title: Adherence to Healthcare Waste Management Guidelines among Nurses and Waste Handlers in Thika Sub-county- Kenya.
abstract: BACKGROUND
  Despite the set guidelines on Healthcare Waste Management in Kenya, mixing of different categories of waste, crude dumping and poor incineration are still a common phenomenon in public health facilities in Thika Subcounty, Kenya. Thika Subcounty generates 560 Kilograms of healthcare waste daily, which is risk to the many patients (admission rate of 26%). This may pose a potential environmental risk and be a source of disease diffusion. This research explored the adherence to healthcare waste management waste guidelines in health care facilities among the nurses and waste handlers.
  
  
  METHODS
  This was a cross sectional survey in which mixed methods were applied. A census and proportionate random sampling method were used. Quantitative data was analyzed using Statistical Package for Social Science (SPSS) version 20.0, while qualitative data was analyzed manually into themes.
  
  
  RESULTS
  Full adherence to the seven waste disposal guidelines was low (16.3%). Knowledge on waste segregation, waste separation then disposal and means of transports were statistically significant in relation to adherence. The type of incinerator and burning status, protection maintenance and supply of adequate waste bins were also important to adherence level.
  
  
  CONCLUSIONS
  Adherence level was low (16.3%,) and insignificantly different among nurses and waste handlers. From this finding, compliance remains a key challenge. Strategies targeted at contextualizing waste regulations and guidelines into local settings are necessary and important. Policy makers may design and implement standard incinerators across all the health facilities. This study is not exhaustive; therefore, it is necessary to carry out a study linking poor treatment and disposal of clinical waste to purported health outcomes in Kenya.
authors.affiliation: Ministry of Health, Public Health Nairobi, Kenya.
authors.forename: P Mwaniki
authors.initials: PM
authors.lastname: Njue
authors.affiliation: National Museums of Kenya, Centre for Biodivesirty, Nairobi, Kenya.
authors.forename: K Solomon
authors.initials: KS
authors.lastname: Cheboi
authors.affiliation: Great Lakes University of Kisumu - TICH, Nairobi, Kenya.
authors.forename: Oiye
authors.initials: O
authors.lastname: Shadrak
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D019983:Guideline Adherence; D006268:Health Facilities; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017745:Incineration; D007630:Kenya; D009726:Nurses; D011634:Public Health; D018505:Waste Management
keywords: Adherence; healthcare waste guidelines; nurses; waste handlers