Citation
Khanehzaei, Golyasamin
(2017)
Clinical waste management practices in private clinics in Selangor, Malaysia.
Doctoral thesis, Universiti Putra Malaysia.
Abstract
Most research findings on clinical waste in developing countries acknowledge that even though good policies and regulations exist, the clinical waste is a threat to public health and the environment due to the lack of knowledge and awareness, budget constraints, and lack of enforcement. A study on clinical waste management (CWM) was conducted among private clinics in Selangor, Malaysia to assess current management practices, the legal approach and enforcement and factors in relation to sustainability. There were 295 private clinics that participated in the questionnaire survey, from which, 57.6% were medical clinics and 42.4% were dental clinics. Semi-structured interviews and observations were also carried out among 3 medical clinics, 3 dental clinics and 6 clinical waste management organisations. A pairwise comparison survey was also conducted among clinical waste experts from related organizations. The data from the questionnaires were tabulated and analysed using descriptive statistics, cross-tab, Kruskal Wallis test, Mann-Whitney U test and factor analysis. The qualitative data from the semi-structured interviews were analysed in terms of the transcription and theme formation. Observations were also made to further address the issue of CWM. An analytic hierarchy process (AHP) was utilised to analyse expert opinions using the pairwise comparison survey.
The assessment of legislative approach and enforcement shows that there is a gap in the laws and its management practice in reference to the needs of private clinics regarding effective clinical waste management. Based on the results of AHP, water quality with the weight 0.386 was the most important in the top priority. Air quality, management and resources conservation are in the second, third and fourth ranks with weights 0.127, 0.121 and 0.080. Inconsistency rate of pairwise comparison is equal to 0.08 and it is acceptable as it is lower than 0.10. A policy recommendation was made based on the results of the semi-structured interviews using SWOT and TOWS analyses. Some of the recommendations were to connect and strengthen the political and economic will towards the development and implementation of a robust policy on efficient clinical waste management. Others included the involvement of all stakeholders in the policy making process, the promotion of research and the generation of reliable data in the area, the attracting of international technical and financial aid, and the promotion of training and awareness campaigns in the sector. Additionally, promulgating good governance, improving knowledge and skills, establishing benchmark to facilitate monitoring and initiating information and clinical waste data tracking system were also among the recommended policies. The findings of this study can be utilised by both private clinics and relevant clinical waste management organizations in Malaysia to improve clinical waste management practices in order to achieve a more sustainable clinical waste management system.
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