Medical waste management at the primary healthcare centres in a north western Nigerian State: Findings from a low-resource setting

OBJECTIVES: This study aims to examine medical waste management (MWM) practices and identify the challenges of optimal MWM at the primary healthcare (PHC) level in Kebbi State, Nigeria. STUDY DESIGN: This study was a cross-sectional survey of 265 primary healthcare workers (PHCWs) and health facilities (HFs) in Kebbi State. METHODS: The study tool used was a questionnaire adapted from the WHO rapid assessment tool on MWM and water sanitation. Descriptive and inferential statistical analyses were conducted using SPSS version 20 software. RESULTS: Data generated from 257 HWs were used in this study. Amidst other findings, only 65 (25%) HFs had MWM guideline or policy document; out of these 65HFs, only 19 (7%) of them had problem with its implementation. Only 42 (16%) HFs had a compensation package or a health insurance policy to take care of their health workers in case of MWM-associated hazards while 22 (9%) HFs had specific budgetary allocation for MWM. Only 105 (41%) HFs had trained staffers on MWM. Sharps, blood/body fluids and domestic wastes were the top three (3) wastes generated among the surveyed HFs. Medical waste treatment was on-site in 124 (48%) HFs and burn-and-bury method was the adopted method of medical waste disposal in 198 (77%) HFs. However, the majority (76%) of the surveyed HWs expressed dissatisfaction about the waste treatment practices adopted in their HFs. CONCLUSION: Our study revealed a poor level of MWM practices in Kebbi State, Nigeria. The state government and partners need to urgently address the identified operational and policy gaps in MWM in Kebbi State, Nigeria. Furthermore, our study revealed the negative implication of fragmented governance and leadership structure at the PHC level on policy, practice and administration of medical waste management in the Kebbi State, Northwestern Nigeria. Addressing the gaps found in this study would contribute to the attainment of the United Nations Sustainable Development Goals in health and well-being, sustainable cities and communities and contribute to poverty eradication.