Systems Approach to Health-care Waste Management

This thesis attempts to examine the situation of health-care waste management in Guyana using a systems approach and to understand the roles of government in mandating, facilitating, and initiating a reduction of the adverse impacts related to human health and environment. It examines the existing situation of health-care waste management using the principles of the viable system model to guide the analysis and to identify the function(s) and level of interactions among the actors. Health-care waste management is of serious concern in Guyana. Region 4, which includes the capital city of Georgetown, is the largest generator of health-care waste in the country and the country’s largest hospital, the Georgetown Public Hospital Corporation is the main contributor. Moreover, smaller facilities such as Health Centres are widely dispersed throughout the country thereby increasing the risks in the absence of environmentally sound management. The research focused on private and public hospitals and health centres in Georgetown and the rural region of West Demerara. In Guyana waste separation is a recent phenomenon for health-care facilities. However it is limited and depends on awareness and the availability of necessary equipment such as bin liners and sharp boxes. These facilities lack the requisite standards and procedures for waste management. In the absence of treatment, poor handling practices and rudimentary methods for disposal, there are adverse effects on public health and environment. Interventions by government are necessary in order to achieve environmentally benign behaviour. The government has a key role in collaborating with the stakeholders involved in health-care waste management as well as changing behaviour through regulation and increasing the level of awareness. This research therefore concludes the key role of government is to mandate changes through mandatory instruments to immediately address the situation of health-care waste in Guyana.