Green strategies for health care waste management in the healthcare facilities in Pietermaritzburg, KwaZulu-Natal province, South Africa: a stakeholder analysis.

Abstract

Background: Around 5.2 million people die each year from healthcare waste-related diseases worldwide, including 4 million children, and the amount of waste generated by health facilities is increasing, which is a cause for concern. Due to a growth in the number of healthcare facilities and the usage of disposable medical products, South Africa produces 45 000 tons of healthcare waste each year. Hence, there is a need for sustainable interventions to reduce medical waste. The aim of this study was to explore sustainable strategies that exist on healthcare waste management (HCWM) from stakeholders’ perspectives. Methods: Purposive sampling was used to recruit participants. Eleven participated in the study including waste officers, a hospital Chief Executive Officer (CEO), provincial healthcare waste coordinator, an environmental officer, an infection prevention control officer, and a healthcare waste Non-Governmental Organization (NGO) official. Semistructured interviews were conducted using a semi-structured guide. Interview topics included the role of stakeholders in formulating policies, experiences on policy development, and sustainable strategies for HCWM Audio recording was used and transcribed verbatim to isiZulu and translated into English. Findings: Participants reported that recycling of papers is the only HCWM sustainable strategy that hospitals have which is still at the infant stage and faceted with challenges such as mixing of waste and no service providers to sort-out waste. This is further exacerbated by that there is no policy on general waste recycling. Furthermore, participants mentioned that hospitals are planning to use Global Green Healthy Hospital (GGHH) international network to support HCWM sustainable strategies. Lastly, participants stated South African government is not taking a leading role in encouraging waste reduction strategies. Conclusion: Stakeholders agreed that, in general, the Department of Environmental Affairs (DEA) is the custodian of waste management policies, however, the Department of Health (DOH) is responsible for developing healthcare waste policies. Thus far, health facilities have adopted recycling of general waste which still runs on an ad hoc basis because there is no general waste policy. It was suggested that the GGHH initiative had the potential to provide technical support to DOH in reducing waste production, advocate recycling and develop policies that promote green strategies. Interventions aimed at facilitating and upporting healthcare waste reduction are needed, more importantly, there is a need for government to develop policies at national, provincial, and local levels to guide sustainable strategies on HCWM.