Knowledge, attitude and practices of health workers on health care waste management in public and private health facilities in Kitgum Municipality, Kitgum District

Abstract

INTRODUCTION AND BACKGROUND Healthcare wastes are of great importance due to its potential environmental hazards and public health risks that account for around 1-2% of urban wastes which is a critical public health issue as they jeopardize human and environmental health. In Uganda, waste generated in hospital averages 92 Kg per day and 42 Kg per day at Health Centre IV level while Health Centre III and Health Centre II levels generate 25 and 20 Kg of waste, respectively per day. Public and private health facilities in Uganda suffer from poor waste segregation, collection, storage, transportation and disposal practices which can lead to occupational and environmental risks. Knowledge and awareness regarding proper waste management remain low in the absence of training for hospital staff. Hospital sanitary workers and scavengers operate without the provision of safety equipment. Unsegregated waste is illegally recycled leading to further safety risks. The proper healthcare waste management practice is thought to be best strategy to halt the spread of the infectious disease. However, there is scanty study of the healthcare waste management practice in Kitgum Municipality. Therefore, this study will assess the knowledge, attitude and practices of health workers on health care waste management and will provide recommendations that will improve on knowledge and best practices of healthcare waste management among health workers to increase safety of employees and patients by reducing the potential risk to sustain sharp injury and exposure to blood-borne pathogens hence reducing hospital-acquired infections in public and private health facilities in Kitgum municipality. OBJECTIVES To determine knowledge, attitude and practices among health workers on health care waste management in public and private health facilities in Kitgum municipality so as to devise possible measures to be taken to improve healthcare waste management in Kitgum Municipality, Kitgum district. METHODOLOGY A cross-sectional facility based study design using both quantitative and qualitative techniques of data collection will be applied in all public and private health facilities in Kitgum municipality. The study participants were 96 selected randomly using systematic probability sampling methods based on the numbers of health workers from the 17 health facility with different cadres of health workers (nurses, midwives, medical officers, laboratory personnel). The tool was adapted from WHO structured and semi-structured closed ended questionnaire for quantitative data on socio-demographic characteristics, knowledge, attitude and practices such as segregation, availability of waste bins, etc. An observation checklist with predetermine responses was also designed together with a key informant interview guide for key informants that was administered to in-charges of different departments like laboratory, maternity, stores, OPD etc. The tool was pretested by few health workers and after administered to study participants that were systematically and randomly selected from the health facility. RESULTS About a third 30/96 (31.2%) and 28/96 (29.2%) of the respondents were nurses and midwives while the mean working experience was 5.8 years and a standard deviation of 7.9. In addition, 74.0% (71/96) and 94/96 (97.9%) of healthcare workers had good attitudes and adequate knowledge towards healthcare waste management respectively. All 96/96 (100.0%) healthcare workers had good healthcare waste management practices with scores greater than 5.5. No healthcare facility reported to be receiving or reporting healthcare associated risks and accidents like needle stick injuries. CONCLUSION With the good practices among health Care workers accompanied by recording many of the health workers having good attitudes and adequate knowledge. There is a need for maintenance and improvement of the current situation in order to reduce the likely impacts of exposure to health care waste and poor health care waste management.