The Management of Medical Waste in Bangladesh: A Policy and Practices Analysis

Abstract

Medical waste management (MWM) is a critical aspect of healthcare delivery, particularly
in countries like Bangladesh. A significant body of literature emphasizes the importance
of an effective medical waste management in low-income countries and the implications
of poor MWM on public health and the environment. Inadequate MWM contributes to the
pollution of the environment, leading to various health risks. Appropriate management of
medical waste is essential to prevent spreading diseases, toxicities and injuries, protect
the environment, and promote sustainable development. The growing burden of
communicable diseases like dengue fever, COVID-19, AIDS, hepatitis B, and hepatitis C
cases in healthcare facilities has heightened the urgency to address medical waste issues
effectively. In Bangladesh, the underutilisation of MWM services presents significant
challenges that impact not only human health and the environment but also the nation's
economic growth and the future healthcare workforce. This research aims to analyse
existing policies and practices related to medical waste management in Bangladesh,
identifying barriers to effective implementation and proposing comprehensive strategies
to enhance MWM service uptake for sustainable development. Despite substantial
resources allocated to improve the technical and financial support of MWM systems in
low-income countries, the effectiveness of these initiatives largely depends on their
practical implementation within the local socioeconomic and political context in a
particular country. Building on prior research, this study investigates the specific steps
and strategies necessary for the successful enforcement of medical waste management
policies in Bangladesh.
Employing a mixed methods approach, quantitative and qualitative data were collected
through interviews, field surveys, and questionnaires—distributed across healthcare
establishments, waste disposal units, and relevant government and no-government
authorities. A total of 51 key informants including policymakers, implementors and HCEs
managers on MWM were interviewed. In-depth interviews with key informants provided
insights into challenges, barriers, and potential solutions. Additionally, 63 HCEs were
surveyed and an eight-year dataset on medical waste disposal and management from
PRISM Bangladesh Foundation, engaged in collaborative medical waste management
efforts with local government authorities was collected, providing a clear view of medical
waste production and practices. This research also included observational data to gaining
insights into various aspects of medical waste management, drawing information from 18
healthcare establishments and 6 disposal sites across multiple levels, including the
capital city, a divisional city, two districts, and two upazila (sub-district) tiers.
The study findings illuminate the prevailing barriers to effective medical waste
management across the country, constituting challenges for the authorities and
organizations concerned, e.g. city corporations or municipalities, in carrying out waste
segregation, transportation, storage and disposal while providing healthcare acilities. The research also evaluates the success and shortcomings of current MWM
practices within the context of existing policies. Moreover, the study extracts lessons from
exemplary literatures and case studies to adapt strategic planning to Bangladesh's unique
circumstances. And recommendations were proposed to address the challenges faced
by the vast medical waste management system in the short-, medium- and long-term
period. Recognising the multifaceted nature of challenges, these recommendations
strived to enhance the adoption of MWM services. The recommendation strategies
involve strengthening policy implementation, raising awareness among healthcare
personnel, refining waste segregation practices, improving transportation and disposal
mechanisms, establishing committees, regularly updating policies, further developing
public private partnership and fostering active engagement among actors through
streamlined coordination within relevant organisations.
In conclusion, this research contributes to the existing knowledge base by meticulously
examining policies and implementation procedures related to medical waste
management in Bangladesh. By identifying barriers and suggesting timely interventions,
this study aims to safeguard human health and the environment while fostering
sustainable development through effective medical waste management.

Date of Award	26 Apr 2024
Original language	English
Awarding Institution	Teesside University
Supervisor	Mosharraf Sarker (Supervisor), Shahaduz Zaman (Supervisor) & Claudio Angione (Supervisor)