Medical waste management in Shinyanga municipality health facilities: a case of Shinyanga regional referral hospital, Kolandoto designated district hospital (DDH) and Kambarage urban health centre

Medical waste poses serious threats to environmental health and requires specific treatment and management prior to its final disposal. The problem is growing with an ever-increasing number of health facilities in Tanzania particularly in Shinyanga municipality. However, research on this critical issue has been very limited, and there is no research done in Shinyanga regarding medical wastes. This was a cross section study involving the use of questionnaires, in-depth interview and participant observed strategy. It also involved the collection, sorting (segregation), identification and characterization and weighing of waste types from wards and units in the selected hospitals. A total of 3 major health facilities were involved in the study. This study examined the medical waste management practices at Shinyanga Regional Referral Hospital, Kolandoto Designated District Hospital (DDH) and Kambarage Urban Health Centre. The results of this study revealed that all the three hospitals do not quantify or segregate medical waste. Furthermore, 107 (52%) of health employees including those in the top administrative levels were not aware of the existence of policies, laws and regulations regarding MSWM. The total quantities of MSW generated by the three hospitals were 569, 119 and 85 kg/day for Shinyanga RRH, Kolandoto DDH and Kambarage UHC respectively where the average daily medical waste generation per patient was 1.6 kg/day at SRRH and 1.3 kg/day at KDDH. Medical wastes at Shinyanga regional referral hospital are disposed of by on-site incineration and off-site techniques; at Kolandoto DDH only on-site burning and land disposal is practiced. At Kambarage UHC, incineration was the main treatment method followed by land disposal and burning. Waste management workers neither have formal training on waste management nor provided with PPEs and the hospital administrations pay very little attention to appropriate management of medical waste. In light of this, it is evident that MSWM is not practiced according to the WHO's recommended standards. Therefore, we must educate waste generators of their responsibility to properly manage the waste so that their staff, patients, environment and community is protected.