Challenges in waste segregation in resource limited rural hospitals
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Abstract
Biomedical waste management is a critical aspect of healthcare that significantly impacts the environment and the carbon footprint of the industry. The generation of biomedical waste is inherent in medical procedures and research, affecting both human and animal healthcare settings. Challenges in managing this waste include proper segregation, safe handling, timely transportation, and deposit to central treatment facilities, with variations in difficulties across urban, semi-urban, and rural areas. Rural regions often face greater hurdles due to longer distances to treatment facilities, inadequate training, limited resources for documentation, and the absence of specialized personnel like Infection Control nurses. This article explores the disparities in biomedical waste management across different healthcare settings and proposes solutions to address these challenges, emphasizing the need for equitable access to resources, training, infrastructure, and expertise in rural areas.
Introduction
Another important challenge would be ensuring the continuous handholding and support from the CBWTF that facilitates the proper biomedical waste management in urban and semi urban areas. This continuous interaction, positive reinforcement and critical feedback often serve as a driving force for continual compliance to the Biomedical waste guidelines.
On the other hand, the periodic visit of the institution to the CBWTF may also hampered by the inaccessibility, which may fuel the knowledge gap in the institution. The distant and sporadic collaboration would also leave space for unequal implementation of innovations in these rural institutions.
The required training of the healthcare providers by the CBWTF, which occurs as if clockwork in the urban and semi-urban settings, are often few and far apart in the rural settings, for obvious reasons. Continuous training and reinforcement are pivotal in biomedical waste segregation, as it is done at the point of generation, and wrong segregation puts the entire process at risk.
Lack of availability of trained manpower like Infection Control nurses in the rural scenario. The biomedical waste audit and housekeeping audit, which form part of the routines of infection control nurses, are pivotal in continual compliance with the guidelines and policies.
In rural settings, the availability of web, software and service provider support required for the automated documentation of daily, monthly, and annual reports of waste generation and transactions is often manual, long and drawn out.
An often-flourishing aspect of healthcare in the rural setting is the livestock and veterinary industry. A significant amount of biomedical waste is generated in the veterinary sector, and there exists much scope for improvement with respect to adherence to biomedical waste management guidelines.
Challenges
To address these challenges, we need to ensure that there are CBWTFs established evenly and with adequate spacing in the rural areas. The CBWTFs should be adequately manned and with all required expertise. Adherence to the recommended guideline of clearance once in 48 hours should be ensured. Similarly, periodic visits to the CBWTF should be encouraged to ensure a proper understanding of the processes involved, and the repercussions of wrongful practices. Periodic updates and reports of wrongful segregation, if any should also be ensured.
The need for software and IT infrastructure and correspondingly trained manpower should be ensured by the Local self-governing bodies, and the importance of the same should be communicated by key professionals in the state/ nation.
Provisions for recruitment of Infection Control nurses should be made nationwide, with prioritisation for rural settings, understanding the need for having these professionals to ensure continued compliance.
Measures should be in place to ensure the inclusion of veterinary medical facilities as an important stakeholder in the process. All aspects if biomedical waste management should be implemented and monitored as in the case of hospitals and dispensaries.
We cannot move towards a better tomorrow and better biomedical waste management, when a section of the country is unable to keep up. We should prioritise the process of building a good network of compliant healthcare facilities in the rural areas, for a wholesome approach to biomedical waste management.
Conclusion
The effective management of biomedical waste presents varying challenges across healthcare settings, with rural areas encountering distinctive hurdles due to geographical constraints, resource limitations, and inadequate expertise. To bridge these gaps, it is imperative to establish well-equipped treatment facilities evenly across rural regions, ensuring timely waste clearance and encouraging periodic visits for knowledge dissemination. Investment in IT infrastructure and documentation and compliance monitoring training is crucial and supported by local governing bodies. Moreover, recruiting and deploying Infection Control nurses in rural areas should be prioritized to maintain continual compliance with waste management protocols. Integrating veterinary facilities into the waste management framework and monitoring their adherence to guidelines is also pivotal.
