A Comparative Analysis of Hazardous Medical Waste Management Compliance Before (2019) and During (2020) the COVID-19 Pandemic in Indonesia

A Comparative Analysis of Hazardous Medical Waste Management Compliance Before (2019) and During (2020) the COVID-19 Pandemic in Indonesia

Authors

  • Della Amanda Andika Putri
  • Zakianis
  • Al Aysary
  • Softwan

Keywords:

Compliance, COVID-19, Hospital, Medical waste, Waste management

Abstract

Background. As a producer of hazardous waste, hospitals have the responsibility to manage the waste they produce. Hospital non-compliance in managing hazardous waste can have a negative impact on the environment and public health, especially during the COVID-19 pandemic, when the amount of hazardous waste produced by healthcare facilities is increasing. To protect the environment and public health from the negative impact of hazardous medical waste, this study was conducted to determine the level of compliance of hazardous waste management in hospitals in Indonesia before and during the COVID-19 pandemic, from 2019 to 2020.

Study design. Cross-sectional.

Methods. This study was conducted at 343 hospitals in Indonesia using secondary data obtained from Sikelim (Medical Waste Management Information System), which is owned and operated by the Ministry of Health. The data have been analyzed using chi-square tests and logistic regressions of the determinant model. Results. There was an increase in the level of compliance of hazardous waste management in hospitals from 82% to 86% during the pandemic. Furthermore, the availability of environmental documents and environmental health units were determinant factors of hazardous waste management compliance by hospitals before the pandemic in 2019. The only factor in 2020 was the availability of environmental health units. Conclusions. Despite the good level of compliance, additional efforts are needed to increase the activities of the treatment of hazardous medical waste by hospitals, as before the pandemic (i.e., in a normal situation) only 8% of hospitals was able to independently manage hazardous medical waste using authorized incinerators, a percentage that was reduced to 6% during the pandemic.

References

1. Purwati N, Amin A. Kepatuhan Ditinjau Dari Kepribadian Ekstrovert-Introvert. J Psikol. 2016; 3(2): 87-93. doi: 10.35891/jip.v8i2.

2. World Health Organization(WHO). Health-care waste. 2018. Available on: https://www.who.int/ news-room/fact-sheets/detail/health-care-waste [Last Accessed 2021 November 14].

3. Li M, Xu J, Li B. Analysis of Development of Hazardous Waste Disposal Technology in China. IOP Conf Ser Earth Environ Sci. 2018; 178(1): 1-7. doi: 10.1088/1755-1315/178/1/012027.

4. United Nations Environment Programme. Waste Management During the COVID-19 Pandemic From Response to Recovery. 2020. Available on: https://wedocs.unep.org/bitstream/ handle/20.500.11822/33416/WMC-19.pdf [Last accessed: 2021 June 16].

5. World Health Organization(WHO). Preparation of national healthcare waste management plans in Sub-Saharan countries: Guidance manual. 2004. Available on: http://www.who. int/water_sanitation_health/medicalwaste/en/ guidancemanual.pdf [Last accessed: 2021 June 25].

6. Ministry of Health of the Republic of Indonesia. Medical Waste Management in Healthcare Facilities. 2020. Available on: https://www.kemkes. go.id/article/view/20050200001/pedomanpengelolaan-limbah-rs- rujukan-rs-darurat-danpuskesmas-yang-menangani-pasien-covid-19. html [Last Accessed 2021 June 21].

7. Ahmad R, Liu G, Santagata R, et al. LCA of hospital solid waste treatment alternatives in a developing country: The case of District Swat, Pakistan. Sustain. 2019; 11(13): 1-20. doi:10.3390/su11133501.

8. World Health Organization (WHO). Safe HealthCare Waste Management. 2004. Available on: https://www.who.int/water_sanitation_health/ medicalwaste/en/hcwmpolicye.pdf [Last accessed 2021 June 17].

9. Anozie OB, Lawani LO, Eze JN, et al. Knowledge, attitude and practice of healthcare managers to medical waste management and occupational safety practices: Findings from southeast Nigeria. J Clin Diagnostic Res. 2017; 11(3): 1-4. doi: 10.7860/JCDR/2017/24230.9527.

10. Assemu DM, Tafere TE, Gelaw YM, et al. Healthcare waste management practice and associated factors among private and public hospitals of Bahir Dar city administration. J Environ Public Health. 2020; 2020(October): 1-10. doi: 10.1155/2020/7837564.

11. An S, Marsaulina I, Aulia D. Motivation, Supervision, and Adherence to Medical Waste Policy in South Labuhanbatu, North Sumatera. J Health Policy Manag. 2020; 5(2): 146-51. doi:

10.26911/thejhpm.2020.05.02.07.

12. Dewi O, Sukendi S, Ikhwan YS, et al. Characteristics and factors associated with medical waste management behaviour in private dental health services in Pekanbaru city, Indonesia. Maced J Med Sci. 2019; 7(1): 157-61. doi: 10.3889/ oamjms.2019.039

13. Njue PM, Cheboi KS, Shadrak O. Adherence to Healthcare Waste Management Guidelines among Nurses and Waste Handlers in Thika Sub-county- Kenya. Ethiop J Health Sci. 2015; 25(4): 295-304. doi: 10.4314/ejhs.v25i4.2.

14. Mohiuddin A. Medical Waste: A Nobody’s Responsibility After Disposal. Int J Environ Sci Nat Resour. 2018; 15(2): 45-51. doi: 10.19080/ ijesnr.2018.15.555908.

15. Suryawan IWK, Prajati G, Afifah AS. Bottom and fly ash treatment of medical waste incinerator from community health centres with solidification/stabilization. AIP Conf Proc. 2019; 2114(June): 1-6. doi: 10.1063/1.5112467.

16. Ali H, Khan E, Ilahi I. Environmental chemistry and ecotoxicology of hazardous heavy metals: Environmental persistence, toxicity, and bioaccumulation. J Chem. 2019; 2019: 1-14. doi:

10.1155/2019/6730305.

17. Hassan AA, Tudor T, Vaccari M. Healthcare waste management: A case study from Sudan. Environ - MDPI. 2018; 5(8): 1-16. doi: 10.3390/ environments5080089.

18. Abu-Qdais HA, Al-Ghazo MA, Al-Ghazo EM. Statistical analysis and characteristics of hospital medical waste under novel Coronavirus outbreak. Glob J Environ Sci Manag. 2020; 6(Special Issue): 21-30. doi: 10.22034/GJESM.2019.06.SI.03.

19. Debere MK, Gelaye KA, Alamdo AG, Trifa ZM. Assessment of the health care waste generation rates and its management system in hospitals of Addis Ababa, Ethiopia, 2011. BMC Public Health. 2013; 13(1): 1-9. doi: 10.1186/14712458-13-28.

20. Ministry of Health of the Republic of Indonesia. Regulation of the Minister of Health Number 7 of 2019 on Environmental Health in Hospital.

21. Prasetiawan T. Permasalahan Limbah Medis Covid-19 Di Indonesia. 2020. Available on: https://berkas.dpr.go.id/sipinter/files/sipinter1008-922-20200713145441.pdf [Last accessed 2021 June 29].

22. Ministry of Health of the Republic of Indonesia. Medical Waste Assessment Form. 2018. Available on: http://kesling.kesmas.kemkes.go.id/ limbahfasyankes/assets/uploaded/formulir_pdf/ for mulir_monev_rs_old.pdf [Last accessed 2021 June 22].

23. Irianti S. Current Status and Future Challenges of Healthcare Waste Management in Indonesia. Curr Status Futur Challenges Healthc Waste Manag Indones. 2013; 23(2): 73-81. doi: 10.22435/ mpk.v23i2.3129.73-81.

24. Ministry of Health of the Republic of Indonesia. Indonesia Health Statistics 2019. 2020. Available on: https://pusdatin.kemkes.go.id/resources/ download/pusdatin/profil-kesehatan-indonesia/ Profil-Kesehatan-indonesia-2019.pdf [Last accessed 2021 June 16].

25. Tassakka MIS, Musrianton M, Alsita I, Runtu KGA, Normayasari, Ndahawali DH. Modeling the impact of the COVID-19 pandemic on air emissions indicators of climate change originating from solid waste management in coastal settlements. IOP Conf Ser Earth Environ Sci. 2020; 584(2020): 1-9. doi: 10.1088/1755-1315 /584/1/012062.

26. Kalantary RR, Jamshidi A, Mofrad MMG, et al. Effect of COVID-19 pandemic on medical waste management: a case study. J Environ Heal

Sci Eng. 2021 Mar 18; 19(1): 1-6. doi: 10.1007/ s40201-021-00650-9. Online ahead of print.

27. Khalid S, Haq N, Sabiha Z, Latif A, Khan MA, Iqbal J. Current practices of waste management in teaching hospitals and presence of incinerators in densely populated areas. BMC Public Health. 2021; 21(1340): 1-10. doi: 10.1186/s12889-021 -11389-1.

28. Ministry of Environment and Forestry of the

Republic of Indonesia. Circular of the Minister of

Environment and Forestry Number SE.3/MENLHK/PSLB3/PLB.3/3/2021 on Hazardous Waste Management during the COVID-19 Pandemic.

29. National Academies of Medicine. Health-Care Utilization as a Proxy in Disability Determination. 2018. Available on: https://www.ncbi. nlm.nih.gov/books/NBK500097/ [Last accessed 2022 Jan 20]

30. 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: 1-14. doi: 10.1155/2020/2934296.

31. Da Silva Etges APB, Cardoso RB, Marcolino MS, et al. The economic impact of COVID-19 treatment at a hospital-level: Investment and financial registers of Brazilian hospitals. J Health Econ Outcomes Res. 2021; 8(1): 36-41. doi:

10.36469/jheor.2021.22066

32. Indonesian Government. Government Regulation of the Republic of Indonesia Number 27 of 2012 on Environmental Permits.

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Published

2025-08-04

Issue

Section

Original research

How to Cite

1.
Andika Putri DA, Zakianis, Aysary A, Softwan. A Comparative Analysis of Hazardous Medical Waste Management Compliance Before (2019) and During (2020) the COVID-19 Pandemic in Indonesia. Ann Ig. 2025;35(1):61-74. doi:10.7416/ai.2022.2504