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Introduction of Medical Waste Management
at Public & Private Hospital

Uploaded : February' 2013    .

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The management of waste poses to be a major health problem in Bangladesh like developing countries, specially the hospital waste. It also invites serious health problem. Healthcare wastes pose a serious public health problem. The main purpose of any health care institution is to provide health care services to prevent the diseases and also to cure people who are suffering from various kinds of illness. When visiting health care facilities, patient should not become more ill then they already are. Hence it is very important to ensure patient safety by keeping the health centre clean and environmentally sound. On the other hand the service providers safety during providing health care also to look at meticulously. 

The scenario of medical waste management in different type and category of hospitals are not satisfactory and polluting the environment with toxic substances also contributing public health problem. The country has public specialized hospitals, Medical college hospitals, district hospitals and Upa-zilla health complexes. Moreover a good number of private hospitals and clinics are also providing health care.

The medical waste are simply mixed with the municipal waste in the collecting bins at road side and some percentage are buried without any measure or burn out under open sky. Improper disposal of healthcare wastes aesthetically damages to the environment. Public awareness of healthcare wastes has grown in recent years, especially with the emergence of acquired immunodeficiency syndrome (AIDS)). In addition, the possibility that healthcare wastes could transmit human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other agents associated with blood-borne diseases is also a major concern.

Therefore, the disposal of healthcare wastes and their potential health impact are an important public health issue. The MOH&FW already started to address the medical waste management as one of the priority program by including it as one of the critical area among the identified six critical areas under Health, Nutrition and population sector program (HNPSP). MWM program also considered as one of the Performance indicator of HNPSP activity under MOH&FW.

In Bangladesh medical waste management program is now implemented in Primary, secondary & Tertiary level hospitals under Health, Nutrition and population sector program (HNPSP).

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Introduction of Medical Waste Management
at Public & Private Hospital

ACTION PLAN

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Introduction of Medical Waste Management
at Public & Private Hospital

Status Report

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 Status Report

A . Inter-ministerial level Decision (MOH&FW and MoLG)

a.      In house medical waste management is the responsibility of MOH&FW.

b.      Out-house medical waste management (Collection, transportation and final disposal of medical waste) are the responsibility of MoLG&RD (by City Corporation / Powroshova).

c.      Approval of Committee & TOR  for out house Medical waste management ( final collection, transportation and disposal of medical waste)

·        National level

·        City corporation level

·        District level

·        Upa-zilla level

d.      In house medical waste management, segregated and temporary storage of medical waste will be done under uniform color code approved by MOH&FW

e.      MoLG&RD will do Out-house medical waste management (Collection, transportation and final disposal of medical waste) or can contract out through NGOs.

f.        Ministry of Local Government will issue necessary directives at City Corporation, District and Upa-zilla level.

g.      Centralized out-house MWM technology, so that all the public & private health care facilities could be brought under the same umbrella (treatment technology).

B.    At the Ministry (MOH&FW) level

a)     Formation of the National Implementation coordination committee (NICC) for MWM.

b)     Formation of the MWM Implementation & Coordination committee at different administrative level for Out-house management of MW.

c)      Government hospital will pay service charge to the City corporation /Powroshova for MWM.

d)     MOH&FW will donate 2 (Two) Vehicle (Truck) to DCC for MWM activity.

e)     Regulatory affairs: “Medical waste management and Handling rules” has been issued/published.

f)        In the District/Divisional government Level health care facilities, Out-house MWM will be conducted by City Corporation or could be contracted out to NGOs.

g)     In the Upa-Zilla government health care facilities, Out-house MWM will be conducted by the hospital authority within the hospital premises by PIT method till Powroshova get enough capacity for MWM or could be contracted out to NGOs.

C.    At the Directorate level (DGHS, Mohakhali)

a.    All +-

b.    Government hospital and Private & clinics in Dhaka city bought under MWM program.

c.     One Pickup/Truck already handover to Dhaka City Corporation for strengthening their capacity in MWM related activity.

d.    Handover one Incinerator from Shohid Sohorawardi Hospital complex to Dhaka City Corporation for strengthening MWM program of DCC.

e.    Training manual for In-house medical waste management already approved by the TEC committee and waiting for printing.

f.  There is provision for “Service charge” in the OP. Government health facilities will pay service charge to City Corporation for out-house waste management.

g.       Procurement of Vehicle (2-Pickup covered van) for donation to Dhaka City Corporation is in process.

h.     Supply of Waste management related logistics at all government hospitals in Dhaka city and many District level hospitals.

i.  Coordination meeting among stakeholders and “Out-house MWM committee” members for activation & strengthening Out-house MWM in respective Divisional/District areas.

j.    Health care service providers of all government hospital in Dhaka City already trained on MWM program.

k.      Health care service providers of all government Medical college hospital & 21-District Hospital already trained and logistic supplied on MWM program.

l.  For out-house MWM in Upa-zilla health complex, Pit constructed in 209 Upa-Zilla, service providers of 310 Upa-zilla health complex and Logistics in 133 Upa-zilla health complex is completed.

D.     Further task need to be taken for improvement MWM activity.

Ø      Proper application of the Waste management rules.

Ø      Development of alternative treatment option for medical wastes, targeting on “Short term/long term” basis and “Big city/small city”.

Ø      Development of proper coordination mechanism among the different stake holders.

Ø      Incorporation of Medical waste management in the Medical and Nursing course curriculum.

Ø      Activation of City corporation/Powroshova for out-house MWM by coordination with MoLG&RD

Ø      Mobilization of proper resources.

Ø      Incorporation of the MWM rules in the Clinic Ordinance 1982 for establishing proper regulatory framework.

Ø      Activation of different committee formed for facilitating MWM.

Resource needed in the next 5-Years for implementation MW in Bangladesh

1. Establishment of Medical waste treatment & disposal plant for the Public & private Health care facility, specially Incinerator plant (Double Chamber) – 64 number (Each for one district) =1280 Million BDT equivalent to 18.28 Million US $
2. Purchase of MWM materials (Different color waste Bins, needle cutter, needle crusher, protective materials etc) for the functioning of the Public & Private hospitals = 500 Million BDT equivalent to 7.14 Million US $
3. Capacity development of the service providers ( Doctors, nurse, paramedics & other supportive staff) on MWM practice = 500 Million BDT equivalent to 7.14 Million US $
4. Operating cost for the final disposal of waste (Contracting out to different NGOs) = 250 Million BDT equivalent to 3.57 Million US $
5. Procurement of vehicle for carrying Medical waste to final disposal site (18 for 6 City corporation, 58 for 58 District) = (76 vehicle @ 3 Million each)= 228 million BDT equivalent to 3.25 Million US $
6. Procurement of Vaccine for the service providers as a part of occupational safety program = 500 Million BDT equivalent to 7.14 Million US $
7. Development of awareness program for the community & service providers = 70 million BDT equivalent to 1 Million US $