Training at national level

Also most of the training and awareness efforts with regards to HCWM will have to be made at the level of HCFs, a number of actions should be taken at national level to:

• secure governement support;
• raise awareness amongst the public about HCW risks.

Two other important issue that must be addressed at national level are:

• make sure that medical staff training curricula includes a component on HCWM;
• ensure that waste management operators (transporters, treatment plant and landfill operators…) get appropriate training and support.
  
  

Lobbying decision makers

Securing government commitment and financial support for safe HCWM can only be achieved if decision makers are convinced of the importance of the subject. Raising awareness amongst them is therefore a critical step to be taken and should be essentially conducted using arguments pertaining to public health and environmental risks that arise when HCW isn't managed in a safe and appropriate manner.

If the country is signatory to the Basel Convention, legal arguments may also be used.

Public education on hazards linked to healthcare waste

Different methods can be used for public education on risks, waste segregation, or waste disposal practices:

• In HCFs by displaying posters at strategic points such as waste bin locations, giving instructions on waste segregation. Posters should be explicit, using diagrams and illustrations to convey the message to as broad an audience as possible, including illiterate people.
• Outside HCFs, simple messages can be conveyed through schools, radio or television programmes, raising awareness about the risks involved in scavenging discarded syringes and hypodermic needles, etc…

For maximum effectiveness, all information should be displayed or communicated in an attractive manner that will hold people’s attention.

HCFs should set an example to society by managing their waste in a manner designed to protect both health and the environment. In this respect, waste bins should be easily accessible for patients and visitors and should be clearly marked with the waste category for which they are intended.

Training curricula of medical staff

A review of the training curricula of the medical faculties and schools for nurses to make sure appropriate training is provided in the area of HCWM.

Minimal training should include:

• information on, and justification for, all aspects of the healthcare waste policy;
• information on the role and responsibilities of each hospital staff member in implementing the policy;
• technical instructions, relevant for the target group, on the application of waste management practices.

Training of non-medical staff that handle HCW

The minimal training for all waste management operators should include:

• information on the risks associated with the handling of healthcare waste;
• procedures for dealing with spillages and other accidents;
• instructions on the use of protective clothing.

Administrative procedures (regulations; record keeping; reporting of spillages, accidents and other incidents) as well as technical operation and maintenance of the systems used should also be tought.

Resources

The WHO manual "Safe management of wastes from healthcare activities" provides in chapter 15 some useful recommendations in respect to training issues.