abstract: 'Background: In South Africa, community health workers (CHWs) working in

  community-based care (CBC) programmes provide care to patients most of

  whom are living with HIV/AIDS and tuberculosis (TB). Although studies

  have shown that the caregiving activities provided by the CHWs generate

  health care waste (HCW), there is limited information about the

  experiences of CHWs on health care waste management (HCWM) in CBC. This

  study explored HCWM in CBC in Durban, South Africa from the perspectives

  CHWs.

  Methods: We used three ethnographic approaches to collect data: focus

  group discussions, participant observations and informal discussions.

  Data was collected from 85 CHWs working in 29 communities in the Durban

  metropolis, South Africa. Data collection took place from July 2013 to

  August 2014.

  Results: CHWs provided nursing care activities to patients many of whom

  were incontinent or bedridden. Some the patients were living with

  HIV/AIDS/TB, stroke, diabetes, asthma, arthritis and high blood

  pressure. These caregiving activities generate sharps and infectious

  waste but CHWs and family members did not segregate HCW according to the

  risk posed as stipulated by the HCWM policy. In addition, HCW was left

  with domestic waste. Major barriers to proper HCWM identified by CHWs

  include, lack of assistance from family members in assisting patients to

  use the toilet or change diapers and removing HCW from homes, irregular

  waste collection by waste collectors, inadequate water for practicing

  hygiene and sanitation, long distance between the house and the toilets

  and poor conditions of communal toilets and pit latrines. As a result of

  these barriers, HCW was illegally dumped along roads or in the bush,

  burnt openly and buried within the yards. Liquid HCW such as vomit,

  urine and sputum were disposed in open spaces near the homes.

  Conclusion: Current policies on primary health care (PHC) and HCWM in

  South Africa have not paid attention to HCWM. Findings suggest the need

  for primary health care reform to develop the competencies of CHWs in

  HCWM. In addition, PHC and HCWM policies should address the

  infrastructure deficit in low resource communities. In order for

  low-and-middle-income-countries (LMICs) to develop effective community

  health worker programmes, there is a need for synergies in PHC and HCWM

  policies.'
affiliation: 'Hangulu, L (Corresponding Author), Univ KwaZulu Natal, Discipline Psychol,
  Hlth Promot Postdoctoral Programme, MTB Ground Floor,1X09, ZA-4041 Durban, South
  Africa.

  Hangulu, Lydia, Univ KwaZulu Natal, Discipline Psychol, Hlth Promot Postdoctoral
  Programme, MTB Ground Floor,1X09, ZA-4041 Durban, South Africa.

  Akintola, Olagoke, Univ KwaZulu Natal, Discipline Psychol, Hlth Promot Programme,
  4041King George Ave, ZA-4041 Durban, South Africa.'
article-number: '448'
author: Hangulu, Lydia and Akintola, Olagoke
author-email: lydiamudenda@gmail.com
author_list:
- family: Hangulu
  given: Lydia
- family: Akintola
  given: Olagoke
da: '2023-09-28'
doi: 10.1186/s12889-017-4378-5
eissn: 1471-2458
files: []
journal: BMC PUBLIC HEALTH
keywords: 'Community-based care; Community health workers; Health care waste;

  HIV/AIDS'
keywords-plus: GENERATION; SANITATION
language: English
month: MAY 15
number-of-cited-references: '45'
papis_id: 6bc316dd98972a88e6264bc4cb76990f
ref: Hangulu2017healthcare
times-cited: '13'
title: 'Health care waste management in community-based care: experiences of community
  health workers in low resource communities in South Africa'
type: Article
unique-id: WOS:000401865600003
usage-count-last-180-days: '0'
usage-count-since-2013: '10'
volume: '17'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2017'