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A Study on Small Clinics Waste Management Practice, Rules, Staff Knowledge, and Motivating Factor in a Rapidly Urbanizing Area.

ABSTRACT: Thousands of small clinics in Pakistan are generating dispersed medical waste, unlike large hospitals, small clinic waste management is often ignored. This study was conducted on 135 small clinics in Hyderabad, Pakistan, with the aim to determine small clinics' waste management practices in contrast to rules, level of knowledge, the environmental impact of disposal methods, and motivating factor analysis to understand the current situation from multiple perspectives. Overall, the waste generation rate was calculated to be 2.01 kg/clinic/day and the hazardous waste generation rate was 0.89 kg/clinic/day, whereas the general waste generation rate was 1.12 kg/clinic/day. The hazardous waste generation rate percentage is found to be higher than those found in large hospitals by 20%. The waste management practice among surveyed clinics was deplorable; none of the clinics were completely following hospital waste management rules of 2005 and thus the absence of proper segregation, storage, transportation, and disposal was commonly encountered during the study. Clinic staff possessed low level of knowledge and awareness, and acquired no training about waste management practice and rules, moreover, frequent employee turnover was noticed too. Additionally, two hypotheses were checked for creditability of motivating factors with an exploratory factor analysis to check their contribution to motivating clinic staff to practice sound healthcare waste management. Out of 10 indicators, nine were found in support of the hypotheses. Hence, it was discovered that active government involvement and financial support in providing training and inspecting small clinics could help in improving the condition. The findings of the present study can play a vital role in documenting evidence, and for policymakers and governments to plan solid waste management of small clinics and other healthcare facilities.

SUBMITTER: Khan BA

PROVIDER: S-EPMC6843947 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:By law, the provision of medical treatment to minors in the State of Israel is conditional upon the consent of their parents. In 2004, the Head of the Medical Administration Unit in the Ministry of Health issued Circular No. 4/2004 regarding the treatment of un-accompanied minors in primary care clinics. This circular aims to expand on the law, and permits the treatment of certain minors without parental attendance or consent. The circular does indicate that parents should be notified of the treatment retroactively, and provides cases in which it is possible to avoid notification altogether. The objectives of this study were: (a) to examine the scope of treatment of unaccompanied minors in primary care clinics; (b) to examine caregivers' knowledge of the provisions of the law and of the circular; and (c) to examine the implementation of the law's and the circular's provisions relating to the treatment of unaccompanied minors in primary care clinics in the community. METHODS:In a cross-sectional study, we surveyed 158 doctors and nurses from primary care clinics of the Haifa and Galilee districts of "Clalit Health Services". Respondents were selected via a snowball method, with attention to ensuring a heterogeneous clientele and geographic dispersion. RESULTS:Treatment seeking by unaccompanied minors is an existing and even widespread phenomenon. The vast majority of unaccompanied minors were in effect treated without parental consent. The main reason for minors' solitary treatment seeking was parents being busy. In 40% of the cases, where minors were treated without the presence and consent of their parents - parents were not notified of the fact. None of the respondents correctly answered all questions regarding the relevant provisions of the law and circular, and only 10% answered all the questions regarding the circular's parental notification requirements. CONCLUSIONS:The Israeli legal arrangement, pertaining to the provision of treatment to minors without the consent of their parents, is vague, unclear to medical and nursing practitioners and limited in terms of the needs of the minors themselves, as well as the needs of the medical system. There is a need for methodical and coherent regulatory thinking on the subject, as well as more thorough education of both nurses and physicians, in order to ensure the rights and interests of minors as well as the rights of their parents.

Project description:BackgroundIn many developing countries, private pharmacies play an important role in providing health information and services to local communities for common health issues. The aim of this study was to ascertain medium-term impact of educational interventions on knowledge and practice of pharmacy staff regarding management of childhood diarrhea in Vietnam.MethodsThis was a pre- and post-intervention study with 32 and 44 months difference from the time of the baseline survey to the conclusion of trainings and the time of the end-line survey, respectively. Interventions included in-class training for pharmacy staff, printed materials at the pharmacy, and supportive supervision. Knowledge/reported practice and actual practice of pharmacy staff were measured before and after interventions.ResultsAfter interventions, significant improvements (p<0.01) were observed for all indexes related to pharmacy staff's knowledge about childhood diarrhea; for instance, 31% and 60% of surveyed staff asked about weight of the child and accompanying symptoms of childhood diarrhea, respectively, an increase from 11% and 45% at the baseline. Oral rehydration solution (ORS) was the most frequently reported product recommended (97% to 99%), but probiotics and antidiarrheals were the products most frequently prescribed at pharmacies. Public health facilities remained the preferred choice for referrals from pharmacies, but the use of private clinics was increasing. Consultations and advice provided to caregivers also improved, but considerable gaps between knowledge and actual practice of staff in real pharmacy settings remained.ConclusionsEducational interventions were effective in improving pharmacy staff knowledge and practice regarding management of childhood diarrhea. Knowledge and actual practice of staff in real pharmacy settings did not always correlate; there is need for a stronger regulatory and law enforcement system. Interventions to improve pharmacy practice in developing countries should be focused, comprehensive, and evidence-based.

Project description:BackgroundAn estimated four million deaths occur each year among children in the neonatal period. Current evidence-based interventions could prevent a large proportion of these deaths. However, health care workers involved in neonatal care need to have knowledge regarding such practices before being able to put them into action.The aim of this survey was to assess the knowledge of primary health care practitioners regarding basic, evidence-based procedures in neonatal care in a Vietnamese province. A further aim was to investigate whether differences in level of knowledge were linked to certain characteristics of community health centres, such as access to national guidelines in reproductive health care, number of assisted deliveries and geographical location.MethodsThis cross-sectional survey was completed within a baseline study preparing for an intervention study on knowledge translation (Implementing knowledge into practice for improved neonatal survival: a community-based trial in Quang Ninh province, Viet Nam, the NeoKIP project, ISRCTN44599712). Sixteen multiple-choice questions from five basic areas of evidence-based practice in neonatal care were distributed to 155 community health centres in 12 districts in a Vietnamese province, reaching 412 primary health care workers.ResultsAll health care workers approached for the survey responded. Overall, they achieved 60% of the maximum score of the questionnaire. Staff level of knowledge on evidence-based practice was linked to the geographical location of the CHC, but not to access to the national guidelines or the number of deliveries at the community level. Two separated geographical areas were identified with differences in staff level of knowledge and concurrent differences in neonatal survival, antenatal care and postnatal home visits.ConclusionWe have identified a complex pattern of associations between knowledge, geography, demographic factors and neonatal outcomes. Primary health care staff knowledge regarding neonatal health is scarce. This is a factor that is possible to influence and should be considered in future efforts for improving the neonatal health situation in Viet Nam.

Project description:BackgroundHealth care workers (HCWs) involved in day-to-day care and other healthcare activities play a significant role in biomedical waste (BMW) management. The World Health Organization stated some of the causes for the failure of BMW management, namely, lack of awareness of the health hazards related to BMW and inadequate trained HCWs in BMW management. The present study assessed knowledge, attitude, and practice (KAP) towards BMW management among the HCWs in northern Saudi Arabia.MethodologyThe present study assessed KAP through a self-administered and validated questionnaire. Using a multistage probability sampling method, 384 HCWs from different healthcare facilities participated in this survey. We performed binomial logistic regression analysis to find association between KAP subscales and sociodemographic characteristics. Spearman's correlation test was performed to find the strength and direction of correlation (rho) between KAP scores.ResultsOf the population studied, high knowledge, attitude, and practice scores were found in 47.1%, 65.1%, and 49.5% of the HCWs, respectively. The present study found that knowledge score was significantly higher among the age group from 30 to 39 years (ref: age less than 30 years: AOR = 2.25, 95% CI [1.05-4.85], p = 0.04) and non- Saudi nationals (ref: Saudi: AOR = 2.84, 95% CI [1.63-4.94], p < 0.001) The attitude score towards BMW management was significantly lower among the HCWs working in tertiary care settings (ref: PHC: AOR = 0.38, 95% CI [0.12-0.69], p = 0.01). Regarding the practice score, the male categories had a significantly higher score (ref: female: AOR = 1.82, 95% CI [1.19 -2.99], p = 0.02), while pharmacist (ref: physicians: AOR = 0.39, 95% CI [0.18-0.58], p = 0.02) and lab technicians (ref: physicians: AOR = 0.31, 95% CI [0.11-0.53], p = 0.02) had a significant lower practice score. The test results revealed a weak positive correlation of knowledge with the attitude scores (rho = 0.249, p = 0.001), and a moderately strong positive correlation was found between attitude and practice scores (rho = 0.432, p = 0.001).ConclusionThis study suggests that a regular training program for the HCWs on BMW management is necessary through symposiums, role play, interactive lectures, and other feasible training methods. Furthermore, a multicentric prospective exploratory study is to be conducted in other regions of the KSA to understand the region-specific training needs of HCWs.

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A Study on Small Clinics Waste Management Practice, Rules, Staff Knowledge, and Motivating Factor in a Rapidly Urbanizing Area.

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