Ethical medical service through healthcare waste management!! how it is feasible in a transition Country?

Health institutions have been producing undesirable waste when providing curative, preventive, rehabilitative and palliative health services irrespective of developed or developing countries. It is ethical if they are able to manage the health care wastes properly in addition to providing suitable health services. Hence this paper aims to assess the existing healthcare waste management practices in a town of Ethiopia so as to provide ethical health service. The study was conducted in 14 systematically selected sample health institutions which comprises of two hospitals (public & private), three health centers (governmental & NGO owned), two higher and seven medium clinics. Multi-stage sampling procedure was followed and sample size was determined by Yamane (1967) formula. Thus 196 paramedical and 78 cleaners were selected as sample. Structured questionnaire, interview schedule, observational checklist and waste measurement were used as tools for data collections. Healthcare waste generation was measured for the seven consecutive days (Monday – Sunday) from all the departments in sample hospitals and all health centers in Kg/Patient/Day. The collected data was coded, entered, edited and analyzed with the help of SPSS (version 21) using both descriptive and inferential statistics. The results showed that the healthcare waste generation rate in the study town hospitals and health centers ranges between 1.27 – 0.05 kg/patient/day. There was statistically significant difference in the healthcare waste generation rate between public and NGO owned health centers. The awareness level of above 50% of paramedical and cleaners is low and nearly two third of them have unsafe practice of healthcare waste management. There is no significant difference between healthcare waste management practice between hospitals, health centers and clinics. Allocating adequate resource, sustainable provision of personal protective equipment, a well coordinated healthcare waste management plan, functional healthcare waste management committee and staff training on safe handling of healthcare waste are the determinant factors on healthcare waste management practice in the selected health institutions. Established healthcare waste management system providing technical support and periodic supervision are the main recommendations for the town health offices. Providing training, appropriate resource budgeting, proper healthcare waste management planning, establishing committee, sustainable supply provision, awareness creation and guiding the healthcare waste management in line with the National Healthcare Waste Management Guideline are some of the recommendation for health institutions.