Facilitators and barriers of infectious waste management practice in public and private health facilities of Addis Ababa, Ethiopia: a qualitative phenomenological study

埃塞俄比亚亚的斯亚贝巴公立和私立医疗机构传染性废物管理实践的促进因素和障碍:一项定性现象学研究

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Abstract

BACKGROUND: Management of infectious waste is essential to address health risks to healthcare workers, patients, and the public. Healthcare facilities, especially in resource-poor settings, however, face significant challenges in effectively and safely handling infectious waste. OBJECTIVE: This study is aimed to explore the barriers, and facilitators, infectious waste management in private and public health facilities to inform policy and practice improvement. METHODS: A qualitative study employed a descriptive phenomenological design was used in a public and private health facilities in Addis Ababa, Ethiopia from November 30 to December 30, 2023. Data were collected through 16 key informant interviews and 12 focus group discussions with the health care providers, waste management staff, and other stakeholder involved in infectious healthcare waste management. Participants were purposively selected based on their roles in infectious waste management. All interviews and discussions were audio recorded, transcribed verbatim and analyzed thematically using ATLAS.ti software. RESULTS: Several barriers to effective infectious waste management were identified, including lack of strategic planning, inadequate financial resources, poor infrastructure, and limited training opportunities. Insufficient waste segregation facilities, shortages of specialized waste containers, and irregular waste collection services further hindered proper waste disposal. Facilitators included strong institutional support, targeted training programs, monitoring mechanisms (e.g., waste audits), and reliable disposal services. Motivators for improving waste management included greater stakeholder engagement, financial investment, and integration of waste management into broader healthcare policies. CONCLUSION: Addressing financial constraints, improving training programs, strengthening infrastructure, and fostering stakeholder collaboration were critical for enhancing infectious waste management in healthcare settings. The study highlighted the need for strategic planning, policy revision, and sustained investments to ensure sustainable and safe infectious waste disposal practices.

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