Developing a Sustainable Integrated Solid Waste Management Framework for Rural Hospitals in Chirumanzu District, Zimbabwe

This paper focuses on developing a sustainable integrated hospital solid waste management framework for rural hospitals in Chirumanzu district. Descriptive cross-sectional design encompassing qualitative and quantitative paradigms was used to collect data from 105 and 55 healthcare workers at STT and HC, respectively, and 9 interviewees. Questionnaires, observations, interviews, existing literature, water, and soil samples were data sources. SPSS and ME were used to analyze quantitative data and content analysis for qualitative data. Hospitals generated pharmaceutical, chemical, radioactive, cytotoxic, sharps, infectious, pathological, general waste, construction, demolition, and electronic waste. General waste was 77.35% at STT and 79% at HC, and hazardous waste was 22.65% at STT and 21% at HC. Sharp containers, pedal bins, buckets, plastic bags, and cardboard boxes were storage receptacles. Respondents at STT (72.4%) and HC (69.1%) demonstrated that sharp containers and pedal bins were highly used. Participants at STT (86.7%) and HC (78.2%) noted that solid waste receptacles were emptied on daily basis. Open pits, burning, dumping, incineration, and auto-way pits were disposal strategies used. Respondents at STT (44.8%) and HC (41.8%) indicated that incineration was highly used. Disposal strategies cause soil, water, and air contamination while causing ailments to people. Solid waste management improvement requires resources, raising healthcare workers awareness, technology utilization, stakeholders’ collaboration, and PPE/C. The framework assists to guide hospitals to apply recycle, reuse, and recovery which support CE. The framework enhances socio-economic development, stakeholder participation, and conformity to legal frameworks and reduces waste management cost while facilitating attainment of SDGs, AA 2063, and ZV 2030 goals. Graphical Abstract Research Highlights This paper focuses on developing a sustainable integrated hospital solid waste management framework for rural hospitals in Chirumanzu district. Chemical, pathological, cytotoxic, radioactive, pharmaceutical, infectious, sharps and general waste, electronic, construction, and demolition solid waste are generated at STT and HC hospitals. Solid waste generated at HC hospital consists of 79% general waste and 21% hazardous waste. STT hospital produced 77.35% general waste and 22.65% hazardous waste. Waste increase was ascribed to outbreak of diseases, population increase, high use of disposable PPE/C, and discarding of outdated materials and equipment. Solid waste generated at these hospitals is stored in buckets, pedal bins, sharp containers, plastic bags, and cardboard boxes. Major storage receptacles utilized were sharp containers and pedal bins as noted by 72.4% of the respondents at STT and 69.1% at HC hospital. Hospital solid waste was separated into organic and inorganic waste, sharps and non-sharps, and infectious and non-infectious waste during storage. Infectious waste was disinfected through chlorination or autoclaving at HC and STT hospitals. Solid waste was disposed through incineration, open pits, dumping, auto-way pits, and open burning. Incineration was highly used at STT (44.8%) and HC (41.8%) hospitals. Disposal of hospital solid waste was mostly carried out on a daily basis as indicated by 86.7% at STT hospital and 78.2% at HC hospital. Disposal approaches utilized at these hospitals cause air, soil, water contamination, visual pollution, outbreak of veld fires, and affecting flora and fauna negatively. Occupational health risks associated with management of hospital solid waste encompass pricks, cuts, contacting infectious waste, inhaling noxious odors, musculoskeletal disorders, and being exposed to radiation from waste combustion. There is a need for rural hospital authority to provide adequate PPE/C to those involved in solid waste management. EHTs must carry out training focusing on enlightening health workers on aspects related to hospital solid waste management. EMA officers should carry out workshops where they inform health workers on policies, guidelines, and legislation applied in hospital solid waste management. ZMoHCC should channel enough financial resources to hospital solid waste management aspects. Collaboration of ZMoHCC and NSSA among other stakeholders in mapping out approaches to minimize occupational health risks associated with solid waste generated at rural hospitals is required. Rural district authorities must assist rural hospitals in dealing with solid waste, since rural hospitals generate solid waste with similar characteristics to urban health facilities. There is a need to uphold the use of current technology like GIS and RS in management of hospital solid waste. Application of GIS and RS facilitates determination of solid waste collection routes, location of disposal sites, and determining environmental attributes which are vulnerable to pollutants from hospital disposal sites. The proposed framework supports solid waste recycling, reuse, recovery, and repair of materials, therefore facilitating reduction of solid waste disposed into the environment. The framework upheld involvement of all stakeholders, conformity to national and international legal frameworks, continuous improvement of waste management system, and reduced cost in managing waste while protecting the environment, hence narrowing the gap to reach SDGs, AA 2063, and ZV 2030. SIHSWM (Fig. 13) urges hospitals to consider raw disposal of hospitals as a waste of resources. By adopting this framework, solid waste can be utilized as a resource to catalyze economic growth.