WASTES MANAGEMENT PRACTICES IN SELECTED PUBLIC AND PRIVATE HOSPITALS OF PESHAWAR, KHYBER PAKHTUNKHWA

Abstract

Introduction: Standard hospital wastes management practices are the main preventive measures for infection control, yet no study has been conducted to evaluate the wastes management at tertiary care hospitals in Peshawar, Khyber Pakhtunkhwa.

Materials & Methods: A cross-sectional facility survey was conducted from January to April 2015 on four tertiary care hospitals - Rehman Medical Institute (RMI) & North West General Hospital (NWGH), private sector; Lady Reading Hospital (LRH) & Hayatabad Medical Complex (HMC), public sector - of Peshawar. After taking permission from Medical Superintendents of hospitals, checklist-based observational assessment of the Housekeeping departments and relevant areas (Wards, Sanitation, Wastes Collection, Segregation, Disposal and Incineration) was done on multiple visits by the research team using modified World Health Organization (WHO) checklist and interviews, where required. Binary inputs (yes/No) were recorded for Noninfectious, Infectious, Pathological and Pharmacological wastes. Manual analysis was done for compilation and decision making; outputs were categorized into Segregation, Collection, Storage, and Handling.

Results: All hospitals fared poorly for Pharmacological wastes management with no segregation practices; hospitals were also poor in segregation for different types of wastes. For wastes collection, only NWGH performed adequately. The private hospitals did better than the public ones for wastes storage and handling. Overall the private sector hospitals followed the regulations of EPA and WHO compared to public sector hospitals.

Conclusions: Substandard practices were observed in public sector hospitals. The overall attitude of the staff towards wastes handling was different in both sectors due to different administrative monitoring.

Keywords: Wastes Management; Wastes Disposal Facilities; Sanitation; Healthcare Systems; Public Health.