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SAFE DISPOSAL OF SYRINGES AND NEEDLES

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paying particular attention to primary health facilities (PHFs) where ... Dispositek system for Dar es Salaam. Capacity for all health waste commercial. So, low cost ... – PowerPoint PPT presentation

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Title: SAFE DISPOSAL OF SYRINGES AND NEEDLES


1
SAFE DISPOSAL OF SYRINGES AND NEEDLES
  • In The Context Of Health Care Waste Management
    Systems
  • WHO Taskforce on Immunization (TFI)
  • Luanda, 3-5 December, 2003

2
Waste Workshops GAVI-ITF Workplan 2002-3
  • to review the problem of infectious waste
    management,
  • paying particular attention to primary health
    facilities (PHFs) where immunizations are
    conducted,
  • to review potential technical solutions and
  • to recommend priority actions for national
    planning

3
Issues RaisedTechnical optionsGeneral
recommendations
4
Issues raised
  • Absence of HCWM legislation
  • Poor results of HCWM surveys
  • Problems of small-scale incinerators
  • Lack of waste segregation and sharps boxes in
    PHFs

5
Issues raised (1)
  • Absence of HCWM legislation

of countries
6
Issues raised (2)
  • Absence of HCWM legislation
  • Poor results of HCWM surveys
  • No HCWM rules at PHFs
  • Little segregation of waste
  • Few sharps boxes
  • On-site is by burial or by open burning danger to
    community
  • Small-scale incinerators poorly installed,
    misused and not staffed
  • Many hospital-based incineration systems have
    fallen out of use
  • Little hospital HCWM support for primary health
    facilities

7
Issues raised (3)
  • that the small-scale incinerator has an important
    part to play until research has produced more
    environmentally acceptable and affordable
    alternatives
  • A guideline on the construction methods and
    materials, the correct use and the maintenance of
    these incinerators January 2004
  • Absence of HCWM legislation
  • Poor results of HCWM surveys
  • Problems of small-scale incinerators

8
Issues raised (4)
  • Absence of HCWM legislation
  • Poor results of HCWM surveys
  • Problems of small-scale incinerators
  • Lack of waste segregation and sharps boxes in PHFs
  • Safety boxes used for campaigns
  • Some use in routine
  • None in curative
  • Cost high
  • Local production rare

Senegal 2001
9
Critical indicators of progress
  • National HCWM committee or coordination mechanism
    established
  • HCWM legislation enacted and policies published
  • National injection safety plan prepared
  • HCWM rapid assessment conducted
  • District micro-plans for syringe disposal made
    and implemented
  • Safety boxes provided for all injections

10
Technical options presented
11
Technical options
  • Infectious sharps waste handling
  • Technologies and procedures
  • Final destruction/recycling
  • Incineration, both centralized and on-site at
    PHFs
  • Non-incineration processing of waste

12
Technical options(1)
  • Infectious sharps waste handling technologies and
    procedures
  • Segregation for PHFs
  • Sharps yellow
  • Non-hazardous waste black
  • Hazardous HCW yellow
  • Needle removal reviewed
  • Trials in India, Eritrea, Senegal, and soon Kenya
  • Benefits shown
  • Evaluation continues to 2004

13
Technical options(2a)
  • Infectious sharps waste handling technologies and
    procedures
  • Incineration, both centralized and on-site at
    PHFs
  • Centralized
  • Dispositek system for Dar es Salaam
  • Capacity for all health waste commercial
  • So, low cost
  • Out of town, meets e-standards
  • Interest shown by Uganda, Kenya, DRC.,
    Ghana,Mozambique

0.24-0.42US/kg Compared to 3.50US/kg in
Hospitals
14
Technical options(2b)
  • Infectious sharps waste handling technologies and
    procedures
  • Incineration, both centralized and on-site at
    PHFs
  • District collection small-scale
  • Serves 10 to 30 PHFs by collection system
  • DeMontfort lowest cost, built on site model
  • Emissions OK if
  • WHO Guidelines to be followed
  • UNICEF to supply kits for local assembly

15
Technical options(3a)
  • Infectious sharps waste handling technologies and
    procedures
  • Incineration, both centralized and on-site at
    PHFs
  • Non-incineration processing of waste
  • Centralised collection systems require
  • Autoclaving
  • Shredding/grinding
  • Industries that use recycled plastics

16
Technical options(3b)
  • Infectious sharps waste handling technologies and
    procedures
  • Incineration, both centralized and on-site at
    PHFs
  • Non-incineration processing of waste
  • Decentralised processing at each PHF
  • Research on Solar Melters in Senegal
  • Sterilizes, compacts to cakes for recycling

Cost approx. 200-250US
17
Summary of options
  • Segregation of waste (3part) and use of safety
    boxes for ALL sharps
  • Needle removal at point of use (subject to
    validation policy revision)
  • Centralized, outsourced waste processing for
    large cities (eg. Dispositek)
  • Hospital incineration to serve surrounding PHFs
  • District infectious waste collection and
    small-scale incineration (eg. DeMontfort)

18
General recommendations
19
General Recommendations (1)
  • Every country should have a collaborative
    mechanism for developing a regulatory framework
    for HCWM
  • National HCWM Committee to develop policies for
    handling, processing and final destruction of
    infectious waste

20
General Recommendations (2)
  • Every country should have a collaborative
    mechanism for developing a regulatory framework
    for HCWM
  • Every country should have and pursue a national
    plan for HCWM based on a national assessment
  • Segregation of infectious and sharps waste
  • Centralized systems of waste collection and
    destruction/processing to serve urban areas
  • Small-scale incineration to serve PHFs
    installed, used maintained properly

21
General Recommendations (3)
  • Every country should have a collaborative
    mechanism for developing a regulatory framework
    for HCWM
  • Every country should have and pursue a national
    plan for HCWM based on a national assessment
  • External partners are exhorted to assist
    countries to establish and implement their HCWM
    plans
  • GAVI asked to emphasize importance of HCWM in
    policies
  • Vaccine Fund is asked to include a larger portion
    of disposal costs in the current safety grant
  • Governments are requested to make adequate
    provision for the recurrent costs of the new HCWM
    systems

22
Thank you!
23
Recommendations
  • Every country should have a collaborative
    mechanism for developing a regulatory framework
    for HCWM
  • Every country should have and pursue a national
    plan for HCWM based on a national assessment
  • External partners are exhorted to assist
    countries to establish and implement their HCWM
    plans
  • INDICATORS
  • National HCWM committee or coordination mechanism
    established
  • HCWM legislation enacted and policies published
  • National injection safety plan prepared
  • HCWM rapid assessment conducted
  • District micro-plans for syringe disposal made
    and implemented
  • Safety boxes provided for all injections

24
Waste Workshops GAVI-ITF Workplan 2002-3
  • General recommendations
  • Main issues raised in workshops
  • Technical options available and in evaluation
  • Current status of planning and implementation

25
Current status of planning and implementation
  • Legislation and policy
  • Planning and implementation

26
Legislation and policy (1)
East Africa
Southern Africa
WHO/ICP East African Block analysis
27
Legislation and policy (2)
West Africa
Central Africa
WHO/ICP West African Block analysis
28
Planning and implementation (1)
East Africa
Southern Africa
WHO/ICP East African Block analysis
29
Planning and implementation (2)
West Africa
Central Africa
WHO/ICP West African Block analysis
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