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Volume 8 Journal of Community Medicine & Health Education Public Health Congress 2018
July 23-24, 2018
July 23-24, 2018 Melbourne, Australia
5th World Congress on
Public Health, Nutrition & Epidemiology
Multidimensional intervention for improving health care waste management in Nepal
Deepak Timsina and Thapa T
Worldwide Intellectual Property Solutions, Nepal
Statement of the Problem: The Nepal health sector strategy (2015-2020) has outlined quality of care through improved
infection prevention and Healthcare Waste Management (HCWM) practices. The health facility survey (2015) depicts 92% of
district hospitals segregate health care waste, but only 77% adhered to the ministry of health HCWM guidelines. This study
was conducted between mid-2016 and December 2017 to investigate the gaps and feasibility of a quality improvement process
through HCWM at Trishuli District Hospital.
Methodology & Theoretical Orientation: The study included a mixed-method baseline assessment to evaluate the quantity
of waste (hazardous/non-hazardous) generated, equipment/infrastructure, readiness of the hospital and existing HCWM
practices. Based on the findings, awareness raising and capacity building, interventions were instrumented for 15 months, along
with a HCWM plan with specific interventions on infrastructure, capacity building and localized actions. Final assessment was
held in December 2017.
Findings: Trishuli Hospital generated 36.05 kg of health care waste daily gets composed of hazardous infectious waste 65%,
hazardous sharps 16%, pathological waste 15% and other 4%. Challenges include lack of HCWM plan, lack of technical skills,
aggravated by poor hospital infrastructure. Like NHFS findings, the non-segregated wastes were burnt in an open pit near
the hospital. Health care risk waste reduced from 33% to 20% of the total waste. While wards practiced proper segregation
into color-coded bins, the hospital constructed a treatment plant and institutionalized HCWM through mentoring/coaching
and regular monitoring. Hospital had adherence to HCWM standards and increased staff readiness followed by municipal
sponsorship on exposure visit to health workers to good practices in two other hospitals and commitment to remove treated
HCW from the hospital.
Conclusion & Significance: Multidimensional intervention covering infrastructure, awareness and capacity development
improves HCWM practices to reduce hazardous waste to 20% and adherence to national standards in Nepal.
J Community Med Health Educ 2018, Volume 8
DOI: 10.4172/2161-0711-C3-039