PESHAWAR: The government has decided to outsource the hospital waste management under a public-private partnership initiative to safeguard patients and health workers from infectious diseases, especially Hepatitis B, C and HIV/Aids.

The programme will be started in accordance with Health Foundation Act, 2016 that empowers the government to run the departments in collaboration with the private organisations to improve their performance, according to officials.

The project, to cost Rs1,775 million over a period of five years, will cover a total of 142 public sector hospitals with 13,529 beds that generate an average 2,000 kilograms of infectious waste per day.

Chief Minister Mahmood Khan has approved a summary in March for which a PC-1 has been prepared and Health Foundation has been instructed to start the process to outsource the programme to a private firm through an open competition.

The selected hospitals don’t have any waste management programme at the moment due to which there is no mechanism for safe collection, transportation and incineration of waste. There also not a mechanism to ensure the transparent waste collection, transportation and incineration, which is of particular concern keeping view the infection of HIV and hepatitis.

There is strong evidence of transmission of infection due to injury caused by syringe needles contaminated by human blood. It can occur when sharp waste is poorly managed.

Plan meant to protect patients, medics from infection

Although theoretically any needle stick injury can lead to transmission of blood borne infections, there is some evidence that hollow needles are associated with a higher risk of transmission than the solid ones.

Officials said that the waste management assumed added significance following the advent of Covid-19. The firm to be hired for the purpose will set up three centres in different districts of the province where the waste will be transported under the prescribed rules for incineration.

The firm will also be responsible for continuous training and capacity building of healthcare staff, collection of infectious waste from wards of the hospital, transportation of infectious waste within the hospital via purpose-built waste collection trolley, interim storage of the infectious waste in yellow rooms, if required.

The firm will be also responsible for uploading of collection and disposal data on the waste management information system, transportation of hospital infectious waste to incineration sites via purpose built yellow vehicles, safe disposal of collected infectious waste as per Hospital Waste Management Rules, 2005 by Environmental Protection Agency.

To ensure oversight on the private firm, the hospital administrators or their nominees will be monitoring the activities on daily and monthly basis in respective healthcare facilities.

The hospital waste management committees will be constituted as per Hospital Waste Management Rules 2005 (EPA), at each healthcare facility that will hold regular meetings as per terms of references (TORs) to oversee the performance of hospital infectious waste management operations.

The programme to be carried out in line with the Khyber Pakhtunkhwa Health Foundation Act, 2016 is meant to ensure compliance with the prescribed law and minimise risks to patients as well health workers.

The programme is entitled as “Safe Disposal of Hospital Infectious Waste in Khyber Pakhtunkhwa”, under which the health department will be using procurement and private sector services as a main driver of the proposed project and the project management unit (PMU) will work in a manner that specific committees will be constituted with members from both within the PMU, EPA and the health department to ensure that all processes of procurement are run with transparency.

The Health Foundation will develop proposal for hospital waste management which will be evaluated by the technical committee before hiring the services of a company.

Published in Dawn, December 18th, 2020

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