Healthcare waste management in Bangladesh: practices and future pathways
Book Chapter
Rahman, A, Talukder, B, Karim, MR. (2022). Healthcare waste management in Bangladesh: practices and future pathways
. 37-52. 10.1016/B978-0-323-85698-0.00008-3
Rahman, A, Talukder, B, Karim, MR. (2022). Healthcare waste management in Bangladesh: practices and future pathways
. 37-52. 10.1016/B978-0-323-85698-0.00008-3
Bangladesh has taken many initiatives to support the health of its growing population by investing in health infrastructure development, change management, and policy interventions. In implementing these initiatives, the country has experienced the exponential expansion of clinics and hospitals in recent years. These clinics and hospitals produce huge amounts of healthcare waste, resulting in a big threat to public health through environmental pollution. In this context, healthcare waste management (HCWM) has become a great concern for the country. To understand the present practices and future pathways for managing healthcare waste in Bangladesh, the present HCWM practices are identified and analyzed through a case study of Mymensingh Medical College Hospital (MMCH). A mixed methodology approach including a questionnaire survey and key informant interviews was deployed for data collection and verification. The study tries to explain the HCWM practice through the lens of ecological modernization theory, particularly the triad network model that encompasses economic, policy, and social networks. The findings highlight the current practice and reveal that waste is not segregated at the source or after collection. Improper waste collection, storage, transportation, and disposal practices lead to various health hazards and environmental risks. Nurses and cleaners are aware of HCWM processes, but doctors are less conscientious about it. Bangladesh's Medical Waste Management and Processing Rules, established in 2008, have not been fully implemented by the medical college or the municipality. The case study revealed that doctors play a dual role in the network structure of HCWM in both economic and policy spheres. In the economic network, nurses have good communication with doctors and cleaners as well as patients. However, communication is infrequent and less supportive in the policy network at the ministerial level. The media and NGOs do not play an effective role in the social network to demand safe and appropriate HCWM. To bridge these gaps, this study recommends effective communication among actors in different networks. Doctors and nurses should have access to the decision-making process of HCWM. In addition, NGOs can be involved in the process of management along with the government. Further, a separate section of the hospital must be established to monitor HCWM activities. Therefore, institutional transformation is needed for proper HCWM.
