Status of health care waste management plans and practices in public health care facilities in Gauteng Province, South Africa.

BACKGROUND: Health care waste management is a challenge due to the composition of the waste generated within a health care facility, of which 85% is domestic waste, and at least 15% is hazardous waste or health care risk waste (has been in contact with blood, body fluids or tissues from humans and could cause disease). In this study, we evaluated the status quo of health care waste management plans (HCWMPs) and practices in public health care facilities in Gauteng Province, South Africa. METHODS: A situational analysis was employed in health care facilities (HCFs) that generated more than 20 kg (N = 42) of health care risk waste (HCRW) per day. Data was collected from officials responsible for the management of health care waste using a self-administered questionnaire whilst Chief Executive Officers/ managers of the HFCs were interviewed. RESULTS: The results showed that most (79.0%) of the health care waste officers (HCWOs) as well as management (84.6%) agreed to have HCWMPs in place. The majority (76.9%) of the HCFs have a dedicated person appointed to manage health care waste with the majority (67%) being environmental health practitioners. According to management, only 30.8% have formally appointed an integrated HCW committee. Only 11.7% of the HCWOs are guided by the Occupational Health and Safety Act to develop their HCWMPs with only 20.5% with health care waste minimisation strategies in place. CONCLUSION: The study concluded that there is limited integration of HCWMPs as inadequate health and safety aspects, environmental pollution as well as community participation was reported. The novelty of the study is to contribute to a body of knowledge, information on the establishment of an effective health care waste management system in public health care facilities and for decision-making purposes.

Needs assessment to strengthen capacity in water and sanitation research in Africa: experiences of the African SNOWS consortium.

BACKGROUND: Despite its contribution to global disease burden, diarrhoeal disease is still a relatively neglected area for research funding, especially in low-income country settings. The SNOWS consortium (Scientists Networked for Outcomes from Water and Sanitation) is funded by the Wellcome Trust under an initiative to build the necessary research skills in Africa. This paper focuses on the research training needs of the consortium as identified during the first three years of the project. METHODS: We reviewed the reports of two needs assessments. The first was a detailed needs assessment led by one northern partner, with follow-up visits which included reciprocal representation from the African universities. The second assessment, led by another northern partner, focused primarily on training needs. The reports from both needs assessments were read and stated needs were extracted and summarised. RESULTS: Key common issues identified in both assessments were supervisory skills, applications for external research funding, research management, and writing for publication in the peer-reviewed scientific literature. The bureaucratisation of university processes and inconsistencies through administration processes also caused problems. The lack of specialist laboratory equipment presented difficulties, particularly of inaccessibility through a lack of skilled staff for operation and maintenance, and of a budget provision for repairs and running costs. The lack of taught PhD modules and of research training methods also caused problems. Institutionally, there were often no mechanisms for identifying funding opportunities. On the other hand, grantees were often unable to understand or comply with the funders' financial and reporting requirements and were not supported by their institution. Skills in staff recruitment, retention, and performance were poor, as were performance in proposal and paper writing. The requirements for ethical clearance were often not known and governance issues not understood, particularly those required by funders. CONCLUSIONS: SNOWS believes that working with African universities to develop networks that support African-led research driven by the local context is an effective approach to develop and retain research skills needed to change policy and practice in water, sanitation, and hygiene in Africa.