Published: 2022-05-27

Health care waste management in health facilities during the COVID-19 pandemic in Ghana

Richard Amfo-Otu, Enoch Akyeampong, Michael Affordofe, Philip A. Bannor, Yakubu Alhassan, Doreen Danso, Senam Tengey, Reginald Quansah, Joana Akpabey, Lawrence Obeng, Franklin O. Ayesu, Agyemang Badu, Bernard A. Kwanin


Background: Healthcare waste management (HCWM) system in healthcare facilities is essential in dealing with the spread of infectious diseases, especially during an outbreak period such as the COVID-19 pandemic. The study assessed health care waste management situation in selected healthcare facilities in the greater Accra and Ashanti regions of Ghana during the COVID-19 pandemic.

Methods: This was a multi-facility-based cross-sectional study that used a monitoring tool of the health facilities regulatory agency of Ghana to collect information on health care waste management practices at the peak of the COVID-19 pandemic. Data was gathered from 501 healthcare facilities in the greater Accra (335) and Ashanti (151) regions. Descriptive, Chi-square and multiple logistic regression were performed. All statistical analyses were considered significant at an alpha level of 0.05.

Results: Less than half (45.7%) of the health facilities were assessed as having HCWM systems with majority (54.3%) having effective infectious waste management system. The health facilities in the greater Accra region (38.8%) and Ashanti region (60.9%) were categorized as poor on healthcare waste management system. The assessment levels of governance/leadership, management, quality assurance system, human resource, infection prevention and control equipment and water management were all significantly associated with the adherence to good HCWM systems.

Conclusions: Health facilities were assessed as having good healthcare waste management systems, especially in the greater Accra region compared to the Ashanti, however treatment and safe disposal should be improved.



Healthcare waste management, COVID-19 related waste, Ghana

Full Text:



GHS. Fact sheet: Situation update, COVID-19 outbreak in Ghana, 2021. Available at: Accessed on 16 March 2022.

WHO. Fact sheet: WHO coronavirus disease (COVID-19) Dashboard, 2021. Available at: Accessed on 16 March 2022.

WHO. Fact sheet: Water, sanitation, hygiene, and waste management for COVID-19 virus technical brief, 2021. Available at: emergencies/diseases/novel-coronavirus-2019/ technical-guidance/infection-prevention-and-control. Accessed on 15 March 2022.

World Health Organization. Safe management of waste from healthcare activities. 2nd ed. WHO Press; 2014.

Doremalen N, Morris DH, Holbrook MG, Gamble A, Williamson BN, Tamin A, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382(12):1177-9.

Chin AWH, Chu JTS, Perera MRA, Hui KPY, Yen H, Chan CWM, et al. Stability of SARS-CoV-2 in different environmental conditions. Ann Oncol. 2020;7(1):19-21.

Nghiem LD, Morgan B, Donner E, Short MD. The COVID-19 pandemic: considerations for the waste and wastewater services sector. Case Stud Chem Environ Eng. 2020;1:100006.

Kalantary RR, Jamshidi A, Mofrad MMG, Jafari AJ, Heidari N, Fallahizadeh S, et al. Effect of COVID-19 pandemic on medical waste management: a case study. J Environ Heal Sci Eng. 2021;19(1):831-6.

Liang Y, Song Q, Wu N, Li J, Zhong Y, Zeng W. Repercussions of COVID-19 pandemic on solid waste generation and management strategies. Front Environ Sci Eng. 2021;15(6).

Shammi M, Behal A, Tareq SM. The escalating biomedical waste management to control the environmental transmission of COVID-19 pandemic: a perspective from two south asian countries. Environ Sci Technol. 2021;55(7):4087-93.

Singh E, Kumar A, Mishra R, Kumar S. Solid waste management during COVID-19 pandemic: Recovery techniques and responses. Chemosphere. 2022;288(1):132451.

Singh N, Tang Y, Zhang Z, Zheng C. COVID-19 waste management: effective and successful measures in Wuhan, China. Resour Conserv Recycl. 2020;163:105071.

Yousefi M, Oskoei V, Jafari A, Farzadkia M, Firooz M, Abdollahinejad B, et al. Municipal solid waste management during COVID-19 pandemic: effects and repercussions. Environ Sci Pollut Res. 2021;28(25):32200-9.

Zand AD, Heir AV. Emanating challenges in urban and healthcare waste management in Isfahan, Iran after the outbreak of COVID-19. Environ Technol (United Kingdom). 2021;42(2):329-36.

Limon MR, Vallente JPC, Cajigal ARV, Aquino MU, Aragon JA, Acosta RL. Unmasking emerging issues in solid waste management: Knowledge and self-reported practices on the discarded disposable masks during the COVID-19 pandemic in the Philippines. Environ Challenges. 2022;6:100435.

Kumar A, Islam N, Billah M, Sarker A. COVID-19 pandemic and healthcare solid waste management strategy-a mini-review. Sci Total Environ. 2021;778:146220.

Hantoko D, Li X, Pariatamby A, Yoshikawa K, Horttanainen M, Yan M. Challenges and practices on waste management and disposal during COVID-19 pandemic. J Environ Manage. 2021;286:112140.

Alzghoul SE, Smadi OA, Almomani TD, Alzghoul MB, Albataineh OM. Solid medical waste management practices and awareness in COVID-19 screening stations. Glob J Environ Sci Manag. 2022;8(3):327-38.

Belhadi A, Kamble SS, Khan SAR, Touriki FE, Kumar MD. Infectious waste management strategy during COVID-19 pandemic in africa: an integrated decision-making framework for selecting sustainable technologies. Environ Manage. 2020;66(6):1085-104.

Oyedotun TDT, Kasim OF, Famewo A, Oyedotun TD, Moonsammy S, Ally N, et al. Municipal waste management in the era of COVID-19: perceptions, practices, and potentials for research in developing countries. Res Glob. 2020;2:100033.

Nzeadibe TC, Ejike-Alieji AUP. Solid waste management during Covid-19 pandemic: policy gaps and prospects for inclusive waste governance in Nigeria. Local Environ. 2020;25(7):527-35.

Asante BO, Yanful E, Yaokumah BE. Healthcare Waste Management; its Impact: A Case Study of the Greater Accra Region, Ghana. SSRN Electron J. 2014;3(3):106-12.

Sarkodie SA, Owusu PA. Impact of COVID-19 pandemic on waste management. Environ Dev Sustain. 2021;23(5):7951-60.

Bannor PA, Otu RA, Akyeampong E, Affordofe M, Alhassan Y, Tengey S, et al. Infection prevention and control in healthcare facilities during the Covid-19 pandemic in Ghana. Int J Infect Prev. 2021;(2):29-47.

World Health Organization. Water and Sanitation for Health Facility Improvement Tool (WASH FIT). World Health Organization. 2018: 92.

Adu RO, Gyasi SF, Essumang DK, Otabil KB. Medical waste-sorting and management practices in five hospitals in Ghana. J Environ Public Health. 2020;2020.

UCC-IR. Hospital Solid Waste Management Practices in Eastern Region of Ghana, 2018. Available at: Accessed on 16 March 2022.

Amfo-Out R, Doo IA. Hospital solid waste management at tetteh Quarshie memorial hospital, Akuapem-Mampong, Ghana. Int J Environ Waste Manag. 2015;16(4):305-14.

Gould DJ, Gallagher R, Allen D. Leadership and management for infection prevention and control: what do we have and what do we need? J Hosp Infect. 2016;94(2):165-8.