AIDSTAR-One Fact Sheet: Health Care Waste Management in Uganda

The system generates health care waste that contributes to the spread of infectious communicable diseases, accounting for 60 to 80 percent of the disease burden in Uganda. According to the Ministry of Health's health management information system data, HIV prevalence in the country is estimated to be 6.7 percent, and the prevalence of hepatitis B is 10 percent. The current health care waste management system in Uganda is inadequate, with practices observed not ensuring occupational and public health safety. The system is aggravated by the fact that resources allocated to health care waste management continue to be less than optimal. A health facility assessment conducted jointly by the Ministry of Health and the AIDSTAR-One project in 99 health facilities found that on average, each hospital generates 92 kg of waste per day, 40 percent of which is hazardous. A significant proportion of waste generated in the health sector is considered hazardous, with very few facilities having acceptable methods of final waste disposal. Health care waste is defined as all waste generated during medical activities, including hazardous and non-hazardous waste. Hazardous waste includes sharps waste, infectious waste, highly infectious waste, pathological waste, anatomical waste, pharmaceutical waste, radioactive waste, effluents, heavy metals, and metal scrap. The major problems identified with health care waste in Uganda include technical problems, environmental and public health problems, occupational health problems, and institutional and legislative problems. To improve health care waste management practices in Uganda, it is essential to address key elements such as effective waste reduction and segregation, establishment of a comprehensive system, awareness raising and training, and establishment of safe handling, transporting, treatment, and disposal options. The organizational structure for establishing and running the health care waste management system is accommodated within the existing management for health sector systems. At the national level, a health care management or steering committee is set up to coordinate and monitor implementation and promote nationwide improvements in health care waste management. Roles and responsibilities are assigned to national health teams, district health teams, district leaders, and health facility workers. National health teams are responsible for putting in place favorable policies and guidelines, incorporating waste management commodities in existing essential medicines and supplies lists, providing technical supportive supervision, and mobilizing resources. District health teams are responsible for creating awareness on the need to use centralized, clean methods of waste disposal, identifying minimal funds that can be used for health care waste handling services, supervising compliance with best standards in health care waste management, and providing timely feedback on how health care waste management systems can be improved. District leaders are responsible for building awareness on the dangers of health care waste and the need for proper disposal, supervising the management/handling of health care waste at health facilities through management committees, advocating for increased allocation of district financial resources to support the management of health care waste at health facilities, and promoting the benefits of the public-private partnership model for providing best, affordable, and sustainable alternatives for managing health care waste. Health facility workers are responsible for segregating waste at the source according to recommended best practices, using proper protective gear to avoid exposure, and putting in place systems for proper management of exposure when it occurs. At the current level of effort and resources, the health care waste management system in Uganda is not adequate to address the challenges posed by health care waste. However, with the implementation of effective waste reduction and segregation, establishment of a comprehensive system, awareness raising and training, and establishment of safe handling, transporting, treatment, and disposal options, it is possible to improve health care waste management practices in Uganda.