ASSESSMENT OF PRACTICES AND AWARENESS OF SAFETY MEASURES OF BIOMEDICAL WASTE MANAGEMENT AMONG HEALTH WORKERS IN CAMEROON

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

The rapid increase in the number of hospitals, particularly in urban areas of Cameroon, along with the growing population and utilisation of healthcare facilities, significantly contributes to the overall waste generation, including various categories of biomedical waste. This poses a significant challenge for developing nations in terms of managing, storing, treating, and disposing of such waste. In underdeveloped nations, the improper handling of biomedical waste is often observed due to a lack of awareness about its impact on public health, the absence of government involvement, and ineffectual laws (Derres et al., 2018). The statement indicates that there is a failure to properly manage waste at several stages, including generation, collection, storage, treatment, and transport. This is likely due to inadequate handling practices, insufficient use of personal protective equipment, inexperienced workers, and unsafe disposal techniques (Djibouti, 2021).

Effective management of biomedical waste is an essential aspect of healthcare systems globally, especially in poor nations such as Cameroon, where healthcare infrastructure and regulatory frameworks frequently encounter substantial obstacles (Mambou et al., 2019). Biomedical waste, encompassing sharps, infectious materials, medications, and other perilous compounds, necessitates careful management, separation, and elimination to avert injury to healthcare personnel, patients, and the wider community. Insufficient management techniques can result in significant health hazards, such as the transmission of infectious diseases, needle-stick injuries, and environmental pollution (World Health Organisation, 2017). Priority should be given to the implementation of effective and efficient management of biomedical waste in all operational healthcare delivery systems. The World Health Organisation has developed a biological waste management guideline to ensure the safe handling of waste generated from healthcare activities (Derres et al., 2018). The appropriate management of biological waste involves several crucial processes, which are as follows: segregation, transportation, treatment, storage, disposal, including minimisation and reuse (Rao et al., 2018). The procedure may encompass several intermediary steps (Ola-Adiza et al., 2020).

Inadequate handling and disposal of chemicals and radioactive waste from radiotherapy can lead to death and serious radiation burns (Chalabi et al., 2017). Inadequately regulated and discarded pharmaceutical waste, which encompasses unused and expired medications and vaccines originating from both residential and medical facilities, have been associated with health-related issues (Chalabi et al., 2017; Akter, 2021). Vaccines that have expired and include weakened living germs have the potential to infect waste handlers instead of offering protection against diseases. Extended exposure to drugs in the environment can have harmful consequences for pregnant women and children (Akter, 2021). Pharmaceutical waste has been shown to contaminate surface water and drinking water, resulting in both immediate and long-term health issues, such as reproductive and cellular injury (Akter, 2021; Włoszczak-Szubzda, 2021).

Biomedical waste should be segregated at its source into bags or containers with labels that are colour-coded. Ensuring the proper collection and disposal of this waste should be a major priority for both healthcare personnel and the organisation responsible for producing it (Sarker, 2019). Insufficient handling of medical waste can lead to accidents caused by sharp instruments, environmental pollution owing to hazardous chemicals, and the transmission of diseases through infectious microorganisms (Ahami, 2017). Presently, the management of biomedical waste in healthcare facilities has emerged as a burgeoning issue. Recent information suggests that the handling of biomedical waste in health institutions in Africa is still insufficient (Sarker, 2019). 

According to Shinee et al. (2018), the management of global Health Care Waste production and disposal is still in its nascent phase (Babu, et al., 2019). According to the World Health Organisation (WHO), healthcare workers generate hazardous healthcare waste at a rate ranging from 10 to 25 percent (Chartier, et al., 2018). However, the proportions varied between countries, ranging from 20% to 75%, as documented by Hayleeyesus and Cherinete (2020) in Ethiopia. According to Sawalem et al. (2017), Health Care Waste has the capacity to transmit more than 30 dangerous blood-borne infections. Out of these diseases, HIV, HBV, and HCV infections are especially worrisome since there is solid evidence that they can be transmitted through needle stick or sharp injury caused by improper waste disposal. Health care waste management is a significant issue in most developing nations. The implementation of efficient health care waste management poses challenges due to the limited availability of healthcare workers with expertise in waste management systems and the insufficient public awareness regarding this matter, as indicated by multiple researchers. Insufficient standards, rules, and feasible options for treating and disposing of health care waste can hinder waste management initiatives (Hossain et al, 2021). Studies suggest that Health Care Waste Management is still in its early stages in Africa (Bendjoudi, 2018).

According to the World Health Organisation (WHO), the person responsible for creating each waste item should classify it based on its potential for causing harm, the required treatment methods, and the suitable mode of disposal (WHO, 2018). It is advisable for every medical facility to possess separate bins that are colour-coded to correspond with various categories of healthcare waste. More precisely, infectious garbage must be discarded in yellow bins, chemical and pharmaceutical waste in brown bins, and general refuse in black dumpsters. According to the World Health Organisation (WHO, 2019), waste bags and sharp containers should not be packed above 75% of their maximum capacity. The pickup period should be decided based on the amount of rubbish and should not exceed one day. Every healthcare waste management system requires land access for the final disposal of any leftover healthcare waste materials after reduction or treatment. Landfills should possess specific desirable characteristics, such restricted accessibility to discourage scavenging, regular application of soil coverings to decrease odours, frequent compaction of waste, and proper isolation of the garbage (Annette et al., 2020). Common waste management technologies encompass combustion, landfilling, autoclaving, and chemical treatment. India has pioneered an innovative solar treatment method (Majid, 2019).

Healthcare professionals play a vital role in handling biomedical waste, making it essential for them to have a thorough understanding and implementation of safety protocols to minimise these dangers. Nevertheless, research has indicated that in numerous low- and middle-income nations, such as Cameroon, there exists a substantial disparity in understanding and implementation of appropriate biomedical waste management (Abang et al., 2021; Manga et al., 2020). The existence of this gap can frequently be attributed to inadequate training, limited resources, and insufficient enforcement of current standards. The scenario in Cameroon exemplifies the wider systemic difficulties encountered by healthcare systems in comparable settings. In spite of the presence of regulations for the handling of biological waste, adherence to safety standards by healthcare professionals is frequently variable. Failure to comply with regulations can lead to heightened vulnerability to dangerous substances, hence endangering the safety of healthcare professionals and the general public (Mambou et al., 2019). The objective of this study is to evaluate the implementation and knowledge of safety protocols pertaining to the disposal of biological waste among healthcare professionals in Cameroon.

1.2 Statement of the problem

Effective management of biomedical waste is a crucial concern for healthcare systems globally, especially in developing nations where healthcare infrastructure and practices may be less resilient. Cameroon faces substantial difficulties in effectively handling biomedical waste, which refers to any waste that contains or is contaminated with potentially infectious substances. These issues are worsened by the differing degrees of understanding and compliance with safety procedures among healthcare staff.

Improper management of biomedical waste can result in significant health hazards, such as the transmission of infectious diseases, pollution of the environment, and detrimental effects on public health (Murray et al., 2020). The World Health Organization (WHO) highlights the significance of using proper procedures for managing, segregating, and disposing of biomedical waste in order to reduce these dangers (WHO, 2017). In numerous low-resource contexts, compliance with safety standards continues to be variable, despite the presence of these recommendations.

Studies conducted in Cameroon have identified deficiencies in both the implementation and knowledge surrounding the management of biomedical waste. Research indicates that health personnel in Cameroon frequently face a shortage of proper training and resources when it comes to managing trash effectively (Ngangue et al., 2021). This scenario has the potential to result in incorrect disposal methods for trash, which could contribute to health risks and environmental problems. Furthermore, the adoption of safety protocols is frequently impacted by issues such as constrained infrastructure, inadequate policy implementation, and insufficient education (Kamga et al., 2022). In order to tackle these problems, it is crucial to conduct a thorough evaluation of the existing methods and the extent of knowledge among healthcare professionals. Therefore, the necessity for this investigation arises.

Objectives of the study

The primary objective of this study is to critically assess Practices and Awareness of Safety Measures of Biomedical Waste Management Among Health Workers in Cameroon. Specific objectives of this study are to:

To assess the existing practices among health workers in Cameroon regarding biomedical waste management

To identify level of awareness among health workers concerning the safety measures and guidelines for biomedical waste management in Cameroon

To examine the factors affecting the practices and awareness of biomedical waste management in Cameroon.

To evaluate the extent to which health workers adhere to established guidelines and standards for biomedical waste management in Cameroon.

To develop recommendations for improving biomedical waste management practices and increasing awareness among health workers in Cameroon

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 are the current practices of biomedical waste management among health workers in Cameroon?

What is the level of awareness among health workers in Cameroon regarding safety measures for biomedical waste management?

What factors influence the practices and awareness of biomedical waste management among health workers in Cameroon?

To what extent do health workers in Cameroon comply with established biomedical waste management guidelines?

What strategies can be recommended to improve biomedical waste management practices and awareness among health workers?

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: There is a low level of awareness among health workers towards safety measures for biomedical waste management.

Ha: There is a high level of awareness among health workers towards safety measures for biomedical waste management.

1.6 Significance of the study

This study is important because it examines crucial elements of biomedical waste management that directly impact public health, environmental preservation, policy development, and the overall efficiency of healthcare systems in Cameroon. The study seeks to enhance present practices and awareness levels in order to promote improvements that will have positive effects on both health personnel and the broader population.

Effective treatment of biological waste is essential in order to minimize the transmission of infections and safeguard public health. This study attempts to uncover gaps in current procedures and awareness that may result in health dangers through evaluation. Implementing these measures can greatly decrease the likelihood of disease spread and pollution, hence enhancing public health safety as a whole. Improper management of biomedical waste can lead to environmental pollution, specifically contamination of soil and water. The study's results can aid in the development of more efficient waste management techniques, therefore diminishing environmental contamination and promoting a more robust ecosystem.

Additionally, the findings of this study can offer significant perspectives to policymakers and regulatory bodies regarding the deficiencies and insufficiencies in the approaches to handling biological waste. This could lead to the adoption and enforcement of more stringent regulations and protocols to ensure the secure and legal management of waste.

Furthermore, the findings of this study can provide valuable insights to legislators and health authorities regarding the present state of biomedical waste management methods and the level of knowledge among healthcare professionals. This information is vital for developing and implementing regulations that guarantee the adoption of safe and efficient waste management procedures across the entire country. By identifying the levels of knowledge and identifying the gaps in present procedures, it is possible to drive the development of focused training programs for health workers. Enhanced training and resources can result in enhanced compliance with safety measures, hence mitigating the hazards connected with biomedical waste.

In addition, gaining insight into the elements that impact waste management techniques can aid in the distribution of resources and the enhancement of infrastructure required for efficient biomedical waste management. This can encompass allocating resources towards enhancing waste management technology and infrastructure. The study enhances the overall health and well-being of communities by enhancing biomedical waste management methods. Implementing effective risk management strategies decreases the probability of health risks spreading to the population, therefore fostering a more salubrious living environment.

Moreover, the study establishes a standard for evaluating advancements in the management of biomedical waste over a period of time. Additionally, it establishes the foundation for future study by emphasizing the areas that require further investigations to tackle unsolved matters or emergent difficulties. 

1.7 Scope of the study

Broadly, this study focus is to critically assess Practices and Awareness of Safety Measures of Biomedical Waste Management Among Health Workers in Cameroon. Specifically, this study seeks to assess the existing practices among health workers in Cameroon regarding biomedical waste management, identify level of awareness among health workers concerning the safety measures and guidelines for biomedical waste management in Cameroon and examine the factors affecting the practices and awareness of biomedical waste management in Cameroon. 

Further, this study will focus on evaluate the extent to which health workers adhere to established guidelines and standards for biomedical waste management in Cameroon and it also seeks to develop recommendations for improving biomedical waste management practices and increasing awareness among health workers in Cameroon.

 The study is carried out in Cameroon. 

1.8 Limitations of the study

During the examination, the researchers observed specific minor limitations that are typical in any human activity. The primary constraint was the limited availability of comprehensive literature pertaining to the Assessment of Practices and Awareness of Safety Measures of Biomedical Waste Management Among Health Workers in Cameroon, which was due to the scarcity of data. Consequently, a substantial investment of time and effort was required to choose the suitable materials, books, or information and collect data. 

Moreover, this study is limited by its limited sample size and restricted geographic range, concentrating just on Cameroon. Hence, the ability to generalize the results of this study to a wider scope is limited, emphasizing the necessity for more research. 

Furthermore, the researcher's shortcomings were mostly 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 research location 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 carry out this study while concurrently meeting the responsibilities of attending lectures and engaging in other educational endeavors.

1.9 Definition of terms

Biomedical 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.

Biomedical waste management: Biomedical 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.

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