Knowledge and Practices of Healthcare Waste Management and Trends in Waste Segregation Among Health Workers in Tertiary Hospitals in the Federal Capital Territory, Nigeria

Abstract

Background: Healthcare waste management (HCWM) is an essential component of infection prevention, occupational safety, and environmental protection in healthcare facilities. Improper handling and disposal of healthcare waste expose healthcare workers, patients, waste handlers, and surrounding communities to infectious and environmental hazards. Although effective waste segregation and disposal practices are critical for reducing these risks, many healthcare facilities in low- and middle-income countries, including Nigeria, continue to experience challenges such as inadequate infrastructure, insufficient staff training, and weak regulatory enforcement. In the Federal Capital Territory (FCT), tertiary hospitals generate substantial amounts of healthcare waste due to the high volume of specialized healthcare services provided. However, there is limited evidence regarding healthcare workers’ knowledge and practices related to healthcare waste management and waste segregation in these facilities. This study therefore assessed the knowledge and practices of healthcare waste management and examined trends in waste segregation among healthcare workers in tertiary hospitals in the FCT, Nigeria.Methods: A descriptive cross-sectional mixed-methods study was conducted among 330 healthcare workers selected through a multistage sampling technique from two tertiary hospitals in the Federal Capital Territory, Nigeria. Quantitative data were collected using structured interviewer-administered questionnaires assessing healthcare waste management knowledge, practices, and waste segregation methods, while qualitative data were obtained through 15 key informant interviews with hospital administrators, healthcare waste management officers, and waste disposal contractors. Quantitative data were analysed using descriptive and inferential statistics with IBM SPSS version 25, while qualitative data were analysed thematically. Findings from both components were triangulated to provide a comprehensive understanding of healthcare waste management practices and challenges in the study settings.Results: The findings showed that healthcare workers had moderate knowledge of healthcare waste management, but practices were generally poor and inconsistent across departments. About 54.5% used color-coded bins for waste segregation, while 15.2% reported no segregation. Although 75.8% recognized the importance of proper waste segregation, knowledge gaps remained: 33.3% believed all healthcare waste is hazardous, and 18.2% thought improper disposal poses no community risk. In practice, 54.5% consistently used color-coded bins and 66.7% reported constant availability of PPE. Training was inconsistent, with 36.4% of hospitals conducting quarterly training and 15.2% providing none. Key barriers included inadequate disposal facilities, insufficient training, and weak regulatory enforcement.Conclusion: HCWM practices in tertiary hospitals in the FCT show moderate compliance with guidelines but persistent gaps in training, infrastructure, and regulatory enforcement. Strengthening training programs, improving waste segregation systems, ensuring adequate PPE provision, and enhancing regulatory oversight are essential to improve occupational safety and environmental protection.