Life cycle check as a decision support tool for medical waste management in underdeveloped areas of Africa

Abstract

In most developing countries, the emphasis for health care has moved to community preventative services and away from district curative health services, e.g. immunization. Sterilization and reuse is being replaced with single use and disposal to minimize the risk of cross infection. This has lead to larger amounts of infectious waste in underdeveloped areas. The responsible authorities and agencies do not have waste management infrastructure to safely handle and dispose of the waste. Although not recognised as a significant problem before, health care professionals now require allocation of funds that were previously not identified. In Africa where much of the health care currently receives donor funds, these professionals are also obliged to comply with national regulations and international protocols for waste disposal, mostly only known to specialist waste management practitioners. In order to address these problems a Check List has been developed for planning at District, Regional, and National Managerial levels, using a Streamlined Life Cycle Analysis (SLCA) according to ISO 14040. SLCA can evaluate parameters of the waste life cycle qualitatively and thereby reduce the time and cost of conducting a comprehensive, quantitative life cycle analysis. The SLCA was compiled from data obtained through a case study of an African country and was used to evaluate different management options for health care waste in such a country. The checklist is aimed at providing decision makers and waste management practitioners with a tool to prepare budgets and waste management plans. The planning tool will be discussed using a process assessment and a comparison between waste management options.