A study of health care waste management services to support marginal rural primary health care facilities in pastoral communities in Kenya

The study to identify the capacity gaps in health care waste management HCWM) is concerned as well as assess the adequacy of resource allocation to realize public health objectives. This study was conducted in three PHCs in Kajiado County in Kenya. Three PHCs were selected in Kajiado County. These are: Bissel, Ngaetatek and Namanga PHCs. The population consists of the Maasai, who are rural pastoralists. Pastoral regions are marginalized since independence. A descriptive survey was used to conduct the study. Mixed methods in quantitative and qualitative data collection techniques were used. A total of 30 patients were interviewed (10 per PHCs). For each of the facility, an observation checklist filled, 1 FGD and 1 KII conducted. Across all the three sampled PHCs, no refresher training had been conducted on HCWM. A walk-through to all the clinical care departments in all the three PHCs showed that the bins were left full to the brim before being emptied. When patients were asked why they didn’t like attending the PHCs for treatment, 30% said that it was due to the poor state of cleanliness. Also, as noted earlier, knowledge diffusion from the trained cadres to their client is minimal as 27% of the patients, who are all women in maternity, interviewed said that they didn’t receive any messaging on HCWM. Incinerators were moribund or missing with infectious waste being transported to the headquarters distant away for central incineration. This poses a serious risk of injury and infection to the transporters. Amongst the recommendations are: Proper resource allocation should be done at the national level; revitalization of the vestigial IPCC; Quality maintenance by the County Government embracing Service charters and customer focus. At the PHC level, the focus would be on supportive supervision, attention to employee job descriptions and performance reviews.