title: Impact of waste management training intervention on knowledge, attitude and practices of teaching hospital workers in Pakistan.
abstract: OBJECTIVE
  To evaluate the sustainability and effectiveness of training as an intervention to improve the knowledge, attitude and practices of hospital workers on health care waste management.
  
  
  METHODS
  We conducted this quasi-experimental study in two tertiary care teaching hospitals in Rawalpindi in October 2013. Training, practical demonstrations and reminders on standard waste management were given to 138 hospital workers in one hospital and compared with 137 workers from the control hospital. We collected data 18 months after intervention through a structured questionnaire to assess the impact of the intervention. We used paired t-test to compare the scores on knowledge, attitude and practices at baseline and first follow up and final impact assessment. Chi square test was used to compare group variables between intervention and control groups.
  
  
  RESULTS
  After 18 months since intervention the mean scores on knowledge attitude and practices differed statistically significantly since baseline and intervention group had statistically significantly better knowledge positive attitudes and good health care waste management practices (p < 0.001). Health care and sanitary workers in intervention group scored statistically significantly higher (p < 0.001).
  
  
  CONCLUSIONS
  Trainings of health and sanitary workers on health care waste management guidelines were sustainable among the intervention group after 18 months which shows the positive impact of our intervention. It is recommended that the trainings as intervention be included in the overall policies of the public and private sector hospitals in Pakistan and other similar settings.
authors.affiliation: Ramesh Kumar, MBBS, PhD. College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, Assistant Professor Health Services Academy Islamabad, Pakistan.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Ratana Somrongthong, PhD. Associate Professor College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Ratana
authors.initials: R
authors.lastname: Somrongthong
authors.affiliation: Jamil Ahmed, FCPS. Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain.
authors.forename: Jamil
authors.initials: J
authors.lastname: Ahmed
keywords: Hospital workers; Intervention; Knowledge attitude and practice; Training; Waste management