A lifecycle evaluation of health care waste management by general practitioners in South Durban

Abstract

Health care waste management (HCWM) poses a major risk due to its hazardous and deleterious effects on the environment and communities. It is imperative that specific and correct strategies from generation to final disposal, are implemented at all health care facilities (HCFs). A search of the literature has shown that many incorrect HCWM procedures have been found in HCFs, especially in developing countries. In South Africa, research on HCWM was mainly undertaken in municipal or government hospitals while it appeared to be non-existent in the private sector. This study therefore minimized this important gap in the private sector by investigating the lifecycle evaluation of HCWM by General Practitioners (GPs) in South Durban. The objectives included the following: 1) to assess the GPs‟ knowledge and practices of the hierarchy of waste principles; 2) to evaluate occupational risks associated with handling health care waste in GPs‟ surgeries and 3) to determine regulations utilized during the HCWM process in GPs‟ surgeries. GPs belonging to the Durban South Doctors Guild (DSDG) were assessed in a two staged interview process using a questionnaire and a regulations checklist. Overall, the results indicated that private practicing GPs in the South Durban area do practice HCWM in a responsible manner. Age appeared to play a significant role in terms of knowledge and practices. The areas of compliance showed that correct segregation was practiced by 92% of the sample group and 100% of the GPs utilized accredited waste collection services. Areas of concern were that while regular HCWM seminars were convened by the DSDG, the response rate was poor. Additionally, there seemed to be a lack of knowledge regarding the definition of infectious waste as 18% of GPs noted that their facilities did not produce this type of waste. The occupational risks appeared to be minimal with only 6% of GPs experiencing needle-stick injuries. The GPs were knowledgeable and practiced HCWM according to appropriate South African legislation. In response to the areas of concern, seven recommendations are proposed. This study established that HCWM in private practicing GPs surgeries in the South Durban area are being carried out correctly and in accordance with specific South African regulations and policies. It would also be beneficial when undertaking future research to obtain more holistic outcomes by including GPs who: a) are younger than the majority age group noted in this study; b) have their surgeries in other previously disadvantaged and under-resourced communities; c) are female and; d) are of African, White or Coloured descent.