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. 2020 Mar 4:2020:2934296.
doi: 10.1155/2020/2934296. eCollection 2020.

Medical Waste-Sorting and Management Practices in Five Hospitals in Ghana

Robert Ohene Adu  1 , Samuel Fosu Gyasi  2 , David Kofi Essumang  3 , Kenneth Bentum Otabil  2
Affiliations

Medical Waste-Sorting and Management Practices in Five Hospitals in Ghana

Robert Ohene Adu et al. J Environ Public Health. .

Abstract

Hospital waste management in Ghana faces the risk of cross-contamination from the lack of thorough sorting of the waste at the points of generation, codisposal of hazardous and nonhazardous waste types, and use of open-fire pits and substandard incinerators for burning infectious waste. This has increased the potential for the spread of infections and chemical pollutants. A cross-sectional study was conducted in five hospitals in Ghana to assess behavioral patterns on waste sorting and the effectiveness of hospital waste management in Ghana. A total of 250 questionnaires were distributed purposively to some staff of the five hospitals to assess workers' perceptions on medical waste sorting and handling. Additionally, focused group discussions and transect walks were adopted to examine the current collection, storage, treatment, and disposal methods used in the health facilities. Chi-square analyses showed significant differences in waste-sorting behavior based only on occupation (p < 0.0001, n=180) and not on gender, education, or experience in the health sector. Even though contaminated sharps were separated into brown safety boxes, color coding for other infectious waste containers was inconsistent across the health facilities. The study revealed that incineration is still the modal method of treatment in Ghanaian hospitals and therefore new approaches such as an engineering approach were required to minimize its environmental effects. It is recommended that periodic in-service training workshops be held for healthcare staff on the right source-segregation of medical waste, in order to facilitate the effective and safe handling, transport, treatment, and disposal of waste from health facilities.

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Conflict of interest statement

The authors declare no conflicts of interest in this study.

Figures

Figure 1
Figure 1
Map of Ghana showing selected hospitals (Google images).
Figure 2
Figure 2
Hierarchy of waste management [27].
Figure 3
Figure 3
“Clinical waste only” container and sharps box at the Brong Regional Hospital.
Figure 4
Figure 4
Waste sorting at various units of KATH. (a) Hematology unit. (b) Resuscitation unit. (c) Radiography unit.
Figure 5
Figure 5
Waste sorting at CCTH. (a) Sorted waste at lab. (b) Sorted waste for central autoclave. (c) Infectious waste.
Figure 6
Figure 6
Waste sorting at KBTH. (a) Immunology Lab. (b) Central Lab Corridor.
Figure 7
Figure 7
B.A Regional Hospital. (a) 240 L containers. (b) 12 m3 container. (c) An open pit for infectious waste.
Figure 8
Figure 8
Komfo Anokye Teaching Hospital. (a, b) Waste storage bins outside wards. (c) Storage bins by incinerator.
Figure 9
Figure 9
General waste bins at Korle Bu Teaching Hospital. (a) Yellow-lined basket outside an office. (b) Black-lined bin at corridor. (c) Black-lined bin outside the Child Care Department. (d) Yellow-lined bin by corridor.
Figure 10
Figure 10
Locally made incinerator at UCC Hospital, Cape Coast. (a) 52-kg LP gas (auxiliary fuel) cylinder. (b) Blower. (c) Chimney.
Figure 11
Figure 11
Imported incinerator at Brong Regional Hospital, Sunyani. (a) Combustion chamber. (b) Chimney without APCD.
Figure 12
Figure 12
Central autoclaves for infectious waste sterilization at the CCTH, Cape Coast, Ghana.
Figure 13
Figure 13
Anatomic waste incinerator at KATH. (a) Combustion chamber. (b) Chimney.
Figure 14
Figure 14
An LPG-powered Addfield MP400 incinerator for infectious waste sterilization at KATH. (a) Chimney. (b) Combustion Chamber. (c) Ash after combustion.
Figure 15
Figure 15
Incinerator for burning infectious waste at KBTH. (a) Combustion chamber. (b) Chimney.
Figure 16
Figure 16
Waste-sorting behavior based on gender.
Figure 17
Figure 17
Waste-sorting behavior by occupation.
Figure 18
Figure 18
Waste-sorting behavior by qualification.
Figure 19
Figure 19
Waste-sorting behavior by working experience.
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