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Stakeholders’ Practices and Perspectives on Solid Medical Waste Management: A Community Based Study in Accra, Ghana
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作者 Emilia A. Udofia Julius Fobil Gabriel Gulis 《Journal of Environmental Protection》 2018年第13期1295-1313,共19页
Solid medical waste (SMW) is hazardous and requires specific treatment prior to final disposal. Limited information addresses the management of SMW in non-traditional settings such as in households, traditional birth ... Solid medical waste (SMW) is hazardous and requires specific treatment prior to final disposal. Limited information addresses the management of SMW in non-traditional settings such as in households, traditional birth attendants’ (TBAs) homes and chemical seller (CS) shops. A descriptive, exploratory study was conducted to identify major disposal practices and perceived hazards associated with SMW and explore their views regarding segregation as a potential management option. Twenty-nine household members, 10 TBAs and 8 CS who volunteered to participate in the study were involved in 6 focus group discussions (FGDs). Additionally, five key informants in private sector waste management companies were interviewed. FGDs were audio recorded, transcribed and translated, manually coded into themes and sub-themes using an iterative approach, and integrated with data from the interviews. In households, medicines were discarded by dosage forms with solid forms discarded in the household bin, while syrups were mostly emptied into drains. TBAs buried material used for delivery in clients’ compounds and CS tended to burn expired medicines or discard them with general waste. Participants perceived the following as hazards associated with SMW: infection transmission, penetrative injury, poisoning and aesthetic nuisance. Despite this awareness, they reported barriers to source segregation as a potential management option. Barriers included implied consumer costs, lack of supportive logistics and operational knowledge, and possible injury. Reported methods of disposing SMW supported earlier studies and could be potentially hazardous if not addressed. Provision of storage facilities, supportive logistics and public sensitization might encourage source segregation as a potential management option for SMW in the community. 展开更多
关键词 Medical WASTE COMMUNITY SEGREGATION Qualitative Ghana
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Making a Case for Diversion of Solid Medical Waste from Households: A Generation Study in Ga South Municipal Assembly, Accra, Ghana
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作者 Emilia A. Udofia Gabriel Gulis Julius N. Fobil 《Journal of Environmental Protection》 2018年第1期50-66,共17页
Background: Solid medical waste (SMW) is generated from the healthcare industry but can also be found in households when activity involving patient care occurs. Its hazardous properties require special treatment to mi... Background: Solid medical waste (SMW) is generated from the healthcare industry but can also be found in households when activity involving patient care occurs. Its hazardous properties require special treatment to minimize hazards to the environment. To achieve this, SMW must be safely diverted from house-holds using a systemic approach, which should be informed by the quantities generated and factors associated with generation. Objective: To characterize household SMW in terms of quantity and composition and to describe the factors associated with its generation. Methods: Manual sorting of household waste was conducted in 60 households to measure quantities of SMW and its components in Ga South Municipal Assembly, Accra, Ghana. Sample collection took place in the wet season (October, 2014) and dry season (December, 2014/January 2015). Rates of generation and percentage composition computed. Factors influencing generation were evaluated with non-parametric tests and quantile regression analysis. Statistical significance was set at p -3 kg/person/day. Pharmaceutical waste and sharps waste comprised 98% and 2% of SMW respectively. Generation rates were significantly higher in the wet season than in the dry season (z = 3.129, p = 0.002). Households where medical complaints were reported generated significantly less SMW at the 5th, 10th, 25th and 50th quantiles (β = -2.711, p = 0.001;β = -2.949;p < 0.001;β = -3.429, p < 0.001;β = -4.600, p < 0.001 respectively). Conclusion: SMW was generated in relatively small quantities in households. However, the large proportion of pharmaceuticals with mostly antibiotics raises concerns about drug resistance among other potential hazards. 展开更多
关键词 Medical WASTE Ghana PHARMACEUTICAL WASTE Community
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