PhD Theses

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Browsing PhD Theses by Author "Kagonji, Ignatio Simon"

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    Assessment of medical waste management system in Tanzania district hospitals he case of Amana, Temeke and Lingula Hospitals
    (University of Dar es Salaam, 2011) Kagonji, Ignatio Simon
    The main objective of this study was to Asses the Medical Waste Management System in Tanzanian District Hospitals’’. The perceptions of health workers on medical waste management (MWM) indicated that the waste generation rate ranges from 100 to 1,000 kg/day with different rating between administrators and implementers, which did not match with the actual measured medical waste within the same hospitals studied, making medical waste management difficult. The study showed that about 60% and 80% of health workers segregate their waste. Plastic bins are more utilized at Amana (80%) while metal bins were more in use at Ligula hospital (65%). Container coding and labeling was least implemented (less than 10%) of waste generation points. About 90% of medical waste was transported within the premises manually. The main onsite waste treatment method was medium degree Celsius temperature incinerators (Amana 46% and Ligula 35% of the waste), while the main offsite treatment method used was crude dumping (Amana 74% and Ligula 12% of the waste). The major problems hindering medical waste management were lack of standard MWM procedures (16%); low knowledge and skills on MWM among HWs (16%); and, inappropriate medical waste treatment/disposal technologies in the hospitals (14%). The study revealed that about 60% of health workers (HWs) hale low knowledge on MWM, and lack of administrative documents on MWM was also observed (below 40%). The quantification of medical waste generation observed generation rates of about 2.250 kg/day in Amana and 2,500 kg/day in Ligula hospital, which are very high flom HWs perceptions. The waste generation rate per patient per day was also,high about 1.8 and 2.0 kg/patient.day for Amana and Ligula, respectively: About 6 - 10% of waste generated is left uncollected. The results indicated general waste to have high generation rate compared to other waste types. The results showed chemical, pathological and pharmaceutical waste to have high frequency variations while other categories are evenly generated with little variations. The assessment of treatment/disposal technology and its impact on environment analyzed the incineration process performance at Temeke hospital. Study was conducted for 22 months (N =653 days). The analysis showed that, average sharps waste incinerated were 25% and other wastes were 75%. The average diesel oil used was 30 L/day, and average cycle time was observed to be 3 hrs both being excessively high WHO standards. The financial implication study showed that, a high amount of money about 1300 USD was used per month for fuel only, interfering with hospital plan and budgets. The hospital was advised to install a new incinerator with short incineration cycle time(30 to 45 minutes).and,less fuel consumption (7 to 10 L). The new incinerator was then assessed based on ash characteristics. It was observedthat the pH of ash was more alkaline ranging from 11.0 to 13.0 at 100 g ash/L instead of normal standard 6 to 8. On the other hand, the conductivity of the ash increased with increasing ash concentration ranging from 5.0 to 11 µS/cm alt 100 g ash/L. The investigated tl leachate toxicity of 0.1, 0.1, 0.2, and 0.3 mg/L, respectively, which were observed to be below U.S. EPA limits which are the international standards. It was concluded that, proper medical waste management requires trained/skilled health workers, good appropriate technologies, enough and special designed facilities for collection, storage and transportation and realistic plan and budgets which observe variations in medical waste generation.