Healthcare waste streams are persistent waste streams and which are consistently increasing in volume and complexity in developed and developing countries. When poorly managed, through inappropriate health care waste management systems, they can cause adverse effects to human health and the environment. This paper presents an evaluation of health care waste management systems in Cameroon, based on a survey of five health care facilities in the Southwestern Region of Cameroon. It is established that health care waste collection and handling systems including containers and bins for segregated wastes are generally in a poor state. A proportion of the waste stream is disposed of in open dumps in combination with municipal solid wastes while some are disposed of in incinerators which are often poorly designed. The waste stream is complex and heterogeneous with an average waste generation rate estimated at 44.9 kg/day equivalent to over 16 tonnes/annum comprising 49%, 16% and 14% of general, infectious and sharps respectively for a typical Health Care Facility in Buea which is a medium densely populated town. There is the potential to recover materials from this waste stream, if adequate waste management systems are developed and implemented. Separately recovering the uncontaminated general waste stream for a secondary market ultimately contributes to resource efficiencies and conservation of scarce natural resources. Reducing the waste quantities being incinerated results in less potential for persistent organic pollutants (POPs) and greenhouse gases to be released into the environment, thus contributing to global environmental benefits through climate change mitigation and pollution reduction. The study establishes that the little attention given to medical waste management results from a lack of an integrated approach to policy making at the highest level of decision-making. There is the need for legislation to allow for a more defined roles and responsibilities for health care personnel responsible for the handling and disposal of the waste streams at the point of generation in the health care facilities. Overall, there is the need to formulate more sustainable health care waste management legislation.

Health care waste management in Cameroon: A case study from the Southwestern Region

Healthcare waste management practices and risk perceptions: findings from hospitals in the Algarve region, Portugal.

A qualitative study of the causes of improper segregation of infectious waste at Nemazee Hospital, Shiraz, Iran.

Healthcare waste management has become a major issue of concern for solid waste managers due the treatment of healthcare waste being generated and the potential environmental risks and public health risks to those who come in contact with it Special attention must be paid when dealing with healthcare waste because of infectious and non-infectious waste as well as general waste it contains If managed through inappropriate healthcare waste management systems, it can adversely affect the environment and public health In Botswana, the Waste Management Act was introduced in 1998 not only for healthcare waste handling, but also to promote sustainable treatment and disposal; the document currently applies to the management of all the healthcare waste, including liquid and chemical waste The paper presents an overview of the current healthcare waste management in Botswana A mixed methods study incorporating an exploratory survey was used A range of data gathering techniques including observations, informal dialogues, published and grey literature and semi-structured interviews of selected participants and operatives dealing with waste were used to identify key policies, composition, storage, treatment, disposal, challenges and best practices Specifically, sorting and storage, collection, treatment and disposal systems and the recent regulation of healthcare waste were discussed Current storage facilities and collection services in the healthcare facilities (HCFs) were not operating effectively and efficiently The composition was almost the same in the HCFs, with mean values in the following decreasing order: general waste (4884) >medical waste (3939 %) >sharps (1313 %) Therefore, more attention should be paid on segregation of infectious and non-infectious from general waste, pollution prevention and recovery of valuable materials from HCFs Several suggestions were made to deal with healthcare waste management problems efficiently and to prevent the potential impacts These included development of a legislation to allow for a more defined roles and responsibilities for healthcare personnel responsible for the handling and disposal of the waste streams at the point of generation in the HCFs Therefore, there is an urgent need to formulate a more sustainable healthcare waste management system

Healthcare waste management in Botswana: storage, collection, treatment and disposal system

Increased awareness about inadequate management of solid medical waste (SMW) has led to increased independent surveys in African countries and yet published data remain scanty on the subject in Africa as compared to the rest of the world. To evaluate the overall compliance with World Health Organization (WHO)’s ten recommendations on SMW practices in Africa through a literature review, we conducted literature search using search terms as “medical waste OR clinical waste OR biomedical waste OR hospital waste OR healthcare waste OR hazardous waste AND Africa” in PubMed, African Journals Online, Web of Science, Proquest, Embase, Google scholar and Scopus. Additional articles were included from open google search. Articles were selected for inclusion if they described SMW management activities such as waste segregation, collection, transport (on-site and/or off-site), temporary storage, treatment and final disposal; were located in an African country and were written in English; or if written in a different language, had an English abstract with the relevant information. Evaluations were based on fifty eight (58) full text articles which were pooled together. The fifty eight (58) full text articles represented research undertaken in 20 countries. Overall, six countries (30%) broadly met half of the WHO’s 10 recommendations. Based on the reviewed articles, the greatest compliance was shown with “daily collection of waste from the service areas” (100%). Areas of least compliance were “appropriate use of color codes” (18%) for labeling waste bins, “off-site conveyance” (16%) and “periodic training” (18%). In spite of growing awareness, SMW management in most African countries was sub-standard. Appropriate use of color codes, periodic training and off-site conveyance need to be addressed in terms of reporting and practice. Common challenges and unremarkable progress in SMW management in Africa raise a question about whether a unified approach should replace independent country efforts.

	 

	Key words: Africa, hospital waste, solid medical wastes, waste management.

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Solid medical waste management in Africa

Standards of clinical waste management in hospitals- : A second look

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Standards of clinical waste management in hospitals- : A second look