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Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

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Advances in Infectious Diseases 2024年第1期14卷 279-295页

作者： Mariam Mahamudu Hussein Mohamed Michael Habtu Dennis Rweyemamu Anyitike Mwakitalima Amour Seleman Erick Mgina khalid massa Grace Saguti Andre Arsene Bita Fouda Zabulon Yoti Ministry of Health Dodoma Tanzania Department of Environmental and Occupational Health Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania Regional Office for Africa World Health Organization Brazzaville Republic of the Congo National Institute for Medical Research Dar es Salaam Tanzania

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

关键词： Dispensaries Low Level Health Care Facilities Service Levels Basic WASH Dar es Salaam

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Readiness of Healthcare Facilities to Implement Onsite Healthcare Waste Management Protocols and Incineration Guidelines in Tanzania

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Journal of Environmental Protection 2022年第11期13卷 913-940页

作者： Samwel Manyele Honest Anicetus Michael Habtu khalid massa Mahir Said Josephat Saria Grace Saguti Zabloni Yoti Department of Chemical and Mining Engineering University of Dar es Salaam Dar es Salaam Tanzania Ministry of Health Dodoma Tanzania World Health Organization Dar es Salaam Country Office Dar es salaam Tanzania Department of Physical and Environmental Sciences The Open University of Tanzania Dar es Salaam Tanzania

The aim of this study was to assess Readiness of Healthcare facilities to Implement onsite Healthcare Waste Management Protocols and Incineration Guidelines in Tanzania. To address this, a national assessment was conducted country wide to assess readiness of Healthcare Facilities (HCFs) to undertake various Healthcare Waste Management (HCWM) initiatives with particular focus to adherence to HCWM protocols and incineration guidelines. The assessment of healthcare waste management was conducted in facilities in the 26 regions of Tanzania mainland for one month. A standardized checklist and tools were used to assess and monitor various aspects related to healthcare waste management using open source software for data collection (ODK). Data were analyzed using SPSS computer software. It was observed that 46.2%, 33.3% and 25% of the health centres, district hospitals and regional hospitals did not have appointed supervisors, which makes it difficult for the HCFs to perform better in managing healthcare waste in their respective facilities. It was further revealed that healthcare facilities have made remarkable improvement in the overall healthcare waste management with evidence of ongoing common activity on purchasing injection safety boxes (69.2%) and purchasing of waste bins (53.8%) at all levels. On average, about 70% of the HCFs have plans and budget though inadequate to support HCWM activities. In a conclusion Healthcare Facilities must designate a better system to compressively address healthcare waste management issues. Again the findings provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources.

关键词： Healthcare Waste Incinerators Waste Segregation Waste Collection Color Coding Ash Pits

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Assessment of Environmental Cleaning Practices and the Impacts on Infection Prevention and Control in Selected Hospitals in Tanzania

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Journal of Environmental Protection 2022年第10期13卷 698-715页

作者： Honest Anicetus Samwel Manyele Michael Habtu Adolf Kiyunge Josephat Saria Robert Njee Linda Thadei khalid massa Grace Elizabeth Saguti Zabulon Yoti Ministry of Health Community Development Gender Elderly and Children Dodoma Tanzania Department of Chemical and Mining Eng. University of Dar es Salaam Dar es Salaam Tanzania World Health Organization (WHO) Tanzania Dar es Salaam Tanzania Department of Environmental Studies The Open University of Tanzania Dar es Salaam Tanzani National Institute of Medical Research Dar es Salaam Tanzania National Council for Technical Education Dar es Salaam Tanzania

To achieve Sustainable Development Goal (SDG) in healthcare facilities (HCFs,) the provision of water, sanitation, healthcare waste management, hand hygiene and environmental cleanliness services is crucial. Good WASH services in HCFs settings have the potential to reduce healthcare acquired infections (HAIs), increase trust and uptake of healthcare services, increase efficiency and improve staff morale. To address this, a National Assessment was carried out to ascertain environmental cleanliness condition of the healthcare facilities at all levels. The assessment of healthcare waste management in the facilities was conducted in all the 26 regions of Tanzania Mainland including districts and lower healthcare facilities. A standardized checklist and tools were used to assess and monitor various aspects related to healthcare waste management using open source software for data collection (ODK). Data were analyzed using SPSS computer software. It was observed that most of permanent staff (88%) in the Healthcare facilities had knowledge on hand hygiene, but the gap was observed to the waste handlers (12%) who were not equipped with the hand hygiene knowledge. About 89% of the hand washing stations were available at mortuary units, followed by 75% at main entrance and the lowest was 3% at waste zone areas of the healthcare facilities. Hand washing materials like soap were mainly found at theaters (64%) followed by mortuary (60%) and last at waste zones. The assessment concludes that handling of healthcare wastes is not practiced to the expectations, and there is a need to strengthen the situation. The findings provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources.

关键词： Environmental Cleaning Infection Prevention Sanitation Hand Hygiene and Water Supplies

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