PROGRESS REPORT ON THE IMPLEMENTATION OF HEALTH CARE WASTE MANAGEMENT PLAN

1. PROGRESS REPORT ON THE IMPLEMENTATION OF HEALTH CARE WASTE MANAGEMENT PLAN Presented by Honest Anicetus National Coordinator Healthcare Waste Management Programme Directorate of Preventive Health Services Ministry of Health and Social Welfare Tanzania

2. Introduction • Tanzania has created an extensive network of Health –Care Facilities • There a total of 219 hospitals 481 HC and 4679 dispensaries • Of these the Govt own 64.2 • The Basel Convention rests the responsibility for waste management to the polluter and in this case, it is the Health facility.

3. Introd… • National Health Policy, address effectively the management of HCW • Development of Public Health Act, (2009). Which address protection of environmental health • The HSSP III which translate the NHP 2007 under strategy 8 - emphasize to provides for HCWM implementation at all level

4. Why Healthcare Waste • It pose a potential health risks to health workers, environment and community at large i.e HIV/AIDs • A Major input into the delivery of quality health services • Source of no-socomial infection in all health care facilities • Has a significant contribution in achieving the MDGs and specifically on; - Child Mortality due to unsafe and unhygienic delivery * sepsis/pneumonia account for high (30%) causes of infant mortality rate. • Maternal death following,Sepsis, HIV/AIDS, TB andother diseases. • Protect and sustaining the living environment.

5. Situational analysis • In 2001 and 2003 The Ministry of Health in Collaboration with WHO and WB conducted various surveys on HCWM • 2001 survey focused on quantities, types and practices of HCW generated in various HCF levels • 2003 situational analysis focused more on policy, institutional and legislation framework.

6. Situation analysisIdentified gaps • No specific policy on healthcare waste management • No legislation governing management of HCW • No clear plans and budget for managing healthcare waste at all levels • There is no formal categorization of healthcare waste • Color-coding for receptacles receiving different types of waste is not in practice. 3-bin system

7. Gaps(cont… Gloves (all waste handlers) • Sanitary labors were not protected • Access is not restricted and no protection from the weather (sun, rain and scavenging animals • No standardized safe ways of collecting sharps using standard containers • Highly infectious waste not separated and pretreated before being disposed. • Poor sanitation and unreliable water supply Boots for all waste handlers

8. Country initiative • In 2003 the Government of Tanzania in collaboration with World\Bank developed a National Action Plan on HCWM based on the situation analysis. Major components • Develop the legal and regulatory frameworks for HCWM; • Standardize HCWM procedures; • Facilitate provision of treatment and disposal facilities at medical institutions; • Launch training and awareness measures on HCW to Health workers.

9. Implementation Status of the National HCWM Plan. • the National Guidelines for Healthcare Waste Management in place • National Standards and Practices on HCWM set • Monitoring Plan for the NHCWM developed • Training Manual for Health Workers on HCWM -done • Designation of a National Coordinator for HCW management Programme; • Costing guideline for HCWM equipment

10. Future Plans • At National level • Encourage districts and health facilities to incorporate HCWM in the Comprehensive District Health Plans • Solicit support from key stakeholders and partners on HCW Management • Monitoring HCWM implementation • Capacity building to health facility staff and waste handlers • Facilitate provision of safe and adequate water supply and sanitation

11. Future plans…. Regional Level • Translate policy guidelines and standards into actions • Follow-up districts on HCWM monitoring issues • Support districts to solicit adequate funds for maintaining hospital hygiene • Ensure that the HCWM plan of each hospital is in conformity with the National Guidelines. They shall set up regular monitoring and control procedures. • Summarize district HCWM monitoring reports and forward them to the RHMT

12. Future plans… At District Level • Include HCWM in the CCHP and supervision checklist and Report on HCWM • Provide adequate sanitary latrines at facility level • Create community and house holds awareness on HCWM risks and provide adequate water supply and storage facilities at facility level • Supervise and inspect health facilities on the implementation of HCWM procedure • Ensure safe practices collection, storage, treatment and disposal of HCW

13. Future plans… Facility level • Ensure that monitoring tools are completed at each point in the HCW steam (generation, storage, transportation and disposal) • Identify gaps/weaknesses in HCWM process • Practice proper segregation, collection, storage, treatment and disposal of Healthcare waste • Order and procure working equipments for HCWM and ensure adequate sanitation • Monitor and supervise daily HCWM activities

14. Conclusion • With the few exceptions, the current HCWM practices observed in Tanzania are not yet safe and may have harmful effects to the health and environment. • Soliciting for appropriate financial sources for the regular implementation of the National health Care Waste Management Plan will remain a key issue for its application • Adequate supply of water and equipments at the health-care facilities will facilitate application of the standardized procedures • Last but one we need support of our development partners in financing the strategy and technical assistance where needed.

15. Thank you • Let us Keep our environment safe