Summary

The 'Project for the Improvement of Infectious Waste in Southwest Asia' was launched in 2022 and aims to address the development challenges of inadequate health care waste management of the national and local government health care institutions in Bangladesh, Bhutan and the Maldives, through innovative solutions and capacity building. The three countries will deploy locally appropriate, gender sensitive, safe and sustainable health care waste management practices and technologies. The project is supported by the Government of Japan. 

Background

The threat posed by inadequate health care waste management systems demands urgent attention to safeguard human health and minimize environmental and social impacts. Poorly managed health care waste serves as a significant source of pollutants. Untreated health care waste in open dumps and landfill sites can lead to soil and water contamination. Inadequate incineration of medical waste can result in the release of persistent organic pollutants.

Many low- and middle-income countries have historically faced limitations in both public and private investments in sustainable waste treatment systems. The rapid increase in both infectious and non-infectious health care waste during the COVID-19 pandemic has left a mounting volume of health care waste that surpasses their waste management capacity.

The project aims to deliver sustainable, clean and green solutions to health care waste management, thereby contributing to building strong and resilient health systems and human security. The project will also contribute to dialogue between governments and national stakeholders to shape the future of health care waste management in the countries. 

As a Small Island Developing State (SIDS), the Maldives faces unique  health care waste management challenges. This issue has gained significant importance, primarily due to the absence of infrastructure capable of managing waste generated in health care facilities, whether on-site or at municipal solid waste management sites. These challenges were further exacerbated by the COVID-19 pandemic, which has strained an already overburdened waste management system. 

• Stakeholders have reported various challenges in managing health care waste, including:
• The highly dispersed nature of the Maldivian islands, which makes health care waste management a costly and complex endeavor in terms of building and sustaining required infrastructure and capacities.
• Inadequate services for the collection and segregation of health care waste from health centres in a gender-responsive manner.
• Shortages of personal protective equipment and waste-related consumables for health care staff and waste handlers (both women and men).
• Limited capacities in adopting non-incineration technologies for health care waste treatment.
• Disposal of unsafe or partially chemical-treated health care waste in open pits and landfills.

This initiative will address the inadequate health care waste management processes and techniques in the country. It will enhance capacities in health care centres and hospitals across 18 islands by deploying gender-sensitive, safe, and sustainable health care waste management practices and technologies.

Project Outcomes:

The project aims to achieve the following outcomes:

• Enhance health care waste infrastructure: Improve health care waste infrastructure in 18 islands, including on-site and off-site solutions, to address the lack of proper waste management systems in health care facilities.
• Sustainable waste practices: Replace uncontrolled open burning practices with safer and sustainable health care waste disposal methods, such as increasing the use of autoclaves for infectious waste treatment.
• Equipment procurement: Enable procurement of non-incineration equipment, machinery and vehicles for health care waste treatment and transportation.
• Capacity building: Train health care facility workers and waste handlers in safe waste handling and non-incineration disposal practices with the use of autoclaves. 
• Knowledge sharing: Foster South-South knowledge sharing and collaboration on international standards and conventions for good health care waste management practices.
• Digital tracking: Utilize digital solutions for health care waste management tracking, including readiness assessments at regional health centres.

This project complements the ongoing efforts by the Ministry of Health in partnership with the World Health Organization, Government of Canada and the Asian Development Bank, which includes procuring autoclaves, their installation in medical facilities and staff training. However, efficient equipment storage and handling remain a critical focus of this project, ensuring the safe operation and storage of essential equipment.

GESI Component

The ‘Project for the Improvement of Infectious Waste Management in Southwest Asia’ recognizes the importance of Gender Equality and Social Inclusion (GESI) as a core component. Our approach ensures that health care waste management solutions are gender-sensitive, safe and sustainable. It focuses on enhanced and effective gender responsive national level systems for sustainable health care waste management in Maldives.