Description
Introduction
In most healthcare facilities, syringes are the device of choice for administering vaccines as they are intended for single use, limiting infection transmission owing to contaminated needles. These devices are commonly used in routine immunization programs as well as during mass campaigns such as the recent COVID-19 pandemic. As per reports, an infant in Myanmar receives at least 13 shots before they attain the age of one year, and about 1.5 million needles and syringes are used for administering the Human Papilloma Vaccine to adolescent girls. While these vaccines add to health benefits for the people of Myanmar, the responsible disposal of used syringes and needles, at times, becomes a huge challenge. Apart from the risk of infection transmission, improper disposal of these devices can lead to accidents among health workers and waste handlers.
Given the challenges, PATH collaborated with its partners to assess the healthcare waste generated from private health facilities in Myanmar and recommend potential solutions to address the HCWM needs of private health facilities. In this project, health care waste specifically generated from COVID-19-related equipment, such as Personal Protective Equipment (PPE) kits and syringes used for COVID-19 vaccination, was taken into consideration.
Methodology
In June 2022, PATH, along with its partners, including the National Committee convened by UNICEF France and Myanmar, USAID, Sun Community Health (SCH), and Myanmar Antinarcotic Association (MANA), collaborated to review the national HCWM guidelines and assess HCWM practices in private health facilities in Myanmar. As part of the initiative, the HCWM guidelines were updated, Standard Operating Procedures (SOP) were developed, and a training curriculum tailored for private healthcare professionals was developed. Over a period of 6–12 months, the project team undertook assessment and monitoring visits for implementing the guidelines and SOPs in 157 health facilities, 50 MANA service points, and 135 private practices in 32 townships, which ended in November 2023.
Results and discussion
The results suggests that sharps waste segregation was widely practiced, which involved using a needle cutter.
The findings shows that in private facilities, syringes and sharps segregation is practiced in most facilities and involve using a needle cutter for removing needles from the plastic case of the syringe. Besides, the needles of these syringes are also disinfected and buried in pits, and the plastic parts of the syringes are shredded and sold to social enterprises thereby reducing air pollution. Additionally, the used PPE kits and masks were disinfected and recycled for making bricks or construction materials. It was observed that in private facilities, there are lack of space for needle pits, needle cutter which is not useful in case of mobile syringe collectors and there is a preference for biodegradable bag . The needle exchange program conducted by MANA showed a high return rate of used syringes.
Conclusions
Based on the positive findings of the assessment, PATH and partners are exploring investment options to expand safe and economically feasible HCWM methods and sustainable recycling models that can work across facilities and types of healthcare waste.
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