The management of HCW

Supervision and management structures for HCW

HCWM is first of all a management issue before being a technical one and therefore completely depend on the commitment of both administrative and political authorites as well as the entire staff within HCFs. This dedication will only be possible if people are first of all properly trained and made aware of the risks that this particular type of waste poses.

At the (para-)medical level, it is important to make sure the curricula of future doctors, nurses, etc. includes this important public-health issue.

At the different administrative levels involved, clear institutional and individual responsibilities must be established.

Finding solutions despite limited resources

In many countries, the lack of resources in the health sector tends to affect negatively the way HCW is managed. Furthermore, for a given country, the situation can differ significantly from one region to the other depending on the resources (financial, human and material) locally available.

Under these adverse circumstances, planning remains a key issue. It requires the definition of a strategy that takes into account the given constraints and opportunities, appropriate allocation of resources, clear formulation of objectives, practical indicators of achievement and a well-structured timeframe.

Preparing and implementing a HCWM plan requires going through a number of steps and having in mind the different levels at which it will have to be implemented.

10 steps for a HCWM plan

1. Raise awareness of the problem, especially amongst policy makers.
   
   
2. Define a Policy (the rational for HCWM and what one wants to achieve).
   
   
3. Set up a Strategy (which is basically stating what steps must be taken to achieve the objectives that have been listed in the Policy).
   
   
4. Conduct an assessment of the current situation (using for example the WHO Rapid Assessment Tool).
   
   
5. Draft a HCWM Plan that should contain a National Action Plan (using for example the WHO general guidance document).
   
   
6. Consolidate the legal & regulatory frameworks.
   
   
7. Standardise HCWM practices (edit National Guidelines).
   
   
8. Strengthen the institutional capacities (human and financial resources; training, etc.).
   
   
9. Set up waste management plans at all relevant levels.
   
   
10. Establish a monitoring plan.
    
    
    

Resources

Guidance manual: «Preparation of national health-care waste management plans in sub-saharan countries» (2004) prepared jointly by the WHO and UNEP/SBC.

The Regional Center for Environmental Health Activities (WHO's Regional Office for the Eastern Mediterranean) provides information on the Basic steps in the preparation of health care waste management plans for health care establishments.