8TH INTERNATIONAL MEDICAL EXHIBITION & CONFERENCE WEST AFRICAN HEALTH SUMMIT

Transcription

1 8TH INTERNATIONAL MEDICAL EXHIBITION & CONFERENCE WEST AFRICAN HEALTH SUMMIT BIOMEDICAL WASTE MANAGEMENT IN LAGOS HOSPITALS A.A JIJOHO-OGUN (MRS) GM. ADMIN & SPECIAL DUTIES Lagos Waste Management Authority 6th Sept., 2012

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3 Lagos State At A Glance DEMOGRAPHY Geographical Area: 3,577 Sq. Km (0.4% of National) Population Estimate: 16.86m (27.4% of Country Urban) UN- Habitat Population Density: 4,193 persons/sq. Km Population Growth Rate: Btw. 6-8% (Nigeria = 2.9%)

4 LAGOS... Annual population growth: 600,000 (10 times NYC/LA) Projected population 20.19m (2010); 24.5m (2015) Source: UN-Habitat 20 LGAs & 37 LCDAs Number of Communities: 2,600

5 ATTRIBUTES OF LAGOS STATE Home to Trans-national Corporations and National Conglomerates HQ Largest Stock Exchange in West Africa Home to 200 Firms (out of 250) listed on NSE 5000 Industrial/Commercial Complexes (75% of Country Conglomerates)

6 22 Industrial Estates & several Business Districts 31.89% Contribution to National GDP - (2004) 60% of Nation s Value Added Manufacturing 65% of Nation s Value Added Tax 2500 Medical Health facilities (Private & Government) 258 Nos. Public Primary Healthcare centres

7 About Lagos Waste Management Authority (LAWMA). Agency of Government responsible for solid waste management LAWMA was created in 2005 by Edict No.5. The Law empowers LAWMA to provide commercial/ domestic waste services throughout Lagos State. Responsible for the collection and disposal of Solid Waste including Medical Waste. Register private individuals for waste collection services

8 Core values of LAWMA Professionalism Efficiency Resilience Integrity. VISION/ MISSION To provide unprecedented efficient waste management services to all its domestic, industrial and commercial clients and government agencies etc.

9 LAWMA S ACTIVITIES Highway sanitation/ Street Sweeping:- 100 companies Indusrial- Commercial waste collection Domestic (House- House) waste collection: over 400 private operators were engaged Recycling: waste buy- back, composting, waste to energy Industrial Cleaning:- Drainage clearance Destruction of classified waste and expired products Marine Waste Collection: Local policing of highways & inner streets Implementing government(state & Federal) policies on total waste management. Healthcare /medical waste collection, treatment & disposal, registration of private operators

10 CHARACTERISTICS OF WASTE Biodegradable Waste e.g. chen Wastes Recyclable Waste e.g. Paper, Glass & Plastic, Electronics MUNICIPAL SOLID WASTE Domestic/Commercial/ Industrial Wastes e.g. Batteries, Chemical, Hazardous Medical Waste e.g. Sharps. Inert Waste e.g. Construction Debris LANDFILL

11 Characterization of Medical Waste General Household Type Waste Non-Risk Waste (75-90) % Healthcare Waste Risk Waste(10-25)%

12 OBJECTIVES OF THE PRESENT ADMINISTRATION Basically to transform Lagos to Africa s Model megacity. Conform to the MDGs... Environment, Health, Education & Poverty Alleviation To accelerate the delivery of economic & social infrastructure to its citizens... Established the office of Puplic- Private Partnership in Dec The law backing it was promulgated in June Several models were adopted to involve private concerns in Government projects

13 DEFINITION &FINANCING MODELS OF Private Public Participation (PPP) It is a contractual agreement between the Federal, State or local government and a private sector entity using the skills and assets of each sector in delivering a service or facility for the use of general public. MODELS Supply & Management Contract: management of a part or whole of public enterprise by the private sector e.g. Franchising Turnkey Projects: Private contractor designs and builds a facility for a fixed fee, rate or total cost.

14 Lease: private operator is responsible for operating and maintaining the facility and services. Concessions: government defines and grants specific rights to an entity to build and operate a facility for a fixed period of time e.g. Lekki Epe express road toll fee Private Ownership of assets: private sector is responsible for design, construction and operation of an infrastructure facility

15 THE SUCCESS AREAS OF PPP PROJECTS IN LAGOS STATE CBD: Central Business District Ibile Holdings International Power Project Lagos State Water Corporation Lagos Metropolitan Area Transport Authority: BRT & LAGBUS Lekki Worldwide Investment Limited Lagos Waste Management Authority

16 STRATEGIES OF WASTE MANAGEMENT Basic Components of Biomedical Waste Management: Waste segregation at point generation Collection and containerization within the Healthcare facility (Containment and packaging) (Transport to treatment location) Treatment or decontamination Transport to disposal site Discharge to solid waste landfill

17 LAWMA S MODEL OF PPP UPSTREAM INFRASTRUCTURES: DUMPSITES/ TRANSFER / LOADING STATION / TREATMENT SUPERVISION BACK- UP LAWMA / ASSIGNED PSP LAWMA REGULATORY DEFINE DELIVERY STANDARD SERVICE ASSURANCE EMERGENCY OPERATION ENFORCRMENT PSP FRANCHISE Per Segment FINANCE-OPERATE DOWNSTREAM ( CLIENTS) COLLECTION/ SERVICE CHARGE DOMESTIC INDUSTRIAL/COMMERCIAL HEALTHCAREWASTE ETC

18 CHALLENGES OF HCWM Inadequate planning for HCWM centrally (Federal, State and Local Government) HCWM Policies and Plans yet to be passed into law Few Healthcare Facilities (HCFs) have Health, Safety & Environment (HSE) or Hospital Infection Control committees Inadequate funding for Waste Management in HCFs (Government-owned and Private) Lack of/inadequate training for staff/personnel turn-over Lack of knowledge of hospital workers and The ignorance syndrome etc 18

19 GOVERNMENT EFFORT IN MANAGEMENT OF HCW Define the roles of all tiers of Government and Healthcare facilities. For the purpose of this presentation, we shall look at the responsibility of Healthcare facilities which are: Ensure segregation of waste at every point of generation Use the appropriate primary collection equipment with appropriate colour coding. By 2008 all Healthcare facility shall provide a BUDGET line with sufficient funds and manpower dedicated to Healthcare waste management.

20 Provide facilities for the safe disposal of all hazardous Healthcare waste produced Engage the services of registered Healthcare waste collector for collection and disposal purpose With higher installed capacity for on- site disposal: shall provide other Healthcare facilities in the area of waste disposal at a reasonable cost.

21 ROLES OF NGO S/CBO S Mobilize Community through awareness campaign Provide support for IEC material on Healthcare waste management Develop programmes to support the programme Educate the Communities on Healthcare waste management The policy also identify for funding through financial and logistic resources to sustain the policy. Government: To provide yearly budgetary allocation for infrastructural provision for Healthcare waste facilities.

22 Components of HCWM budget RECURRENT EXPENDITURE Appointment of personnel (waste management officer(s)) Training On-going training for healthcare workers Procurement of Waste Containers Safety boxes for sharps Color-coded bags for non-sharp medical waste Consumables PPE (Apron, Safety boot, Gloves, Nose mask) Hand wash and Disinfectant Spill kits Salaries for waste disposal staff Fuel or electricity used by the treatment technologies where applicable Equipment maintenance and Researches. 22

23 LAWMA MEDICAL WASTE MANAGEMENT PROGRAMME IN PERSPECTIVE Material Distribution and Waste Collection: 2007 till date Registration of companies for Healthcare waste collection Government purchase of and installation of Medical waste treatment facilities Research project on safer disposal techniques

24 KEY PARTNERS OF LAWMA Federal Ministry of Environment Federal Ministry of Health Lagos state Ministry of Environment Lagos State Ministry of Health: Health Facilities Monitoring and Accreditation Agency (HEFAMAA) NMA :Nigeria Medical Association etc. MAN: Manufacturer Association of Nigeria CBO/NGO S FOE, WAMASON Aid Star One Ecobank USAID Serria Leone Ghana Ivory Coast etc in West Africa Region

25 MODE OF OPERATION OF HCWM Education on the key steps in HCWM: segregation/ sorting, Collection/ containerization, Transportation, Treatment & disposal Enlistment of facilities for the programme Free distribution of colour coded bin liners: provided by: Lagos State govt., AIDSTAR- one & Oceanic bank Assignment of PSP operator for collection and transportation to treatment site and final disposal (PPP Initiative). Customer care unit with dedicated lines Sectoral workshop on regional basis with HEFAMAA Annual Medical Summit October each year.

26 ACHIEVEMENTS/OPPORTUNITIES Increased awareness on proper HCWM within Lagos and Nigeria Intensive training for healthcare personnels and HCW handlers on best practices. Enlistment of all Government Hospitals and over 2000 private HCF for regular services to showcase Government s commitment Employment of 80 medical PSP operators for HWC collection and transportation Production of 30 million colour coded bags freely distributed Production of 10 million injection safety boxes Procurement of treatment equipment: ECODAS T1000 that treats 12,000kg (Hcw)daily. Enlistment of 350 Primary Health Centres in the State.

27 ACHIEVEMENTS Provision of employment Acquisition of more infrastructures (20 automatic bins for waste storage Enhanced waste management services in the State. Cleaner & healthier Environment and Reduction of nonsocomial diseases Synergy with all major stakeholders 23 rd 24 th October National Healthcare Waste Management Summit in Abuja.

28 ANNUAL SUMMIT ON MEDICAL WASTE MANAGEMENT

29 FREE DISTRIBUTION OF COLOUR CODED BAGS TO HOSPITALS

30 STOCK PILLING OF SAFETY BOXES

31 STEPS TO MEDICAL WASTE MANAGEMENT

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33 SHOW CASING HOW TO MANAGE HCW FACILITIES LIST OF ITEMS TO BE PURCHASED ON REGULAR BASIS: CONSUMABLES Street Sweeping

34 DESIGNATED BINS

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36 Medical Waste Collection PSP VANS

37 TREATMENT EQUIPMENT: ECODAS T1000 It is automated Shreds & sterilizes waste at HTHP Reduces waste to about 80% Non release of ODS

38 SHREDDER IN ECODAS EQUIPMENT

39 HOW NOT TO DO IT TYPICAL INCINERATOR

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41 WAY FORWARD Engagement and project expansion of private sector involvement for HCWM in PHCs. Transfer Loading Station (2): plan for 20 nos TLS with corresponding HCW treatment Equipment More Private investors to buy- own- operate treatment equipments under PPP arrangement. Encourage all HCFs to make adequate budgetary provision for their waste management and procurement of PPE and training of workers. Ensure best practices in ALL HCF in Lagos State and beyond.

42 CONCLUSION The State plans to purchase and install the Ecodas/Tanit Medical Treatment in all the TLS in the nearest future. Encourage individual to partner with LAWMA in treatment project. Join the State as an advocate for change to create cleaner environment for both the patient and your worker. See the Government as your partner for best practices Your suggestions to further improve on services is another level of partnership that can be sustainable.

43 THANK YOU Eko o ni baje oo For more information about LAWMA Contact: Free Toll line -5577