Table of Contents

1.2 Introduction...........................................................................................................................................2
1.3.objectives..............................................................................................................................................2
1.4.Purpose of the plan...............................................................................................................................2
1.5.Scope Of The Health Care Waste Management Plan.............................................................................3
1.6.Formulation Of The Committee.............................................................................................................3
1.6.1.Responsibilities And Duties................................................................................................................3
The Head of Hospital...................................................................................................................................3
Waste Management Officer (WMO.............................................................................................................5
The Matron (or Senior Nursing Officer) and the Hospital Manager............................................................7
Infection Control Officer..............................................................................................................................7
.Chief Pharmacist.........................................................................................................................................7
Supply Officer..............................................................................................................................................8
Hospital Engineer........................................................................................................................................8
1.7.Training of stuffs....................................................................................................................................8
1.8.Waste segregation.................................................................................................................................8
1.9. Collection and on-site transportation.................................................................................................11
2. Waste handling......................................................................................................................................11
2.2. On-site storage...................................................................................................................................12
2.3.Transportation.....................................................................................................................................12
2.4.Health care handling practices............................................................................................................14
A1 Recyclable waste..................................................................................................................................14
A2 Biodegradable health care wastes.......................................................................................................14
A3 Other non-risk waste............................................................................................................................14
B Biomedical and health-care waste requiring special attention...............................................................15
B2 Waste sharps........................................................................................................................................15
3. Procedures in case of accidents and spillages.......................................................................................17
4. Implementation of the plan...................................................................................................................18
5. BUDGET.................................................................................................................................................20
APPENDIX..................................................................................................................................................21
Abbreviation..............................................................................................................................................21

1
1.0. Introduction
Zambia has continued recording poor waste management in the health sector. Waste from the
health department is a major challenge which if not properly managed can lead to spread of
diseases. Proper management of hospital waste can minimize the risks both within and outside
healthcare facility. It is essential that hospital waste should be collected, stored and disposed in a
proper process with standard technique.

Hospital waste is a potential reservoir of pathogenic microorganism and requires appropriate,

safe and reliable handling. The plan recommends safe, efficient, sustainable, affordable and
culturally acceptable methods for the treatment and disposal of health care waste, both within
and outside health-care facilities. Proper hospital waste management is a prerequisite to
minimize hospital acquired infection. However, This assignment is aimed at formulating a waste
management plan.

1.2. Mission
To promote high standards of Health Care Waste Management in order to reduce the risk of
exposure to Hazardous waste and improve the safety of patients, clients, Health Care Waste, and
the general public

1.2.1 Objectives
 Enable the environmentally sound treatment and final disposal of health care waste to be
established and operated
 Improve the occupational health conditions for the employees in the system such as health
workers, waste collectors and landfill staff.

2
1.4. Purpose of the plan
To describe procedures and management of the waste generated by the health facility. This plan
has been developed to ensure wastes are reduced, reused and recycled wherever possible.

1.5. Scope of the Health Care Waste Management Plan

This Waste Management plan covers all activities involving waste generation to waste disposal.
Whilst this Waste Management Plan will act as a ‘framework’ to determine what the health care
providers will be expected to produce, health are required to ensure that all the requirements of
the Waste Management are adopted within their own waste management plans. Further
information on Roles and Responsibilities is provided.

1.6. Formulation of the Committee

It is in the powers of the head of facility to make the Health Care Waste Management committee
which should include;

 Head of Hospital (as chairperson)

 Heads of Hospital Departments
 Infection Control Officer
 Chief Pharmacist
 Radiation Officer
 Matron (or Senior Nursing Officer)
 Hospital Manager
 Hospital Engineer
 Financial Controller
 Waste Management Officer

1.7. Responsibilities and Duties

Health Care Waste Committee

The Waste Management committee shall be responsible for the better administration,
preparation, careful planning, monitoring, periodic review, cordinate and control disposal
operations, revision or updating if necessary, and implementation of the Waste Management
Plan.

3
The focal point unit

The focal point unit shall drive the health care waste management issues in the facility and shall
be constituted from from heads of departments and duties is as follows:

 To facilitate preparation of the Health Care Waste Management plans for the facility
 To liaise with all the departments that generate Health Care Waste
 To support implementation of Health Care Waste Management through unit heads.
Radiation Safety Officer or Protection Officer
The duties and responsibilities of the Radiation Safety Officer, Protection officer or radiographer
are the same as those of the Pharmaceutical Officer but seemingly relate to radioactive waste
guided by the relevant legislation in force.
The Radiology Officer shall be responsible for the sound management of radioactive waste, and
in particular shall:
The Radiology Officer shall be responsible for the sound management of radioactive waste, and
in particular shall -

 Give advice regarding formulation of appropriate procedures for management of radioactive

waste and coordinate implementation of these procedures
 Ensure that the concerned hospital staff members receive adequate training in radioactive
waste management procedures.
 Ensure that the radioactive waste is being dispose of in accordance with the Waste
Management Plan.

Hospital Administrator
The Hospital Administrator will ensure that all members of staff are aware of their own
responsibilities for Health Care Waste Management.
Matron and Hospital Manager
The Matron (or Senior Nursing Officer) and the Hospital Manager are responsible for training
nursing staff, medical assistants, hospital attendants, and ancillary staff in the correct procedures
for segregation, storage, transport, and disposal of waste. They should therefore:
 Liaise with the Waste Management Officer and the advisers (Infection Control Officer, Chief
Pharmacist, and Radiation Officer) to maintain the highest standards;

4
 Liaise with Department Heads to ensure coordination of training activities, other waste
management issues specific to particular departments.
Pharmacist in-Charge
The Pharmacist in-Charge is responsible for the sound management of stores and pharmaceutical
waste minimization. The duties are to:
 Liaise with Departmental Heads, the Focal Point Person, the Matron, and the Hospital
Administrator, giving advice, in accordance with the national policy and guidelines, on the
appropriate procedures for pharmaceutical waste disposal;
 Coordinate continuous monitoring of procedures for the disposal of pharmaceutical waste.

Infection Control Officer

The Infection Control Officer should liaise with the Waste Management Officer on a continuous
basis and provide advice concerning the control of infection and the standards of the waste
disposal system. His or her duties are to:
 Identify training requirements according to staff grade and occupation;
 Organize and supervise staff training courses on safe waste management;
 Liaise with the Department Heads, the Matron, and the Hospital Manager to coordinate the
training.
Laboratory department

 Ensure necessary steps for educating of staffs on the safe handling and disposal of various
waste which include hazardous ,sharps, infectious
 Its also encompasses all necessary tracking of waste after is is removed from the department
and from the facility.

Waste Management Officer (WMO)

The Waste Management Officer is responsible for the day-to-day operation and monitoring of
the waste management system. However, in the area of waste collection the Waste Management
Officer will;
 Control internal collection of waste containers and their transport to the central waste storage
facility of the hospital on a daily Basis.

5
 Liaise with the Supplies Department to ensure that an appropriate range of bags and
containers for health-care waste, protective clothing, and collection trolleys are available at
all times;
1.9. WASTE PRACTICES
Full set of personal protective equipment (PPE), with gloves, mask, shoes and apron, will be
provided to the waste handlers because lack of sufficient Person Protective Equipment, and
knowledge regarding correct usage and benefits of using Person Protective Equipment, might
expose them to infections and injury . The waste handlers, nurses and all healthcare workers
should immunized against hepatitis B thrice (initially, on first month, and after six months), and
then 2–3 months later. The booster dose would be given after 5 years.

1.8. QUANTITIES OF WASTE GENERATED

Based on Health Care Waste Management assessment report. A one day waste generation
survey was conducted at the Theresa chileshe’s facility on 20 th of June, 2023 with the objective
of identifying current situation of hospital on healthcare waste management. With the average
patient occupancy of 63%, it is revealed that the waste generated within five(5) months periods
from the health facility 1131Kg out of which 409 Kg (36.2%) is general healthcare waste (Non-
hazardous) while, Chemical, radiological, cytotoxic and pharmaceutical( Harzadous health care
waste) 397Kg (35.1%) and the Infectious,sharps and pathological( Harzadous health care waste)
325Kg (28.7%) is healthcare risk waste. As per WHO standard, Waste in Health Care Facilities
should be around 20% hazardous and 80% non-harzadous waste.

6
Estimate of waste generation at Health Care Facility

Pie chart below shows the percentages of typical

waste compositions at Health's facility

29%
36%

35%

General ( Non- Hazardous health care waste) 36.2%

Chemical, radiological,cytotoxic and pharmaceutical( Hazardous health care waste) 35.1%
Infectious,sharps and pathological( Hazardous health care waste) 28.7%

Based on the information demonstrated on the pier chart, the following precaution should
be taken.
 If on-site treatment is impossible or uneconomical, cooled storage facilities should be
provided and there should be a regular collection by a contractor who has suitable
incineration facilities.
 Highly infectious waste should be autoclaved or incinerated on site whenever possible and
should be handled only by trained and authorized staff.

Health Care Waste at the health facility

Health facility were assessed to verify the health care waste generation capacity per month. It
was estimated that, health facilities have the potential of generating upto 0.12 tonnes within the
period of five months of infectious health care waste. Currently the estimated waste generation
is at 1131 Kg in a period of five months.

7
2.0. WASTE MINIMIZATION AND REUSE.
Protecting public health through the management of wastes can be achieved by a variety of
methods. These can be summarized in an order of preference called the ‘waste hierarchy with the
most desirable method at the top to the least desirable at the base.

Most preferable
Prevent
Reduce
Reuse
Recycle
Recover
Treat
Least preferable

Least
1.8. HEALTH CARE WASTE HANDLING PRACTICES
Segregation will:

 Always take place at the source, that is at the ward bedside, Operation Theatre, Medical
Analysis Laboratory, or any other room or ward in the hospital where the waste is
generated.
 Be simple to implement for the medical and ancillary staff and applied uniformly
throughout the country.

Black Yellow Brown

 Non-risk waste of category  Infectious waste and  Pharmaceutical waste of
 Exceptionally, small quantity of highly infectious waste categories B3,
waste of categoryB1 of categories C1 and C2  Classes B32 and B33
 Pharmaceutical waste of radioactive waste of category D such as
category B3, class B3.1 only category chemicals, heavy metal
wastes

8
1.9. Collection and on-site transportation
In order to avoid accumulation of the waste, it will be collected on a regular basis and
transported to a central storage area within the Health care facility before being treated or
removed. The collection will follow specific routes through the facility to reduce the passage of
loaded carts through wards and other clean areas.

The carts should be, easy to load and unload, have no sharp edges that could damage waste bags
or containers and easy to clean

2.1. Waste handling

Great care will be taken when handling health care wastes. The most important risks are linked
with the injuries that sharps can produce.

When handling health care wastes, sanitary staff and cleaners should always wear protective
clothing including, as minimum, overalls or industrial aprons, boots and heavy duty gloves.

2.2. On-site storage

The wastes will be temporarily stored before being treated or disposed of on-site or transported
off-site. A maximum storage time should not exceed 24 hours. Non-risk wastes will always be
stored in a separate location from the infectious / hazardous wastes in order to avoid cross-
contamination.

2.3. Transportation
Transportation will be required when hazardous waste will be treated outside the facility. The
transportation will always be properly documented and all vehicles will be carrying a
consignment note from the point of collection to the treatment facility.

The waste producer is then responsible for the proper packaging and labelling of the containers
that are transported. One of the reasons for labelling wastes bags or containers is that in case of
an accident, the content can be quickly identified and appropriate measures taken.

9
2.4. MONITORING AND EVALUATION

Regular reporting and field visits as well as a good information system to store and analyse the
data are the basis of an efficient monitoring plan. The monitoring plan aim at providing relevant
information for two different but complementary objectives:

 Progress in the implementation of the Health Care Waste Management plans within the
Health Care Facility and evaluation of the impact of the Health Care Waste Management
Plan.
 Measure the Operation and Maintenance performance of the health services to maintain a
good standard of Health Care Waste Management within the Health Care Facility.

2.5 CONTIGENCY PLANS

The Contingency Plan shall be used by the Primary or Secondary Emergency Coordinator for
emergencies involving chemical spills, releases to the environment, and fires or explosions
involving chemical substances.

Control Procedures
The primary chemical spill emergency control measure will be the adequate provisioning of
containment areas.
Access to and housekeeping of each department shall be the responsibility of the organization
that is the end user. The end user shall monitor the building to ensure chemical waste storage
capacity is not exceeded and that all materials are stored with compatible materials.

2.6. EMERGENCY PROCEDURES IN CASE OF SPILLAGES OR ACCIDENTS

In case of accidents or spillages, the following action shall be taken:

 The contaminated area shall be immediately evacuated, if required;

 The contaminated area shall be cleared and, if necessary, disinfected;

2.7. RECORDING KEEPING

The Waste Management Officer shall immediately investigate, record and review all such
incidents to establish causes and where necessary shall amend the Waste Management Plan to
prevent recurrence. The transportation of waste is properly documented, and all vehicles carry a

10
consignment note from the point of collection to the incinerator or landfill or other final disposal
facility, and all vehicles are cleaned and disinfected after use.

2.8. TRAINING OF STAFFS

Capacity building of health care workers through comprehensive training and orientation. All
healthcare staff should be aware of the technical aspect of hospital’s basic healthcare waste
management and their role in the plan. They shall be properly trained and prepared for
emergency response. For this hospital will arrange training on waste management and on its
implementation plan.

2.9. ESTIMATION OF COST RELATING TO WASTE MANAGEMENT

Accurate record-keeping and cost analysis must be undertaken by a designated individual.

Health-care waste costs should be the subject of a separate budget line. This allows costs for
different periods to be compared and helps to reduce management costs.
Estimation Of Cost Relating To Waste Management:
Item/Activity Unit Cost Multiplying Cost (ZMW) Source of
(ZMW) Factor funding
Incinerator 25,000.00 1 25,000.00 GRZ
Biohazard 550.00 7 3,850.00 GRZ
boxes
PPEs 450.00 9 4,050.00 GRZ
HCWM 38,000.00 1 38,000.00 GRZ
workshops
Storage waste 345.00 11 3,795.00 GRZ
receptacles
Total 74,695.00
Total Contingency @ 10% 7,469.50

3.0 STRATEGY FOR THE IMPLEMENTATION OF THE PLAN

Implementation of waste management plan is the responsibility of the head of a health care
facility and the following shall be the steps of implementation of the waste management plan:
 Provision for future expansion of the hospital or of waste storage facilities shall be made.
 The officer in charge appoints personnel to the post with the responsibility for waste
management.

11
3.1. SECURITY MEASURES
A range of measures will be developed in relation with the handling and the treatment or disposal
of Health Care Waste to promote personal hygiene and protective measures. These measures will
also concern municipal staff operating in solid waste management at the city level.
Personal hygiene
Basic personal hygiene is important in reducing the risks that occur from handling Health Care
Waste. Hospital administrators and planning officers should ensure that washing facilities are
made available to people handling Health Care Waste. This is particularly important at storage
and treatment facilities.
Personal protection
As already mentioned, staff which are in contact with Health Care Waste should wear the
following personal
Protective clothing:
 Suitable heavy-duty gloves when handling HCW containers;
 Safety shoes or industrial boots to protect the feet against the risk of containers being
accidentally dropped;
3.2. MANAGEMENT INFORMATION SYSTEMS
Standard documents should be used to manage health care waste at the health facility as follows:
 Standardize recording and management procedures to be followed.
 Set-up a reliable information system.
 Establish adequate control and backstopping procedures.

3.4 BUDGET AND EXPENDITURES

The table below shows the annualy budget for the health facility. This budget contains the items
and the cost of each for a year. Therefore, each year the waste management committee will be
reviewing the budget and makes some necessary amendments if required.

12
BUDGET ITEMS UNITY MULTIPLYING COST
COST FACTOR KWACHA
KWAC
HA
Incinerator( Commercial)
 Building of incinerator 40,000 1×1 40,000
 Consultancy fees 5,000 1×1 5,000
(Environmental/waste
management
consultant
Engineering
Architectural)

Maintenance fee 1000 100×10 10,000

Subtotal K55,000
Storage facilities
 Waste storage room 15,000 1×1 15,000
 Refrigerators for storage of 20,000 1×5 100,000
waste if Necessary

Subtotal K115,000
Waste transport
 Waste collection trucks 500,000 1×2 10000000
 Bins/containers for transporting 200 1×10 2000
waste from
from hospitals to incinerator site

Subtotal K1002000
Equipments and PPE( Personal protectives equipments
 Trolleys for collecting waste 12,000 12,00×4 48,000
bags
from wards
 Yellow bags with tags for 150 150×5 750
infectious
wastes
 Black bags for non-risk 150 150×5 750
13
 waste
 Sharps container 200 200×5 1000
 Chemicals 700 700×6 4200
 Thermometers 1000 1000×5 5000
 Sterilizers 1000 1000×5 5000
Subtotal K64700
PPE( Personal protectives equipments)

 Boots 150 150×6 900

 Industrial Gloves 100 100×7 700
 Overals 400 400×5 2000
 Face masks 100 100×5 500
 Eye glasses 150 150×5 750

Subtotal K4,850
TOTAL K1241,1550
CONTIGENCY K124,114
GRANT TOTAL K12,545,664

3.5. PROCUREMENT PROGRAMMES

The Procurement Officer or department should liaise with the Focal point Person to ensure a
continuous supply of the items required for waste management (plastic bin liners in approved
colours and containers of the right quality, spare parts for on-site health-care waste treatment
equipment, purchase of waste transport tricycles, bin trolleys, hand-held thermometers and it
should be based on the budget constituted.

3.6. CONCLUSION
The absence of or improper management measures to prevent exposure to hazardous health-care
waste (HCW) results in important health risks to the general public, in and outpatients as well as
the medical. However, the lack of resources in the health sector tends to affect negatively the
way Health Care Waste is managed. Therefore, implementations of health care waste
management plan will in the managing of health care waste generated in the health care facility.

14
APPENDICES

Chemical waste

Period 1 2 3 4 5
Chemical volume 34 42 43 46 48
weight

15
waste Accumulative 34 76 119 165 213
wastes

Sharp waste

Period 1 2 3 4 5
Sharp volume 29 25 33 32 29
waste weight
Accumalative 29 54 87 119 148
waste

Infectious waste

Period 1 2 3 4 5
Infectious volume 19 22 25 33 21
weight
waste
Accumulative 19 41 66 99 120
waste

Accumulative
Waste

16
250 Chemical waste Sharp waste Infectious waste

213
200

165
150 148

119 119 120

100 99
87
76
66
50 54
41
34
29
19
0
Month 1 Month 2 Month 3 Month 4 Month 5 Period

17