1.1 Introduction
Health care waste refers to all the waste generated by health care activities, including diagnosis, treatment, immunization, laboratory work, and research, which is either infectious, hazardous, or potentially harmful to humans and the environment (World Health Organization, 2014). It includes sharps, pathological, pharmaceutical, chemical, and general non-hazardous waste. Improper handling of health care waste is a major public health concern, where inadequate infrastructure, lack of training, and poor regulatory enforcement is contributing to environmental pollution and occupational health hazards (Chartier et al., 2014; Windfeld & Brooks, 2015).
In primary health care facilities, workers play a crucial role in the proper segregation, collection, transportation, and disposal of medical waste. However, studies is indicating that health care workers often do not adhere strictly to recommended waste management practices due to limited knowledge, insufficient training, negative attitudes, and resource constraints (Devi et al., 2018; Askarian et al., 2018).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Health care waste management has evolved significantly over the past decades, as awareness of its public health and environmental implications has increased. According to Chartier et al. (2014), the formal recognition of medical waste as a critical component of health systems emerged in the late 20th century, prompted by global outbreaks of infectious diseases and increasing hospital-generated waste. Early approaches to health care waste management primarily focused on disposal methods, such as incineration, landfilling, and open burning, with limited attention to segregation, reduction, or recycling strategies.
In Nigeria, health care waste management gained formal attention during the early 2000s with the introduction of national guidelines and policies aimed at improving waste handling practices in hospitals and primary health care facilities. Oladele et al. (2019) contended that while tertiary institutions received more focus, primary health care centers remained under-resourced, with many facilities lacking functional incinerators, proper disposal bins, and staff training programs. Devi et al. (2018) affirmed that even with the existence of national policies, compliance among health care workers varied widely, often due to a combination of inadequate knowledge, negative attitudes, and limited enforcement.
Health care waste is a by-product of health care services that is generated from hospitals, clinics, laboratories, and primary health care facilities. According to the World Health Organization (2014), health care waste includes sharps, infectious, pathological, pharmaceutical, and chemical materials that pose significant risks to health and the environment if not managed appropriately. Improper handling of such waste is reported to be a major contributor to occupational hazards among health workers and environmental pollution in many developing countries.
Several studies have highlighted that inadequate health care waste management in primary health care facilities is linked to poor knowledge, lack of training, insufficient equipment, and weak enforcement of policies. Devi et al. (2018) asserted that health care workers' compliance with standard waste management practices is often sub-optimal, even when guidelines exist, due to limited awareness and improper attitude toward waste handling. Similarly, Askarian et al. (2018) contended that inadequate waste segregation and disposal methods such as open dumping and burning significantly increase the risk of infectious disease transmission among both workers and community members.
Furthermore, infrastructural and organizational factors is reported to influence health care waste practices in facilities. Birpınar et al. (2015) stated that the availability of proper disposal equipment, functional incinerators, and supervisory support is critical in ensuring adherence to safe waste management practices. Windfeld and Brooks (2015) affirmed that in the absence of these facilities, health care workers may resort to unsafe practices, which not only compromise occupational safety but also impact the surrounding environment. On the other hand, Chartier et al. (2014) reported that workers' personal attitudes, knowledge, and perceptions about waste management is equally important, as infrastructure alone does not guarantee proper compliance.
In the context of Nigeria, primary health care facilities play a pivotal role in providing essential health services, especially in semi-urban and rural communities. However, many facilities are reported to operate under resource constraints, with limited training programs, inadequate monitoring, and poor enforcement of existing waste management policies (Oladele et al., 2019). This study is set against the backdrop of understanding these multifaceted factors, as they is critical for designing effective interventions that improve health care waste management practices, safeguard the health of workers, and protect the community from environmental hazards.
1.3 Statement of Problems
Investigation revealed that health care waste is a by-product of health care activities that is hazardous to both health and the environment if not managed properly. In many primary health care facilities, improper segregation, storage, transportation and disposal of health care waste is a persistent problem that exposes health workers, patients and surrounding communities to biological, chemical and physical risks (World Health Organization, 2014; Chartier et al., 2014).
In the context of Jalingo, there is limited empirical evidence on the actual practices of waste handling among primary health care facility workers and the underlying factors that influence such behaviours. Many facilities is still operating without adequate waste segregation bins, functional incinerators or routine training for staff on safe waste management (Askarian et al., 2018; Birpınar et al., 2015).
Furthermore, inadequate monitoring, weak enforcement of regulations and limited access to continuous professional development is undermining the ability of primary health care facilities to maintain safe waste management practices. It is against this backdrop that this study seeks to assess the factors influencing health care waste management practices among primary health care facility workers in Jalingo.
1.4 Aim and Objectives of Study
The aim of this study is to assess the factors influencing health care waste management practices among primary health care facility workers in Jalingo.
The specific objectives of the study are to:
- Examine the level of knowledge and awareness of primary health care workers regarding proper health care waste management.
- Identify the institutional and infrastructural challenges affecting waste management practices in primary health care facilities.
- Assess the attitudes and perceptions of health care workers toward health care waste management.
- Determine the impact of supervision and policy enforcement on the compliance of health care workers with standard waste management practices.
- Suggest practical recommendations for improving waste management practices in primary health care facilities.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level of knowledge and awareness of primary health care workers regarding proper health care waste management in Jalingo?
- What institutional and infrastructural challenges is affecting waste management practices in primary health care facilities?
- How do the attitudes and perceptions of health care workers influence their waste management practices?
- What is the impact of supervision and policy enforcement on compliance with standard waste management practices?
- What measures will improve health care waste management practices in primary health care facilities?
1.6 Research Hypotheses
The following generalized hypothetical statements have been designed to guide and aids in obtaining the result for the experiment to be conducted.
- H01: There is no significant relationship between the factors influencing health care waste management practices and the compliance of primary health care facility workers in Jalingo.
- H02: There is a significant relationship between the level of knowledge of health care workers and their compliance with waste management practices.
- H03: Institutional and infrastructural challenges significantly influence the waste management practices of health care workers.
- H04: Attitudes and perceptions of health care workers significantly affect their adherence to standard waste management protocols.
- H05: Supervision and policy enforcement significantly impact the compliance of health care workers with proper waste management practices.
1.7 Significance of Study
The outcome of this research will inform policymakers and administrators about gaps in existing waste management systems, enabling the development of more effective interventions. The study will also benefit health care workers by improving awareness, knowledge, and skills for proper waste handling, thereby reducing occupational hazards and promoting workplace safety.
Furthermore, the research will contribute to environmental protection by ensuring that health care waste is managed in a way that reduces contamination and public health risks. In addition, proper waste management practices resulting from this study will reduce environmental contamination and health risks for the public.
Lastly, the study will serve as a reference point for academics and researchers interested in understanding the behavioral, institutional, and infrastructural factors influencing waste management practices in similar contexts.
1.8 Scope of Study
The scope of the research is focused on the assessment of factors influencing health care waste management practices among primary health care facility workers in Jalingo, Taraba State. The research is limited to staff directly involved in health care service delivery within selected primary health care facilities in the state.
1.9 Limitations of the Study
The study was limited by insufficient data from some facilities, frequent power failures, delays from respondents, and financial and time constraints. Additionally, some records and documentation on waste management practices was incomplete or outdated, which affected comprehensive data collection.
1.10 Definition of Terms
Health Care Waste: According to World Health Organization (2014), health care waste is any waste generated in the course of medical, diagnostic, treatment, or research activities that is infectious, hazardous, or potentially harmful.
Primary Health Care Facility: These are health institutions that provide basic and essential health services at the community level, including preventive, curative, and rehabilitative care (Oladele et al., 2019).
Waste Management Practices: The activities and procedures involved in the collection, segregation, transportation, treatment, and disposal of health care waste (Chartier et al., 2014).
Compliance: The degree to which health care workers follow recommended guidelines and protocols for proper waste management (Devi et al., 2018).
Occupational Hazard: Any risk to the health or safety of workers arising from exposure to infectious agents, chemicals, sharps, or unsafe practices during the handling of health care waste (Askarian et al., 2018).
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