Waste Management Assessment and Planning for the National Immunization Programme

The purpose of the missions was to conduct a rapid assessment of the current methods used in the management of all healthcare wastes in the country. This task was proposed in order to develop an overall plan that could provide a solution to National Immunization Programme (NIP) wastes that would be in agreement with potential solutions for the management of other types of wastes and, at the very least, determine other actions or activities necessary.


Healthcare wastes are not stored appropriately. Some of the wastes are not segregated correctly within the healthcare facilities and are mixed with the general waste and therefore end up untreated at the land disposal sites. A large percentage of the healthcare facilities that were visited in the course of this analysis rely on direct combustion of some pathological wastes, as well as of needles and syringes. Some of the “incinerators” used for the combustion process are very simple and lack any type of air pollution control devices.

Hospital administrators, although aware of the process used for managing the wastes, do not seem to be giving enough importance to proper waste management.

All of the facilities visited had a supply of safety boxes for residues from immunization.

The majority of facilities visited did not have sufficient financial resources to deal with the management of healthcare wastes.

Insufficient training is conducted at the healthcare facilities in the area of waste management. In general, the management of healthcare wastes is inappropriate and requires immediate attention. Wastes are not properly segregated and they are burned in the open air or taken directly to the dumpsites.


Residues from immunization, and in particular needles and syringes, require that specific steps be undertaken to prevent injury and infection during their handling inside and outside of the healthcare facilities. These residues should be collected and managed separately from other types of healthcare wastes. Needles, syringes, and other residues from immunization programmes should continue to be placed in containers specifically designed for that purpose (safety boxes). The safety boxes must be puncture and leak-proof.

Storage of used needles and syringes, as well as other residues from immunization, should always take place at a location that is accessible only to personnel assigned to that task. Once the safety boxes are full and sealed, they can be discarded along with other healthcare waste, depending on the type of disposal technology that is available.

All disposable syringes and needles must be discarded immediately after use. In the process, needles should not be recapped. Furthermore, used syringes, needles, or safety boxes should never be discarded along with municipal solid waste or discharged anywhere without prior treatment.


  • Financial resources for the management of immunization wastes must be defined;
  • Capacity building and training programmes have to be developed;
  • Information, education and communication supports developed;
  • Monitoring and Evaluation plan set up.