Strengthening and Empowering Four Hub Hospitals of Kathmandu Valley on Healthcare Waste Management

Abstract

Background: Managing healthcare waste effectively is crucial globally, especially in Nepal, where facilities struggle with infectious waste due to COVID-19. Insufficient waste management in hospitals risks public health and the environment. This paper outlines a strategy in partnership with Health Care Without Harm (HCWH), Health Environment & Climate Action Foundation (HECAF360), and support from German Development Cooperation/ GIZ-S2HSS and Management Division/Department of Health Services, Nepal, to empower four COVID-19 hub hospitals as sustainable waste management models.
Method: Diagnostic waste assessments determined baseline waste generation in hospitals and identified gaps in their existing systems. The hospitals were capacitated to lead internal training, manage logistics, implement, and monitor their waste management systems, and be introduced to the Global Green and Healthy Hospitals Network.

Results: Initially, the four hospitals were generating, on average, 95% risk waste, which could be reduced to 31%. Starting with model wards, a new segregation system was rolled out, plus safe transportation and treatment by autoclaving. This also promoted recycling to generate revenue within a circular economy framework. Approximately 600 medical staff and waste handlers were trained, including training trainers and multiple orientation sessions from trained staff during implementation. This pool of experts, system monitoring, waste management committees, and long-term plans are designed to ensure sustainability.
Conclusion: By employing non-burn treatment technology, autoclaves, and ongoing mentoring, hospitals are empowered to take charge of tracking waste generation, autoclave use, waste sales, and disposal and be models of sustainability in Nepal.