Improved Waste Management Facilities and Protocols

Photo by Steve Sara / MCSP

Appropriate Resources:

In their 2017 progress update report, the Joint Monitoring Programme released the first international standard monitoring service ladders for WASH services in HCFs. Waste Management service levels are defined as:

  • Basic: Waste is safely segregated into at least three bins in the consultation area, and sharps and infectious waste are safely treated and disposed of.
  • Limited: Waste is segregated but not disposed of safely, or bins are in place but not used effectively.
  • No service: Waste is not segregated or safely treated and disposed of.

Note: National policies and standards should also be consulted when designing, monitoring or evaluating healthcare waste standards.

Appropriate Staff, Process and Management Considerations:

Maintaining conveniently placed and separate waste receptacles is an essential part of HCF infection control and prevention. Waste management receptacles should be clearly marked to store various types of health care waste.

HCF management should establish routine and frequent waste collection and disposal schedules and procedures. Waste management roles and responsibilities should be clearly established among HCF staff. Patients and visitors should be instructed to comply with waste management protocols, and the rules should be enforced by HCF staff. In facilities without municipal or private waste collection and disposal services, HCF waste should be disposed of in a designated and enclosed location. The location should not be easily accessible to children or animals and should be clearly marked as hazardous.

MCSP Rapid Assessment Questions:

To improve waste management, each HCF can consider the following questions from MCSP’s health care facility rapid assessment tool. The tool was adapted from WHO’s Essential Environmental Standards in Health Care.

Waste Management: Waste is segregated, collected, transported, treated and disposed of safely.

Design and construction Operation and maintenance
  • Are there facilities (e.g., appropriately marked waste containers/bins) in place for segregating health-care waste from “non-health care waste” at the point of generation?
  • Are the segregated facilities used effectively?
  • Are there appropriate treatment and disposal facilities in place for the quantity and nature of health-care and non-health-care waste produced, e.g., incinerator or enclosed waste pit (i.e., an enclosed area with nothing outside the perimeter)?
  • Is the waste-disposal zone operated so as to prevent contamination?
  • Is there a dedicated staff person responsible for waste management?
  • Is there a staff person with waste management in their job description?
  • Is there a plan for operation and maintenance of the treatment/disposal HCF?
  • Are disposal facilities that people use embedded in the HCF’s operational plan?

Additional Tools and Resources for Improved Waste Management Facilities and Protocols in HCF settings:

  • In 2014, WHO published the second edition of the Safe Management of Wastes from Health-care Activities handbook. This resources provides in depth guidance on how to manage various types of health-care waste.
  • In 2017, WHO & UNICEF published the WASHFit Tool, which includes essential indicator and advanced indicator assessment tools for waste management (Tool 2), risk assessment templates (Tool 3), and improvement plan templates (Tool 4).