Healthcare waste management in Uganda: Management and generation rates in public and private hospitals in Kampala

Aim: The aim of this study was to assess the management, characteristics and generation of healthcare waste (HCW) in public and private hospitals in Kampala City, Uganda. Methods: We employed mainly qualitative methods through the use of a waste inventory, observations, document review and key informant interviews. The HCW inventory was done to determine the rate of generation of infectious waste and general waste in one public and one private hospital. Observations using an observation checklist were done to establish HCW management practices in three hospitals. Results: The average generation rate for infectious waste from Nsambya hospital (private hospital) was 0.23 kg/patient/day as compared to 0.25 kg/patient/day for Mulago (public hospital). Generation is influenced by type and state of sickness/ condition, the level or seriousness of the sickness, the number of people nursing the patient, the visitation rate/number of people visiting a patient and the items they carry to the ward. These factors can be used by health facility managers to minimize the quantities of healthcare waste generated. Conclusion: The study found no evidence that either public or private ownership is a decisive factor for the successful management of healthcare waste. However, contracting of healthcarewaste management services to a private party as was seen in the public hospital had resulted in improved services and this strategy should also be tried in private hospitals.