Healthcare waste management in the Tamale Central Hospital, northern Ghana. An assessment before the emergence of the COVID-19 pandemic in Ghana

Healthcare waste (HCW) poses several environmental and public health challenges. However, much attention has not been given to its management. The present study sought to assess the healthcare waste management (HCWM) practices in the Tamale Central Hospital (TCH) by characterizing and measuring the quantities of waste generated and the associated implications. Observation of the value chain of healthcare waste management, waste quantification using a weighing scale (Top-pan-spring balance), and semi-structured interviews were used in the data collection. The study revealed that, except for sharps, there was no segregation of infectious and non-infectious waste, and healthcare waste was not treated before final disposal. The study showed that a daily record of 5.1 kg of sharps, 24.46 kg of infectious waste and 59.45 kg of general waste was generated. The maternity ward produced more general waste (14 kg), whereas the theatre generated the highest infectious waste (5.70 kg) and sharps (0.8 kg) daily. Generally, the maternity ward recorded the highest daily waste generation of 17.9 kg. The waste treatment method available in the hospital was incineration. However, the incinerator was found to be dysfunctional. Thus, an improvised method (dug pit) was used irrespective of the associated health and environmental implications. The study also revealed that the hospital did not quantify the amount of solid waste that was generated. Inadequate finance and lack of supervision were linked to the problem of poor healthcare waste management in the study area. Also, 82% of the workers mentioned that there was poor HCW segregation at the departments whereas 76% of the patients who received healthcare at the facility were unsatisfied with the HCWM practices. A strong linear relationship in the responses made was recorded. The healthcare waste management index showed that the HCWM practice at the facility was unsatisfactory as it was medium-ranked. The study, therefore, recommends that the hospital considers constructing an on-site waste treatment facility, segregate and quantify waste for effective allocation of resources for treating healthcare waste.