AN ASSESSMENT OF PUBLIC HEALTH BENEFIT OF MEDICAL WASTE MANAGEMENT IN CAMEROON

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

The protection of the environment has become a collective concern of date because issues of waste management affect our daily life’s both at professional and family levels. Indeed, the world is generating more and more waste; hospitals and health centers are no exception. Medical waste is an issue of growing concern since it is a source for contamination and pollution, capable of causing diseases and illness either through direct contact or indirectly by contamination of soil, ground water, surface water and air as health care establishments are an integral part of the life support system (El Mabrouk, 2014). Healthcare waste contains infectious pathogens, toxic chemicals and heavy metals and may contain substances that are genotoxic or radioactive (Mmereki et al. 2017). When hazardous health care wastes are not properly managed, exposure to them could lead to infections, infertility, genital deformities, hormonally triggered cancers, mutagenicity, dermatitis, asthma and neurological disorders in children; typhoid, cholera, hepatitis, AIDS and other viral infections through sharps contaminated with blood (Oli et al. 2016). For example, WHO estimated that, in 2000, injections with contaminated syringes caused 21 million hepatitis B, 2 million hepatitis C and 260,000 HIV infections (WHO, 2005). 

The people at risk of healthcare hazardous waste include healthcare workers, patients, visitors to healthcare establishments, workers in support services, workers in waste disposal facilities, fetuses in the wombs of mothers, members of public and scavengers (Oli et al. 2016).  World Health Organization (WHO) defined medical waste as any waste which consists wholly or partly of human or animal tissue, blood or other bodily fluids, excretions, drugs or other pharmaceutical products, swabs or dressings, needles or other sharps; and any other waste arising from medical, nursing, dental, veterinary, pharmaceutical or similar practice, investigation, treatment, care, teaching or research, or the collection of blood for transfusion (Tiong et al. 2019). A World Health Organization (WHO) report states that 75–90 % of hospital waste is non-risk or general waste, comparable to municipal solid waste (MSW). The remaining 10–25 % of hospital waste is regarded as infectious and hazardous and may pose a variety of health risks. If both these types are mixed together then the entire quantity becomes contaminated and harmful (Mmereki et al. 2017). 

Though there is a greater recognition worldwide today that health centers waste should be managed properly (Mmereki et al. 2017; Hadipouret al. 2014; Shineeet al. 2008), several studies in Africa pointed out that healthcare waste management is still in its infancy; characterized by the lack of awareness on the impacts of healthcare waste, the total absence of medical waste regulations and a high incidence of noncompliance in cases where they exist (Mmereki et al. 2017). This despite the fact that during the past decade, large amounts of diverse healthcare risk waste discarded by health care facilities (HCFs) have been rapidly piling up in emerging economies (Mmereki et al. 2017; WHO, 2008) due to increase in population accompanied with different health needs. This is in contrast to developed countries, where legislation and good practice guidelines define medical wastes and state the various possible mays for collection, transport, storage and disposal of such wastes (Tudor et al. 2005). Because medical waste management is an important public health concern; one of the first critical steps in the process of developing a reliable waste management plan requires a comprehensive understanding of the benefits.

Effective medical waste management has several public health benefits. Garg et al., (2020) asserts that Proper segregation, treatment, and disposal of medical waste reduce the risk of transmission of infectious diseases. By ensuring that infectious waste is safely handled and disposed of, the spread of diseases such as hepatitis, HIV, and tuberculosis can be minimized. Kumar et al., (2021) opines that Effective management of sharps waste prevents needle-stick injuries and other accidents that could lead to infections among healthcare workers and patients. Safe disposal methods reduce the risk of such injuries. Proper disposal of pharmaceutical and chemical waste prevents environmental contamination. This protects water sources, soil, and air quality, which in turn safeguards community health and preserves natural ecosystems (Kolpin et al., 2020). furthermore, Effective waste management contributes to overall community health by reducing the risks of pollution and ensuring that waste does not contribute to health hazards. Improved waste management practices can lead to better public health outcomes and a higher quality of life (Jin et al., 2021). According to WHO, adherence to regulatory standards for medical waste management ensures that healthcare facilities meet required safety and environmental guidelines. This helps maintain public trust in healthcare services and reduces the likelihood of legal and regulatory issues (World Health Organization, 2018).

The expansion of healthcare facilities and services in Cameroon has led to a significant increase in the generation of medical waste. This waste includes hazardous materials such as infectious waste, sharps, and pharmaceuticals, which pose serious health and environmental risks if not managed properly (Garg et al., 2020). As the healthcare sector grows, the need for robust waste management systems becomes even more pressing to handle the increasing volumes of waste effectively. This study aims to assess the public health benefits of medical waste management practices in Cameroon by evaluating how these practices impact health outcomes and community well-being. Understanding these impacts can provide valuable insights into the effectiveness of current waste management practices and guide improvements.

1.2 Statement of the problem

The management of medical waste is being increasingly acknowledged as a crucial public health concern, especially in developing nations such as Cameroon. With the expansion of healthcare services, there is a corresponding increase in the amount of medical waste. This requires the implementation of efficient waste management procedures to protect both public health and the environment. Below is an elaborate analysis of the significance of this subject, substantiated by pertinent references.

Mane (2019) asserts that the contamination resulting from medical waste can have substantial detrimental effects on ecosystems, biodiversity, and natural resources. Insufficient handling of medical waste can lead to environmental contamination. For example, the infiltration of medications into water bodies can disrupt aquatic ecosystems by affecting the health and reproductive abilities of fish and other wildlife (Kolpin et al., 2020). In addition, the incineration of medical waste can lead to the emission of toxic compounds including dioxins and furans, which can accumulate in the food chain (Yamazaki et al., 2019). Wildlife can be directly affected by exposure to medical waste. Animals have the ability to ingest or become entangled in waste materials, which can lead to injuries or death. Research has shown that marine organisms suffer negative consequences when they ingest plastic and other forms of garbage (Jambeck et al., 2017). Furthermore, pollutants derived from medical waste can have adverse effects on the natural habitats of wildlife, resulting in a reduction in species diversity and disruptions to ecosystem functioning (Harrison et al., 2020).

Inadequate management of medical waste poses significant risks to public health. Improper disposal can lead to the spread of infectious diseases, physical injuries, and long-lasting health problems for both persons and communities. Medical waste, such as abandoned needles, infected dressings, and other things having biological hazards, may include pathogenic germs that can cause diseases. Unmanaged sharps waste poses a significant risk of needle-stick injuries, which can lead to the transfer of diseases including HIV and hepatitis (Kumar et al., 2021). Unsuitable waste disposal practices, such as open burning or landfill burial, can exacerbate these concerns by introducing pathogenic bacteria into the environment (Garg et al., 2020). Inadequate management of medical waste can lead to broader public health implications. Contaminated waste can lead to the pollution of water and soil, resulting in adverse effects on agricultural productivity and the availability of clean drinking water (Murray et al., 2019). Extended exposure to hazardous waste can result in the emergence of enduring health problems, such as respiratory and dermatological disorders (Baker et al., 2018).

A significant challenge faced by numerous healthcare facilities in Cameroon is the inadequate implementation of effective practices for segregating, storing, and disposing of medical waste. This deficiency can result in dangerous manipulation and heightened susceptibility to infectious agents, perilous drugs, and toxic materials (Garg et al., 2020). Furthermore, there is a dearth of thorough data evaluating the direct public health advantages of efficient medical waste management procedures in Cameroon. It is essential to comprehend the influence of these strategies on health outcomes in order to assess their efficacy and direct enhancements. Therefore, this investigation is necessary.

Objectives of the study

The primary objective of this study is to critically assess public health benefit of medical waste management in Cameroon. Specific objectives of this study are to:

To Evaluate the Impact of Medical Waste Management on overall Public Health outcomes in Cameroon

To Evaluate the Impact of Medical Waste Management in mitigating environmental contamination.

To identify the barriers faced by healthcare facilities in implementing effective medical waste management practices in Cameroon.

To propose recommendations to enhance medical waste management practices in public health facilities.

1.4 Research Questions

The following research questions which are in line with the objectives of this study will be answered in this study:

What is the Impact of Medical Waste Management on overall Public Health outcomes in Cameroon?

What is the Impact of Medical Waste Management in mitigating environmental contamination in Cameroon?

What are the barriers faced by healthcare facilities in implementing effective medical waste management practices in Cameroon?

What are the recommendations to enhance medical waste management practices in health facilities in Cameroon?

1.5 Research Hypotheses

To determine the effectiveness of this study, the following research null hypotheses will be formulated to guide the study and it will be tested at 0.05% levels of significance.:

Ho: Medical Waste Management has no significant impact on overall public outcomes in Cameroon.

Ha: Medical Waste Management has significant impact on overall public outcomes in Cameroon.

1.6 Significance of the study

The research on the public health advantages of medical waste management in Cameroon has important implications for multiple stakeholders, such as public health authorities, healthcare facilities, and the wider community. Gaining insight into the effects of medical waste management techniques on public health is essential for improving health outcomes, safeguarding the environment, and ensuring compliance with regulations.

Efficient management of medical waste immediately helps to the reduction of health risks by preventing the transmission of infectious diseases, minimising contact with dangerous substances, and reducing the chances of accidents caused by sharp objects. The study aims to analyse the effects of current behaviours on public health and provide methods to reduce these risks. The study aims to elucidate the correlation between effective waste management and enhanced health outcomes, specifically in terms of mitigating healthcare-related infections and other health complications associated with inadequate garbage disposal. This can result in an improved overall health of the population and decreased expenses related to healthcare.

Moreover, proficient administration of medical waste aids in averting environmental contamination, such as the poisoning of water supplies and soil. Preserving ecosystems and ensuring safe environmental conditions for communities is crucial. The study aims to elucidate the ecological advantages of existing waste management strategies and identify potential areas for enhancement. The study examines the environmental consequences of medical waste and advocates for the adoption of sustainable waste management strategies that adhere to international environmental norms and promote long-term ecological well-being.

In addition, the study will assess adherence to local, national, and international regulations pertaining to the handling of medical waste. It is imperative to prevent legal consequences and retain public confidence in healthcare organisations. The study's findings will offer evidence-based suggestions for politicians to create or modify legislation and guidelines, guaranteeing their effectiveness and alignment with waste management's best practices. 

Moreover, the identification of deficiencies in medical waste management methods would emphasise the necessity for improved training and capacity-building among healthcare personnel. Enhanced training will result in more effective management and proper disposal of medical waste. The study's results will aid healthcare facilities in enhancing their waste management systems, resulting in more streamlined and productive waste handling and disposal procedures.

Additionally, the project will provide significant data to the current pool of information on the management of medical waste, specifically in the context of Cameroon. This can contribute to future study and improve comprehension of efficient waste management strategies. The study will provide guidance for future research endeavours and aid in addressing developing concerns pertaining to the management of medical waste in comparable contexts, so facilitating continued enhancements in public health and environmental preservation.

1.7 Scope of the study

Broadly, this study focus is to critically assess public health benefit of medical waste management in Cameroon. Specifically, this study seeks to Evaluate the Impact of Medical Waste Management on overall Public Health outcomes in Cameroon and Evaluate the Impact of Medical Waste Management in mitigating environmental contamination in Cameroon. 

Further, this study will focus on identifying the barriers faced by healthcare facilities in implementing effective medical waste management practices in Cameroon and it also seeks to propose recommendations to enhance medical waste management practices in public health facilities.

 The study is carried out in Cameroon. 

1.8 Limitations of the study

During the examination, the researchers observed numerous minor limitations, which are typical in any human attempt. The primary constraint was the paucity of comprehensive literature on the subject, stemming from the dearth of data on an assessment of public health benefit of medical waste management in Cameroon. Consequently, a substantial investment of time and effort was required to ascertain the suitable materials, books, or information and collect data. 

Moreover, this study is limited by its limited sample size and restricted geographic coverage, concentrating exclusively on Cameroon. Hence, the ability to generalise the results of this study to a wider scope is limited, emphasising the necessity for more research. 

Furthermore, the researcher's shortcomings were predominantly attributed to financial restraints, as they are a student who lacks the necessary financial resources to support themselves. The excessively high transportation fees at the study site presented a difficulty in fulfilling the financial responsibilities associated with transportation costs.

In addition, the researcher encountered a time limitation as a result of the necessity to do this research while concurrently meeting the responsibilities of attending lectures and engaging in other educational endeavors.

1.9 Definition of terms

Waste management: Waste management refers to the process of managing, treating, and disposing of waste in a safe and environmentally responsible manner. The goal of waste treatment is to reduce the harm caused by waste to human health and the environment.

Medical waste: Biomedical waste is any waste containing infectious or potentially infectious materials. These wastes are generated during the diagnosis, treatment, and immunization of humans and animals. Biomedical wastes can be in both solid and liquid forms.

Medical waste management: medical waste management plays a crucial role in safeguarding the safety and well-being of individuals and the environment. It encompasses the proper handling, treatment, and disposal of waste generated by healthcare facilities.