Sandrine Andriantsimietry and Hantanirina Ravaosendrasoa
United Nations Development Programme, Madagascar
Scientific Tracks Abstracts: Prim Health Care
Statement of the Problem: Incineration of health care waste, frequently through open burning is the most common practice of
treatment and elimination of health care waste across the country. Autoclave is a best available technology for non-incineration
of health care waste that permits recycling of treated waste and prevents harm in environment through the reduction of
unintended persistent organic pollutants from the health sector. Madagascar, in 2018, set up the first best available technology,
autoclave, to treat the health care waste in public hospitals according the best environmental practices in health care waste
management.
Method: A Global Environment Funded project supported the introduction of the non-incineration treatment of health
care waste to help countries in Africa to move towards Stockholm convention objectives in the health sector. Two teaching
hospitals in Antananarivo and one district hospital in Manjakandriana were equipped, respectively with 1300 L, 250 L and
80 L autoclaves. The capacity of these model hospitals was strengthened by the donation of equipment and materials and the
training of the health workers in best environmental practices in health care waste management. Best environmental practices
including particularly segregation of infectious and domestic waste and recyclable vs. non-recyclable waste, non-incineration
treatment and recycling of health care waste autoclaved that are recyclable are innovative in the country.
Findings: Over four months of autoclaving the health care waste in two teaching hospitals, 7.1 tons per year of health care
waste was treated and 9.4 g toxic equivalent per year of Unintended Persistent Organic Pollutants (UPOPs) are avoided by
autoclaving the health care waste. Currently, 60% of (2018 /3364 kg) plastics are recycled. Proper segregation of waste in the
wards to collect the infectious waste that was treated in the autoclave was the main step guaranteeing a cost-efficient, nonincineration
of health care waste.
Conclusion: Public hospitals in low income countries can be model in best environmental practices in health care waste
management but efforts must be made internally for sustainment. Improving the health care waste management contributes in
prevention and control of infection within the hospitals.
Sandrine Andriantsimietry has completed her PhD in Biology and Master of Public Health specialized in Environmental Health and Sustainable Development from Madagascar University. She is currently the National Project Manager of the UPOPs project in Madagascar.
E-mail: sandrine.andriantsimietry@undp.org
