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As per the national legislation and regulation, MOPH has the responsibility to address environmental concerns in the project. Besides, development of a comprehensive Health Care Waste Management Plan (HCWMP) is a key covenant of SEHAT Project. Therefore, the MoPH developed a Preliminary HCWM Plan for the first 6 months of the SEHAT project in 2012. The major interventions that were recognized included development and adoption of guidelines for effective healthcare waste management, creating awareness and training to the end user/the waste producer/waste handler.
The preliminary HCWM plan was not purported to cover many issues in detail. To prepare a detailed plan based on the recommendation of the preliminary plan, MoPH recruited an international consultant to work on development of a comprehensive healthcare waste management plan.
The consultant along with the officials from the Environmental Health Directorate at Ministry of Public Health, undertook field visits in Kabul, Parwan, Panjshir, and Balkh provinces having detailed interactions with various stakeholders including the health care facilities (e.g. national hospitals, regional hospitals, provincial hospitals, district hospitals, comprehensive health centers, basic health centers), international funding agencies, various department of MoPH, non-governmental organizations, landfill sites, municipalities, regulatory bodies, and other relevant agencies.
The inputs from the desk research, and interaction with the stakeholders were useful in assessing the regulatory framework and its compliance in practice, present status of HCWM at different types of HCFs, quantities of health care waste (HCW) generated, current technology in use for treatment of HCW and its disposal, monitoring & evaluating mechanism, and training needs assessment. The specific issues such as segregation of HCW and color coding practices, type of equipment in use for collection & transportation, use and disposal of sharps, development of landfill facilities for HCW disposal, and status of infection control were addressed. The plans for management of HCW from rural areas have been worked out separately based on the interaction with the various stakeholders.
These inputs were useful in developing recommendations for the HCWMP. A gap analysis was also undertaken to compare the present status and the recommendations made. The Comprehensive HCWMP duly incorporates the gap analysis as well as the capacity of the various stakeholders to adopt and implement the proposed plan.
The plan contains major guidelines to be followed during the implementation stage-which by itself is another covenant of SEHAT- provision of pilot projects for CWTFs, alternate technologies for the remote and rural areas, third party monitoring and evaluation framework, format and contents of training programs, procurement policy for major treatment technologies and safety equipment, and construction guidelines for sharp and burial pits.
To review the full plan please click to the following link: