Compliance Level with Current Health Care Waste Management Regulation in Thulamela Local Municipality Health Care Establishments, South Africa

Abstract

Non-compliance with Health Care Risks Waste (HCRW) management regulation continues to be a major challenge all over the world. Improper management of HCRW has potential negative impacts on human health and the environment. This study was conducted to assess the level of compliance with HCRW management regulation in health care establishments at Thulamela Local Municipality, Vhembe District. The study adopted a mixed method which consists of qualitative and quantitative research approaches. The three hospitals and 15 clinics were purposively sampled from public health care establishments in the Municipality. The 15 clinics were selected using simple random sampling. Qualitative data was collected using semistructured interviews to gather in-depth information from the participants, and observation checklist was used during fieldwork. Semi-structured questionnaires were adopted in gathering quantitative data from 167 respondents in the selected health care establishments. Qualitative data was analyzed through Atlas.ti version 8.4 for citations, and quantitative data was analyzed with the Statistical Packages for the Social Sciences (SPSS) version 25. Findings of the study revealed that 77.8% of the 18 health care establishments had health care waste management plan, but the remaining health care establishments did not have management plan, which is an indication of non-compliance with the regulation. The study revealed that types of HCRW generated in the study included: sharps and vials; infectious; anatomical/pathological; pharmaceutical and chemical; as well as radioactive waste. They are the same types of HCRW generated in establishments globally. Sharps and infectious wastes are the most generated sub-categories of HCRW. The daily practice of operational workers on health care waste management and handling shows lack of knowledge and non-compliance with the regulation. Most of the health care establishments do not have proper temporary storage room that meet regulation standards. This is the main challenge that shows the lowest level of compliance, whereas the highest compliance level is on keeping the records of the type and amount of HCRW generated. To improve the level of compliance with the regulation and reduce the negative impact of poorly managed health care waste on the environment and human health, this study recommends that all health care workers should be regularly trained on health care waste management. It further recommends continuous monitoring of compliance with health care waste regulations and policies at all times at the health care establishments.