Factors Associated with Poor Healthcare Waste Management among Health Workers in Government Health Facilities in Uganda

Abstract

Healthcare waste management (HCWM) remains a critical public health concern, particularly in low-resource settings such as Buvuma District, Uganda. Despite the existence of national guidelines and policies issued by the Ministry of Health, poor HCWM practices persist in many government health facilities, posing risks of infection transmission, environmental contamination, and occupational hazards. Previous district support supervision reports indicated that over 80% of facilities in Buvuma demonstrated poor HCWM, yet limited empirical data exist on the underlying factors contributing to these deficiencies; hence, this study. A cross-sectional study design employing quantitative methods was conducted among 134 health workers across 10 government health facilities in Buvuma district. Data were collected using structured questionnaires and observational checklists. Descriptive statistics summarised HCWM practices and facility characteristics. Bivariate and multivariate logistic regression analyses were performed using SPSS version 21 to identify predictors of poor HCWM, with statistical significance set at p < 0.05. Findings revealed that 53.0% of health workers exhibited poor HCWM practices. While 64.2% reported consistent use of gloves, only 51.5% practised proper waste segregation, and just 36.6% adhered to recommended safety box filling levels. Significant predictors of poor HCWM included having less than two years of work experience (AOR = 2.09, 95% CI: 1.21–4.35, p = 0.03), working at Health Centre II level (AOR = 2.16, 95% CI: 1.32–5.29, p = 0.004), and possessing certificate-level education (AOR = 2.04, 95% CI: 1.91–3.05, p = 0.001). The findings from the chi-square analysis that the presence of written policies or standard operating procedures (SOPs) on HCWM (χ² = 1.56, p = 0.04), support supervision from District Health Teams (DHT) or other regulatory bodies (χ² = 1.33, p = 0.006) observable changes in HCWM systems following supervision (χ² = 2.65, p = 0.03) was significantly associated with better waste management outcomes. HCWM practices among health workers in Buvuma district are suboptimal, with significant gaps in segregation, timely waste removal, and adherence to safety protocols. Poor practices are strongly associated with limited experience, lower education levels, and facility infrastructure. Strengthening training, improving facility resources, and enforcing policy compliance through effective supervision are essential to enhancing HCWM and protecting public health.