Abstract:
Health care or medical solid wastes, if not managed properly, can pose serious health damage
and spread various diseases. The main objective of this study was to develop a hospital waste
management index (HWMI), which would indicate the overall condition of medical waste
management in a hospital. A list of thirty three parameters having significant influence on
medical waste management was identified from relevant national and international guidelines.
The relative importance grading of these parameters was done to understand which parameters
were more important with respect to overall hospital waste management. The grading values
(from 5 to 1) were reflective of qualitative significance of parameters: „most important‟,
„important‟ „essential (loss of life may not occur, but other losses and injuries are high)‟,
„essential (damage of health and injuries are considerable)‟ and „not essential (but preferable)‟,
respectively. Importance grading of the parameters were collected from eight experts from
relevant Government (DGHS, DoE, DU) and non-government (Prism, ICDDR,B) authorities
working in the field of hospital waste management. From the experts‟ evaluation, the parameters
were ranked based on the weighted average of relative importance grading of each parameter. A
total of 30 hospitals were physically surveyed (twenty four hospitals inside Dhaka city and six
hospitals outside Dhaka city) to assess condition of the selected parameters and a rating of each
parameter was done (on a scale of 0 to 5). Physical survey rating values (from 5 to 0) represented
qualitative conditions of parameters like „excellent‟, „good‟, „average‟, „poor‟, „very poor‟ and
„absent‟, respectively. Relative importance grading from experts and assessment of the
parameters from physical survey were combined to produce a Hospital Waste Management
Index (HWMI), which provided a dimensionless single value indicating overall waste
management condition of a given hospital. Comparisons were made between hospitals having
different management (Government. or non-government.) or locations (inside vs. outside of the
capital city). Privately owned and operated hospitals showed better hospital waste management
scenario compared to Government hospitals. The average HWMI for Government and private
hospitals were found to be 2.85 and 3.07, respectively. From the comparison of hospitals inside
and outside Dhaka it was found that, although hospitals inside Dhaka scored better points in most
of the parameters, the average HWMI of hospitals inside and outside Dhaka are 2.98 and 2.86
respectively, which is not statistically significant. This close value of HWMI resulted due to
high difference in some ratings of parameters in favor of hospitals outside Dhaka city.
