TABLE OF CONTENTS
Content                                                                                                        Page
Title Page                                                                                                            i
Certification                                                                                                       ii
Dedication                                                                                                              iii
Acknowledgements                                                                                                 iv
Abstract                                                                                                               vi
Table of Contents                                                                                           vii
 List of Tables                                                                                               xi
 List of Figures                                                                                                     xii
 Abbreviations                                                                                         xiii
CHAPTER ONE: INTRODUCTION
1.1      Background to the Study                                                                        1
1.2 Statement of the Problem 3
1.3.     Objective of the Study                                                                      4       Â
1.4      Research Questions                                                                                      4
1.5      Hypothesis                                                                                                    4
1.6      Scope of the Study                                                                          4        Â
1.7      Justification for the Study                                                                        4
1.8      Operational definition of terms                                                    5
CHAPTER TWO: REVIEW OF LITERATURE
2.0      Introduction                                                                                                7
2.1      Nature of healthcare waste                                                                   7
2.1.1   Sharps waste                                                                                              11
2.1.2   Infectious waste                                                                                    11
2.1.3   Pathological waste                                                                               11
2.1.4   Pharmaceutical waste                                                                        11
2.1.5   Chemical waste                                                                               12
2.1.6   Radioactive waste                                                                                     12
2.2      Healthcare waste management                                                       14
Content                                                                                                    Page
2.3      Healthcare waste generation                                                               15
2.3.1   Healthcare waste generation in developing countries                       17
2.3.2   Healthcare waste generation in developed countries        18
2.4      Healthcare waste management practices                                             19
2.4.1   Segregation                                                                                   19
2.4.2   Handling and collection                                                                     21
2.4.3   Storage                                                                                                  21
2.4.4   Transportation                                                                                       22
2.4.5   Treatment and disposal                                                              23
2.4.6   Training and education                                                                        25
2.5      Health waste management practices in developed countries  26
2.6      Healthcare waste management practices in developing countries           27
2.7      Potential impacts associated with healthcare waste                          34
2.8      Acts and legislation on healthcare waste management                   37
2.9      Theoretical Framework                                                                        40
2.10    Concept adopted for the study                                                      42
2.10.1 Concept of cleanliness                                                                        42
CHAPTER THREE: METHODOLOGY
3.0      Introduction                                                                                            43
3.1      Research Design                                                   43                             3.2           Population                                                                                    43
3.3      Sample size and sampling Technique                                 45
3.4      Research Instruments                                                                  47
3.5.1   Questionnaire                                                                      48
3.5.2   Field Observation                                                              48
3.5.3   Validity and Reliability of Instrument                                      48
3.6      Method of Data Collection                                                            48
3.6.1   Method of Data Analysis                                                  49
3.7.1   Inclusion criteria                                                                               49
Content                                                                                                         Page
3.7.2   Exclusion criteria                                                                                     49
3.8      Ethical Consideration                                                                49
3.8.1   Permission for the study                                                                       49
3.8.2   Post research benefits                                                                              49
CHAPTER FOUR: DATA ANALYSIS, RESULTS AND
DISCUSSION OF FINDINGS
4.1      Results                                                                                                     50
4.2      Discussion                                                                                     60
CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATIONS
5.1      Summary                                                                                                  63
5.2      Conclusion                                                                                        64
5.3      Recommendations                                                                                    65
5.4 Limitation of the Study 65
5.5 Suggestion for further Studies 66
REFERENCES 67
APPENDICES 75
LIST OF TABLES
Table Page
2.1      Categories of healthcare waste                                                  10      Â
3.1      Numbers of healthcare facilities in the study area                     44
3.2Â Â Â Â Â Â Sample size of each healthcare facility in ASLGÂ Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â 47
4.1: Demographic Characteristics                                                             51
4.2: Types of Healthcare waste generated in each healthcare facility 52
4.3:Knowledge of respondents regarding Healthcare waste management and its Segregation                                                                    53
4.4: Practice of healthcare waste management by health workers 54
4.5: Practices of healthcare facility on final disposal of waste 55
4.6 Relationship between the knowledge and practices of the respondents 58
4.7 Observation made by Researcher on Healthcare Waste Management in
Abeokuta
SouthLocal Government. 59
LIST OF FIGURES
Figure                                                                                                    Page
2.1Healthcare waste compositions                                                          8
2.2     Categories of waste from healthcare facilities                          13
2.3      Differentiation of Waste Management                                          16
2.4     Healthcare wastes with municipal waste in open dump           30
2.5 Burning of Healthcare waste with municipal waste in dumping site at Abeokuta 34
2.7 Conceptual Model 42
4.1 Level of practice of Healthcare Waste Management 56
4.2 Knowledge of respondents on Healthcare Waste Management 57
4.3Dustbin and Improvised sharp boxes for Segregation on site (Survey Data 2017) 78
4.4Open vehicle for transportation of healthcare waste (HCW)(Survey Data 2017) 79
4.5Scavengers with waste at dump site (Survey Data 2017) 80
4.6Healthcare waste (HCW) at dump site with municipal waste(Survey Data 2017) 81
ABBREVIATIONS
AIDS Acquired immune-deficiency syndrome
ASLG Abeokuta south local government
FDA Food and Drug Administration
HBV Hepatitis B Virus
HCW Healthcare waste
HCWM Healthcare waste management
HCV Hepatitis C virus
HIV Human immune deficiency virus
ICO Infection control officer
LG Local government
U.S.A United State America
WHO World Health Organization
CHAPTER ONE
INTRODUCTION
1.0 Background to the Study
Healthcare waste threatens the public health due to its contagious nature. Most healthcare facilities are located in the heart of the cities and therefore, healthcare waste that are not correctly managed can cause dangerous infection and pose potential threat to the nearby environment, health workers, patients and to the public (WHO, 2014). Dehghani, Azam, Changani and Fard (2008) noted that Healthcare Waste (HCW) if not appropriately managed can be a serious threat to human health due to their infectious attributes. Nigeria, one of developing countries, has health issues that are competing for limited resources; it is not amazing that healthcare waste management receives less attention and precedence than it merits (Stephen, & Elijah, 2011). Therefore, there is a serious challenge in developing countries, where there are no Institutional provisionsfor healthcare waste management. Clinical wastes are disposed openly in the dumpsite along with municipal waste and the practice make the members of the community gain access to it which may lead to outbreak of infectious diseases (Alagoz, Kocasay, Abah, & Ohimain, 2010) . Cheng, Sung, Yang, Lo, Chung and Li (2009) noted that as small as healthcare waste is in proportion to the total community waste, its management is considered an important issue worldwide. World Health Organization (2014) reported that 15% of total waste generated in the healthcare facility is hazardous and must be properly segregated at the point of generation to prevent the whole healthcare waste becoming 100% hazardous. The World Health Organization estimates that each year there are about 8 to 16 million new cases of Hepatitis B virus (HBV), 2.3 to 4.7 million cases of Hepatitis C virus (HCV) and 80,000 to 160,000 cases of human immune deficiency virus (HIV) due to unsafe injections disposal and mostly due to very poor waste management systems.
Across the globe, the risk associated with Healthcare Waste (HCW) and its management has gained tremendous attention from health practitioners and non practitioners. If healthcare facilities know the types and quantities of clinical waste generated, it will help them in planning, budgeting adequate revenue for the management of hazardous waste (Bongayi, 2013). A study conducted by Olubukola (2009) in two General hospitals at Lagos reported that due to lack of quantification of healthcare waste, there was no waste reduction plan in the hospitals.
This lack of plan for healthcare waste management eventually leads to inadequate waste segregation at point of use, collection, storage and final disposal. This poor healthcare waste management practice creates health hazards for health workers, patients and the environment. Identified gaps like lack of colour code bags for segregation of healthcare waste at point of use, lack of guidelines on segregation and disposal for health workers lead to poor healthcare waste management in hospitals. The mismanagement of healthcare waste by healthcare facilities does not pose health hazard to health workers and patients alone but also to patients’ visitors and the community where they are improperly disposed by contaminating the soil, air and water. Healthcare facilities are supposed to protect the health of people in their environment, not to be a creator of potential health hazard for them.
Furthermore, increase in patient turned-out has increase the generation of healthcare waste. Mboguwe, Mimereki and Magashula(2008) also reported that increase in population results to increase in healthcare facilities that lead to increased healthcare waste generation. It is expected that because of this increase, more attention should be paid to and priority given to proper healthcare waste management in Abeokuta South Local Government (ASLG). Management of healthcare waste continues to present an array of challenges especially as economic situation of the country deepen daily therefore, healthcare waste management has become a concern.
So many studies have been conducted on healthcare waste management but little or no work has been done concerning segregation of clinical waste which is a vital aspect in healthcare waste management (Coker, Sangodoyin, Sridhar, Booth, Olomolaiye, 2009). Segregation of waste is crucial in healthcare waste management because it is the first step in clinical waste management. Segregation of healthcare waste helps in reduction of the quantity of waste that is hazardous. Once healthcare waste are segregated, collection will be easy, proper storage will be done and disposal of infectious waste carried out in the way that it will not pose any harm to health workers, patients and the environment (WHO, 2014). Proper management of healthcare waste depends on good organization, sufficient funding and active participation of trained personnel. It was observed that healthcare facilities were not spending resources on clinical waste management Healthcare facility must allocate resources for colour coded bags and training of generator of healthcare waste for proper segregation and disposal for its sustainability. The intention of this study is to assess healthcare waste management practices at health facilities in Abeokuta South Local Government.
1.2 Statement of the Problem
