Abstract
Background: Biomedical waste management (BMWM) is a critical component of infection control and environmental safety in healthcare systems. Despite the existence of regulatory frameworks, compliance remains inconsistent, particularly in resource-limited settings. This national survey was intended to identify the existing practice, the extent of compliance, and also issues of biomedical waste management in various forms of medical establishments.
Objectives: This study aimed to assess adherence to biomedical waste management guidelines across medical institutions, identify key operational challenges, and evaluate the impact of training, internal audits, and resource availability on compliance. Additionally, a composite compliance score was developed to compare performance across different types of healthcare facilities.
Methods: A nationwide cross-sectional descriptive survey was used, and 288 medical institutions were sampled through stratified random sampling in different regions, ownerships, and levels of care. The data were collected with the help of a structured questionnaire and observation checklist that was built based on segregation, storage, documentation, and PPE use practices. Some of the statistical tests that were conducted on SPSS and Excel software on the normality of the response involved t-tests, ANOVA, Kruskal-Wallis, Chi-square, correlation, and multiple regression.
Results: The normality of the proposed quantitative variables (p > 0.05) was met, and justified the use of parametric tests. There was good instrument reliability (Cronbach's Alpha = 0.91) and the validity tests indicated that the sampling is adequate (KMO = 0.812, p < 0.001). There were strong statistically significant differences between training status, type of institution, and level of care in compliance (p < 0.05). The correlation helped to realize that compliance and training (r = 0.63), internal audit (r = 0.59), and PPE availability (r = 0.55) are strongly and positively associated. The multiple regression analysis showed that all of them were important predictors of compliance (Adjusted R² = 0.57, p < 0.001), which indicates that both the competence of staff and institutional systems jointly increase the BMWM performance.
Conclusion: The study concludes that the waste management process in medical institutions is considerably influenced by the staff training and the internal control, along with the provision of safety measures. The level of compliance between the government and the tertiary hospitals is greater compared to the primary-level and the private hospitals. Compliance in the country can be greatly improved through making the training more effective and performing regular audits, and the regular provision of PPE. The findings outline the importance of human resource growth and system departmental intervention as one of the steps towards sustainable biomedical waste management.