ABSTRACT:
With the expansion of healthcare services, effective management of healthcare waste, both hazardous and non-hazardous, has become a concern to prevent and control pollution to ensure environmental sustainability. Out of the healthcare wastes, clinical waste management is the most important for healthcare managers. Clinical waste management includes segregation, transportation, storage, and treatment of waste, and may face challenges due to inadequate segregation, improper collection, transportation bottlenecks, storage issues, and frequent breakdowns of incinerators. This study aimed to assess the current clinical waste management system in Gampaha District's major curative healthcare institutions. The specific objectives were to assess the current state of clinical waste management, identify problems in the existing system, and propose recommendations for improvement. A descriptive cross-sectional study was conducted in all secondary (n=4) and tertiary care (n=1) hospitals in the district from September to October 2022. Qualitative data were collected on the existing waste management practices, associated problems, and gaps through semi-structured key informant interviews, direct observations, and desk reviews of secondary data. Content analysis method was used to analyze data. The major problem was identified and analyzed to identify the root-causes. Results indicated that all those institutions incinerate clinical waste, and, in most instances, general waste is added to the clinical waste increasing the incinerating waste. Improper collection of large amounts of waste to incinerate, comprising both clinical and general waste was the major problem in the current state of clinical waste management in the district. This is an additional strain on waste management resources. The root-causes for this were inadequate waste segregation caused by knowledge and attitude gaps and inefficiencies in local general-waste collection systems. Solutions for the root-causes were identified as the initiation of discussions with local authorities to streamline general waste disposal processes, development of Standard Operating Procedures for waste management, supervisory plans for waste management processes, and regular waste audits for performance evaluation. These solutions can be implemented by enhancing infrastructure for waste segregation, training the staff handling waste, establishing a district waste management committee, and conducting regular waste audits. In conclusion, there are clinical waste management issues in the Gampaha district due to the collection of large amounts of waste to incinerate. Improving clinical waste management practices in Gampaha District's healthcare institutions through a collaborative approach involving local authorities, healthcare institutions, and the Regional Director of Health Service is essential for sustainable clinical waste management, to safeguard public health and prevent pollution.