RESUMO
Nowadays, together with the economic development, public health activities have gained substantial attention with increasing number of hospitals during the past decades. A multi-method approach involving site visits, questionnaires, and interviews, in combination with secondary data revealed that the healthcare waste (HCW) generation, varied with different specialties (general or pediatric/obstetric hospitals) and different level of hospitals (central, provincial, district levels). The HCW generation from different kinds of surveyed hospitals varied from 0.8 to 1.0 kg/bed/day for domestic waste, 0.15 to 0.25 kg/bed/day for infectious and hazardous waste, and less than 0.1 kg/bed/day for recycled waste. Only 94.3% of central hospitals, 92% of provincial hospitals, and 82% of district hospitals complied with national regulation in hazardous medical waste treatment. For healthcare wastewater treatment, the actual operating rates were 91%, 73%, and 50% for central, provincial, and district hospitals, respectively. The cost for HCW management accounted for only 10-15% of the total budget allocated for the medical facilities. Most of the provincial hospitals spent about $0.2-$0.4/bed/year for HCW management. This is the root cause of ineffective HCW management.