Globally, governments and health care facilities struggle to meet community needs and achieve global goals for prevention of diseases, including HIV. Yet many facilities compromise health outcomes by failing to follow (or not knowing) procedures for infection prevention and control (IPC) and health care waste management (HCWM). HCWM is frequently neglected at all levels—from facility procedures to national policies. The combination of improper waste disposal and insufficient budgeting and planning for HCWM puts health care staff, patients, communities, and the environment at chronic risk from contamination and contagion.
This was the scenario in Nigeria’s Benue State, where AIDSFree began working in 2015. A 2013 assessment by JSI Research & Training Institute, Inc. showed that the majority of Benue’s health facilities lacked systems for HCWM, posing significant risk from hazardous waste. The state had no HCWM policy.
Beginning in November 2015, AIDSFree provided training and commodity seed stock to build capacity for HCWM and IPC. To support sustainability, the project facilitated stakeholders to develop state-level policies on IPC and HCWM by adapting the national HCWM policy to the needs of Benue State building consensus for the draft policy. To help guide implementation of the policy, the project supported a study tour to network with HCWM officials in Lagos State, where HCWM systems such as waste collection, transportation, and treatment (including publicprivate partnership), were already in place and functioning.
The combination of improper waste disposal and insufficient budgeting and planning for HCWM puts health care staff, patients, communities, and the environment at chronic risk from contamination and contagion.
By December 2015, Benue State had a robust collaboration among the state ministries of health and environment and the Benue State Environmental Sanitation Authority. AIDSFree provided technical assistance in quantification for procurement of essential supplies such as sharps boxes, bin liners, and protective equipment; and helped develop specifications for three high-temperature incinerators. These will be installed in three facilities, one in each of the three senatorial districts in Benue State.
Sound policies, supported by a realistic budget, are essential to ensuring the safety of health care workers, their patients, and their communities.
Benue now has a policy covering HCWM; and a budget line for HCWM is now included in the annual budget, which will ensure sustained availability of HCWM and IPC supplies. Benue’s waste management agency is currently focused on providing cascade-style training for all health care staff and ensuring safe disposal of transported waste. To that end, the high-temperature rotary kiln incinerator at the Federal Medical Center in Api is being prepared for reactivation.
AIDSFree’s work in Benue State underscores the fundamental role of HCWM policy in strengthening systems and fostering effective interagency collaboration. Sound policies, supported by a realistic budget, are essential to ensuring the safety of health care workers, their patients, and their communities.