This is the fifth and last topic in my six-part Vaccine Supply Chain Futures series focused on the potential to address safety issues related to the management of sharps waste including syringe and needles.
Progress of efforts to achieve safe infectious sharps disposal in many low to middle income countries is impeded by the lack of funding to establish an infrastructure of medical waste handling in the countries. Immunization generates a small fraction of the sharps waste in public health services but the clients for immunization are not ill at the time they make contact with the service. Rejection of the service is provoked by perceived risks to a healthy child from a preventive intervention. As tolerance of the public to perceived risks reduces towards zero, immunization should be a leading champion of safe disposal of injection materials.
Immunization services have introduced safe collection boxes for use syringes and needles. Many countries use on-site incinerators as an alternative to burial to dispose of filled safety boxes. In-spite of some progress in immunization services, disposal facilities remain far below acceptable standards, especially in health centers. Strategic options do exist and are described briefly in the attached paper. They depend on a new or stronger link between the financing and infrastructure of medical supplies together with disposak of infectious sharps. A successful outcome of efforts to establish safe medical waste disposal in a country should include:
- National policy for system of disposal of infectious sharps, centralized or localized
- National plan for the introduction of waste management infrastructure country-wide including disposal ‘hubs’ and transport integrated with supply
- Integration of disposal and supply via regulation of packing volumes and materials, and establishment of annual budget built on the workload/medical supplies anticipated
- SOPs in health facilities aligned with hospital waste management practices and adjustments made to in-service and basic training of health personnel
Please open attached file for full text.
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