 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 et al., (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 et al., 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 Ohafia Local Government Area. 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.

Therefore, in Nigeria, where the research was carried out, the activities that was conducted is to know the Factors Influencing Proper Healthcare Waste Management Practices among Healthcare Workers in Health Centers.

1.3 Statement of Problems

Investigation revealed that 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, and 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 Abia 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 Factors Influencing Proper Healthcare Waste Management Practices among Healthcare Workers in Health Centers in Ohafia Local Government of Abia State.

1.4 Aim and Objectives of Study

The aim of the study is to investigate the Factors Influencing Proper Healthcare Waste Management Practices among Healthcare Workers in Health Centers using Ohafia Local Government Area of Abia State as a reference point. In achieving this aim, the following specific objectives were laid out as follows:

To identify different types of waste generated in Healthcare facilities in the area under review;
To determine the level of knowledge of health workers on proper healthcare waste management and its segregation;
To assess the proper healthcare waste management as practiced by health workers in the area under review; and
To determine how healthcare wastes are finally disposed off, by the healthcare facilities in Ohafia Local Government Area.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

What are the types of Healthcare wastes generated at health facilities in area under review?
What is the level of knowledge of health workers on proper healthcare waste management?
What is the practice of proper healthcare waste management by health workers?
What is the final disposal of healthcare waste practiced by healthcare workers in Ohafia Local Government Area?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

H0: There is no significant relationship between knowledge and practice of respondents on Healthcare waste management in Ohafia Local Government Area.
H1: There is significant relationship between knowledge and practice of respondents on Healthcare waste management in Ohafia Local Government Area.

1.7 Significance of Study

The outcome of this research will help keep health care providers abreast with effective waste management practices to reduce the risk of infections and injuries to workers and the general public. This study will also be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The scope of the research is focused on the Factors Influencing Proper Healthcare Waste Management Practices among Healthcare Workers. This research will cover only the Health Centers in Ohafia Local Government Area of Abia State.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this research work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
Lack of Initial Cooperation from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.

1.10 Definition of Terms

Health Care Waste:

It is by-product generated from hospitals or healthcare related facilities and is considered a major source of environmental contamination because it is made up of potentially harmful substances.

Waste Prevention:

It is the method of eliminating waste at source and reducing the demand on natural or origin resources.

…

CHAPTER TWO

2.0 Literature Review

2.1 Introduction

The review of relevant literature is the main topic of this chapter. A literature review covers theoretical and methodological contributions to a certain issue in addition to the state of knowledge at the time of writing. It provides information about the state of the art in relation to the subject you are writing about. It examines the body of work on the chosen subject. The literature evaluation in this study comprises the …

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TABLE OF CONTENTS
PRELIMINARY PAGES

Title page
Approval page
Dedication
Acknowledgement
Table of Contents
Abstract
CHAPTER ONE
INTRODUCTION
1.1 Introduction
1.2 Background …
⋮
CHAPTER TWO
LITERATURE REVIEW
2.1 Introduction
2.2 Conceptual Review
2.3 Theoretical Framework
⋮
2.4 Empirical Studies
CHAPTER THREE
RESEARCH METHODOLOGY
3.1 Introduction
3.2 Research Design
3.3 Population of Study
3.4 Sampling and Sampling Technique
3.5 Validation of Research Instrument
3.6 Method of Data Collection
3.7 Method of Data Analysis
3.8 Questionnaire Administration
3.9 Ethical Consideration
3.10 Statistical Analysis
CHAPTER FOUR
DATA ANALYSIS, RESULT AND DISCUSSION
4.1 Introduction
4.2 Presentation and Analysis of Data
4.3 Re-statement of Research Questions
4.4 Test of Hypotheses
4.5 Discussion of Findings
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
5.1 Introduction
5.2 Summary of Findings
5.3 Conclusion
5.4 Recommendation
5.5 Suggestion for Further Study
REFERENCES
APPENDIX A - “QUESTIONNAIRE”

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