Healthcare waste management practices and safety indicators in Nigeria

BACKGROUND Adequate management of healthcare waste (HCW) is a prerequisite for efficient delivery of healthcare services. In Nigeria, there are several constraints militating against proper management of HCW. This is raising some environmental concerns among stakeholders in the health sector. In this study, we analyzed the practices of HCW management and determinants of risky/safe indices of HCW disposal. METHODS The study used the 2013/2014 Service Delivery Indicator (SDI) data that were collected from 2480 healthcare facilities in Nigeria. Descriptive statistics, Principal Component Analysis (PCA) and Ordinary Least Square (OLS) regression were used to analyze the data. RESULTS The results showed that 52.20% and 38.21% of the sampled healthcare facilities from Cross River and Bauchi states possessed guidelines for HCW management, respectively. Trainings on management of HCW were attended by 67.18% and 53.19% of the healthcare facilities from Cross River and Imo states, respectively. Also, 32.32% and 29.50% of healthcare facilities from rural and urban areas previously sent some of their staff members for trainings on HCW management, respectively. Sharp and non-sharp HCW were burnt in protected pits in 45.40% and 45.36% of all the sampled healthcare facilities, respectively. Incinerators were reported to be functional in only 2.06% of the total healthcare facilities. In Bauchi and Kebbi states, 23.58% and 21.05% of the healthcare facilities respectively burnt sharp HCW without any protection. Using PCA, computed risky indices for disposal of sharp HCW were highest in Bayelsa state (0.3070) and Kebbi state (0.2172), while indices of risky disposal of non-sharp HCW were highest in Bayelsa state (0.2868) and Osun state (0.2652). The OLS results showed that at 5% level of significance, possession of medical waste disposal guidelines, staff trainings on HCW management, traveling hours from the facilities to local headquarters and being located in rural areas significantly influenced indices of risky/safe medical waste disposal (p < 0.05). CONCLUSION The study concluded that there was low compliance with standard HCW management. It was recommended that possession of HCW management guidelines, staff training on HCW disposal and provision of requisite equipment for proper treatment of HCW would promote environmental safety in HCW disposal.