Gap assessment in implementation of Biomedical Waste Management in Health Care Facilities: Nationwide survey in India

Biomedical Waste (BMW) management presents significant challenges globally. Despite the establishment of BMW management rules in India and their subsequent amendments, compliance gaps persist. To address these, the Consortium of Accredited Health Care Organizations (CAHO) conducted a nationwide survey aimed to identify gaps in the implementation of the BMW rules in India.

The survey was designed by CAHO in collaboration with experts across India. A validated tool with 144 questions captured information on BMW management practices across India. A purposive sampling technique was conducted via online survey tool from July to September 2023. Compliance among healthcare facilities (HCFs) was analyzed, and geographical maps were created.

A total of 267 HCFs responded to the survey with 178 (67 %) were accredited. Among them, 51 % of the HCFs directly discarded the needles in the sharps container and 49 % cut the needles before disposal. In 50 % of HCFs blue bins with blue covers were used. Around 115 (43 %) only used dedicated tags to secure the BMW and 58 % fully implemented barcoding. Autoclaving of laboratory waste was done in 211 HCFs (79 %). Dedicated temporary storage areas were found in 245 (92 %) HCFs. Mercury filled devices were still in use in 75 (28 %) of the HCFs.

The survey provides valuable insights into the BMW management practices, gaps and areas of improvement in India. The most notable variations evidenced are sharps disposal practices, usage of blue bins, disposal of pharmaceutical waste and continued use of mercury devices.