Solid medical waste management in Africa

Abstract

Increased awareness about inadequate management of solid medical waste (SMW) has led to increased independent surveys in African countries and yet published data remain scanty on the subject in Africa as compared to the rest of the world. To evaluate the overall compliance with World Health Organization (WHO)’s ten recommendations on SMW practices in Africa through a literature review, we conducted literature search using search terms as “medical waste OR clinical waste OR biomedical waste OR hospital waste OR healthcare waste OR hazardous waste AND Africa” in PubMed, African Journals Online, Web of Science, Proquest, Embase, Google scholar and Scopus. Additional articles were included from open google search. Articles were selected for inclusion if they described SMW management activities such as waste segregation, collection, transport (on-site and/or off-site), temporary storage, treatment and final disposal; were located in an African country and were written in English; or if written in a different language, had an English abstract with the relevant information. Evaluations were based on fifty eight (58) full text articles which were pooled together. The fifty eight (58) full text articles represented research undertaken in 20 countries. Overall, six countries (30%) broadly met half of the WHO’s 10 recommendations. Based on the reviewed articles, the greatest compliance was shown with “daily collection of waste from the service areas” (100%). Areas of least compliance were “appropriate use of color codes” (18%) for labeling waste bins, “off-site conveyance” (16%) and “periodic training” (18%). In spite of growing awareness, SMW management in most African countries was sub-standard. Appropriate use of color codes, periodic training and off-site conveyance need to be addressed in terms of reporting and practice. Common challenges and unremarkable progress in SMW management in Africa raise a question about whether a unified approach should replace independent country efforts.

Key words: Africa, hospital waste, solid medical wastes, waste management.