Introduction
Healthcare waste poses significant risks to patients, health workers, communities, and the environment when not properly handled. In Ethiopia’s public health sector, especially in busy urban centers like Adama City, effective healthcare waste management (HCWM) is essential to minimize exposure to infectious materials, sharps injuries, and chemical hazards. This article summarizes a 2024 cross-sectional study examining HCWM practices and the factors that influence them among health workers in public health centers in Adama City, located in southern central Ethiopia. The findings highlight practical gaps, drivers of compliance, and opportunities to strengthen waste management across the public health system.
Methods at a Glance
The study employed a cross‑sectional design, surveying a representative sample of health workers across multiple public health centers in Adama City. Data collected included self-reported HCWM practices, knowledge of national guidelines, availability of waste disposal tools, training history, supervision, and perceived barriers. The aim was to identify not only how well practices were implemented but also which factors were most strongly associated with proper HCWM.
Key Findings: Practices in Daily Work
Overall, many health workers demonstrated awareness of basic HCWM principles, such as segregating waste at the point of generation, using color-coded containers, and safe sharps handling. However, actual practice varied by facility and role. High compliance was observed in controlled clinical areas with established waste streams, while gaps appeared in outpatient and emergency settings where high patient turnover stressed systems. Handling, storage, and transport of hazardous waste were common areas of concern, with several centers reporting delays in collection or insufficient container replacement. These patterns point to a need for reinforced routines and consistent resource provision to sustain safe practices.
Determinants of Safe HCWM
The study identified several factors associated with better HCWM practices:
- <strongTraining and knowledge: Health workers who had completed formal HCWM training or refresher courses showed higher compliance with segregation, labeling, and proper disposal methods.
- Availability of resources: Ready access to color-coded bins, puncture-resistant sharps containers, and dedicated waste storage spaces correlated with safer handling and lower cross-contamination risk.
- Supervision and institutional support: Regular supervision, clear waste management policies, and leadership emphasis on safety were linked to more consistent HCWM.
- Workload and staffing: Higher patient volumes and staffing shortages were associated with deviations from ideal practices, suggesting the need for scalable processes that can withstand busy periods.
- Infrastructure and workflow integration: Facilities with streamlined, predefined waste pathways—minimizing back-and-forth movement of waste—reported fewer breaches in protocol.
Barriers to Optimal HCWM
Several obstacles hinder ideal HCWM in Adama City’s public centers:
– Inadequate supply of essential waste containers and safe disposal equipment.
– Gaps in continuous on-the-job training and timely updates on national guidelines.
– Inconsistent waste collection schedules, particularly during peak hours.
– Limited budget allocations for maintenance of HCWM infrastructure.
– Physical layout constraints that complicate correct segregation and easy transport of waste.
Addressing these barriers requires targeted investments, routine monitoring, and practical workflow redesign to ensure sustainability beyond initial training campaigns.
Implications for Policy and Practice
Effective HCWM in Adama City hinges on a comprehensive approach that couples education with reliable resources and institutional accountability. Policy implications include:
– Ensuring mandatory, periodic HCWM training for all health workers with certification upon completion.
– Securing a steady supply chain for color-coded containers, sharps disposal boxes, and designated storage areas.
– Establishing simple, clear waste management protocols integrated into daily clinical routines and supported by supervisory checklists.
– Allocating budget for infrastructure upgrades and preventive maintenance of waste handling systems.
– Implementing routine audits to track compliance, identify gaps, and drive continuous improvement.
Conclusion
The 2024 cross-sectional study in Adama City reveals that while awareness of HCWM basics exists among health workers, actual practice is variable and dependent on training, resources, and organizational support. By strengthening training programs, ensuring consistent resource availability, and embedding HCWM into everyday work through strong supervision and streamlined processes, public health centers in Adama City can reduce hazards associated with healthcare waste and protect both health workers and the surrounding community.
