Stakeholders’ Practices and Perspectives on Solid Medical Waste Management: A Community Based Study in Accra, Ghana

Abstract

Solid medical waste (SMW) is hazardous and requires specific treatment prior to final disposal. Limited information addresses the management of SMW in non-traditional settings such as in households, traditional birth attendants’ (TBAs) homes and chemical seller (CS) shops. A descriptive, exploratory study was conducted to identify major disposal practices and perceived hazards associated with SMW and explore their views regarding segregation as a potential management option. Twenty-nine household members, 10 TBAs and 8 CS who volunteered to participate in the study were involved in 6 focus group discussions (FGDs). Additionally, five key informants in private sector waste management companies were interviewed. FGDs were audio recorded, transcribed and translated, manually coded into themes and sub-themes using an iterative approach, and integrated with data from the interviews. In households, medicines were discarded by dosage forms with solid forms discarded in the household bin, while syrups were mostly emptied into drains. TBAs buried material used for delivery in clients’ compounds and CS tended to burn expired medicines or discard them with general waste. Participants perceived the following as hazards associated with SMW: infection transmission, penetrative injury, poisoning and aesthetic nuisance. Despite this awareness, they reported barriers to source segregation as a potential management option. Barriers included implied consumer costs, lack of supportive logistics and operational knowledge, and possible injury. Reported methods of disposing SMW supported earlier studies and could be potentially hazardous if not addressed. Provision of storage facilities, supportive logistics and public sensitization might encourage source segregation as a potential management option for SMW in the community.