HCWM technologies

Technical issues pertaining to the management of HCW are rarely dealt with at national level. The rare occasions where centralized decisions are taken in this respect usually occur before national immunisation campaigns.

There are nevertheless several areas where national level coordination is required or recommended [read more…]

Decisions that can and should be taken at national level and that relate to HCWM technologies typically focus on the elaboration of guidelines and standards (colour coding of containers; legal requirements for the transport of HCW; emission norms, etc…). These documents must take into account both national legislation as well as international legally binding Conventions.

For cost-effectiveness and efficiency, it could be advisable to envisage bulk purchasing of certain items necessary in the HCWM process at national level such as safety boxes and other waste containers, protective equipment, etc.

At the level of HCW treatment options, hazardous HCW can be dealt with in a decentralized manner with each HCF having it’s own on-site system or in a centralized way, HCW being transported off-site to a HCW treatment unit that can be located either in a regional referral HCF or in a public / private waste treatment plant.

Recycling options should be investigated whenever possible.

Decentralised HCW treatment

The advantages of on-site HCW treatment are situated at the level of convenience and minimization of risks to public health and the environment by confinement of hazardous HCW to the healthcare premises [read more…]

Decentralized, on-site treatment is often the only feasible solution for rural / remote HCFs and is also advisable when HCFs are situated far from each other and the road system is poor.

Disadvantages are that extra technical staff may be required to operate and maintain the systems. It may also be difficult for authorities to monitor the performance of many small facilities: this may result in poor compliance with operating standards, depending on the type of systems, and subsequent increased environmental pollution.

Centralised HCW treatment

There are several advantages in choosing off-site centralized HCW treatment solutions such as: [read more…]

  • financial: greater cost-effectiveness can be achieved in larger units unless the running costs for waste collection and transportation remain too expensive;
  • technical: efficient operation and maintenance of units is easier to ensure in a centralized facility than in several plants where financial and human resources may not be readily available;
  • legal compliance: conformance to environmental norms are easier to achieve thanks to the use of more sophisticated/ expensive technology and by the reduced number of facilities that need to be monitored by environmental surveillance authorities.

Public - private partnerships

The initial investments required to set up a central treatment unit can be quite high and public-private partnerships can be potential solutions to this limitation [read more…]

Another option consists in purchasing several units at national level; apart from being financially interesting it could help solve a frequent weak point at the level of technical support by having the training of a group of technical specialists in the operation and maintenance of these systems included in the contract.

The prerequisites for these options are:

  • to have the necessary technical competencies at the level of the Ministry of Health to ensure the tendering and subsequent selection of the technical option be properly carried out;
  • to carry out a comprehensive survey of the needs within the country so as to be able to determine both the number of units required and their optimal distribution.

This last point should be carried out during the national assessment on HCWM taking into account the quantities of waste being produced within the different HCFs, storage and transport issues.