Medical care is vital for our life and health, but the waste generated from medical activities represents a real problem of living nature and human world. Improper management of waste generated in health care facilities causes a direct health impact on the community, the health care workers and on the environment. Indiscriminate disposal of hospital waste and exposure to such waste possess serious threat to environment and to human health that requires specific treatment and management prior to its final disposal. 

An estimated 29 tons of infectious waste is generated daily from the public health sectors HCFs of Punjab. While in the past healthcare waste management received little in Punjab, this changed enormously during the last two years. Awareness raising activities with stakeholders regarding the risk created by healthcare waste management resulted in a willingness to start change processes. The importance of these activities was underlined by a study from the World Health Organization and federal health ministry (2008) which showed very high prevalence of hepatitis B and C among health workers in Punjab pointing to a breach in healthcare waste management safety.

Environmental Health and Medical Waste Management Plan

Environmental Health and Medical Waste Management Plan (EH&MWMP) was developed in 2013 by Punjab Health Sector Reforms Program and implementation was agreed with the World Bank for the achievement of agreed disbursement linked indicators (DLIs) through Policy & Strategic Planning Unit.

The EMWMP was prepared in compliance with the national regulatory requirements and WB Operational Policies. The Plan essentially seeks to effectively implement the Hospital Waste Management Rules, framed by the Government of Pakistan in 2005 and adapted by Gov of Punjab in 2014.  The plan has divided in to three phases. Phase-1 was to implement the HWM Rules, 2014 in pilot health care facilities while the phase-2 is the scale up plan to replicate the same practices in the health care facilities (DHQs/THQs) of the selected 15 districts of the province and phase-3 is the implementation of the HWM Rules in the remaining districts of the Punjab.

Objective

The core objective of this plan is to collect, store and transport the infectious waste according to the set of standards in compliance with the HWM Rules, 2014 and environment friendly disposal of the waste for the safeguard of human health and environment.

Achievements

• PSPU achieved first DLI/World Bank for the implementation of HWMR at pilot health care facilities (THQ Burewala & Wazirabad)
• In second Phase (scale up plan for 15 selected districs) Hospital Waste management Rules, 2014 have implemented in 8 districts (Gujranwala, Jhelum, MB Din, Hafizabad, Lahore ,Sheikhupura, Vehari & Bhawalnagar).
• PC-1 worth of PKR, 2 Billion infection control and waste management has approved
• Environment friendly incinerator and health care waste supplies have procured
• Dedicated vehicle for the transportation of infectious waste with in the districts have purchased
• Plan for outsourcing treatment facilities/incinerators has prepared
• Training of master trainers (TOT) have completed
• Step down trainings among health care workers with in their health facilities have completed.
• Standard Medical Protocols (SMPs) for the sound management of the health care waste have prepared and shared to all health care facilities.

Result

After implementing standards protocols at 6 targeted HCFs (scale up plan) a total of 324 tones of infectious waste (including 48 tones of used syringes) in a year (2016-17) was collected and disposed accordingly.