Background
Methods
Study area
Data and sampling procedures
Location | Mode of operation | Ownership type | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
States | Rural | Urban | Dispensary | Health Centre | District Hospital | Other | Missing | Public | Private | Missing | All |
Anambra | 30.65 | 69.35 | 0.00 | 88.44 | 8.54 | 0.50 | 2.51 | 100.00 | 0.00 | 0.00 | 199 |
Bauchi | 73.58 | 26.42 | 45.28 | 28.77 | 10.38 | 1.89 | 13.68 | 98.58 | 1.42 | 0.00 | 212 |
Bayelsa | 57.46 | 42.54 | 0.00 | 69.06 | 13.81 | 12.71 | 4.42 | 84.53 | 14.92 | 0.55 | 181 |
Cross River | 75.12 | 24.88 | 0.00 | 90.73 | 8.29 | 0.00 | 0.98 | 94.15 | 5.37 | 0.49 | 205 |
Ekiti | 4.81 | 95.19 | 0.00 | 67.31 | 8.17 | 20.19 | 4.33 | 97.60 | 1.92 | 0.48 | 208 |
Imo | 87.39 | 12.61 | 2.61 | 70.87 | 8.26 | 3.91 | 14.35 | 77.39 | 22.17 | 0.43 | 230 |
Kaduna | 63.26 | 36.74 | 1.40 | 70.23 | 13.02 | 4.19 | 11.16 | 81.86 | 17.67 | 0.47 | 215 |
Kebbi | 78.47 | 21.53 | 47.37 | 42.11 | 8.61 | 0.00 | 1.91 | 98.56 | 0.48 | 0.96 | 209 |
Kogi | 55.83 | 44.17 | 0.00 | 68.45 | 30.10 | 0.00 | 1.46 | 92.72 | 6.31 | 0.97 | 206 |
Niger | 81.25 | 18.75 | 3.37 | 82.69 | 6.25 | 4.33 | 3.37 | 96.63 | 2.40 | 0.96 | 208 |
Osun | 21.50 | 78.50 | 0.00 | 78.04 | 9.35 | 1.87 | 10.75 | 85.98 | 14.02 | 0.00 | 214 |
Taraba | 84.97 | 15.03 | 26.42 | 50.26 | 8.81 | 0.52 | 13.99 | 90.67 | 8.29 | 1.04 | 193 |
All | 59.68 | 40.32 | 10.56 | 67.22 | 11.09 | 4.11 | 7.02 | 91.45 | 8.02 | 0.52 | 2480 |
Principal component analysis (PCA) indicator computation
Ordinary Least Square (OLS) regression
Results
Possession of waste management guidelines and staff trainings
Waste Management Guideline | Waste Management Training | |||
---|---|---|---|---|
Variables | No | Yes | No | Yes |
States | ||||
Anambra | 75.88 | 24.12 | 74.37 | 25.63 |
Bauchi | 61.79 | 38.21 | 60.85 | 39.15 |
Bayelsa | 77.35 | 22.65 | 71.82 | 28.18 |
Cross River | 47.80 | 52.20 | 32.84 | 67.16 |
Ekiti | 84.13 | 15.87 | 74.04 | 25.96 |
Imo | 64.35 | 35.65 | 46.09 | 53.91 |
Kaduna | 80.93 | 19.07 | 90.70 | 9.30 |
Kebbi | 77.03 | 22.97 | 79.43 | 20.57 |
Kogi | 82.04 | 17.96 | 72.82 | 27.18 |
Niger | 81.25 | 18.75 | 75.00 | 25.00 |
Osun | 87.38 | 12.62 | 70.56 | 29.44 |
Taraba | 79.79 | 20.21 | 79.79 | 20.21 |
Sector | ||||
Rural | 75.61 | 24.39 | 67.68 | 32.32 |
Urban | 73.80 | 26.20 | 70.50 | 29.50 |
Ownership Type | ||||
Public | 74.60 | 25.40 | 68.34 | 31.66 |
Private | 78.89 | 21.11 | 73.23 | 26.77 |
Mode of Operation | ||||
Dispensary | 79.39 | 20.61 | 77.48 | 22.52 |
Health Centre | 76.06 | 23.94 | 67.95 | 32.05 |
District Hospital | 59.64 | 40.36 | 61.82 | 38.18 |
Other | 81.37 | 18.63 | 76.47 | 23.53 |
Distribution of HCW management practices
Anambra | Bauchi | Bayelsa | Cross River | Ekiti | Imo | Kaduna | Kebbi | Kogi | Niger | Osun | Taraba | All | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sharp Disposal | |||||||||||||
Open burning no protection | 18.59 | 23.58 | 19.34 | 12.68 | 11.54 | 10.87 | 11.16 | 21.05 | 8.74 | 6.25 | 14.02 | 8.29 | 13.79 |
Open burning pit or protected ground | 58.29 | 47.17 | 30.39 | 59.02 | 45.19 | 30.43 | 33.02 | 41.15 | 64.08 | 39.90 | 49.07 | 48.19 | 45.40 |
Dump without burning no protection | 1.51 | 5.66 | 3.87 | 2.93 | 1.92 | 0.43 | 5.58 | 9.09 | 4.37 | 0.48 | 0.47 | 2.59 | 3.23 |
Dump without burning in covered pit or pit latrine | 2.01 | 8.96 | 2.76 | 3.41 | 1.44 | 1.74 | 1.86 | 9.57 | 8.25 | 2.88 | 3.74 | 6.22 | 4.40 |
Dump without burning Open-pit - no protection | 7.04 | 24.06 | 1.10 | 10.73 | 14.42 | 4.78 | 29.77 | 23.44 | 8.25 | 29.81 | 2.34 | 22.80 | 14.96 |
Dump without burning - Protected ground or pit | 18.59 | 20.28 | 3.87 | 17.56 | 7.69 | 0.87 | 6.05 | 15.79 | 16.99 | 16.83 | 3.74 | 25.91 | 12.70 |
Remove off-site stored in covered container | 16.08 | 58.96 | 29.28 | 24.39 | 12.50 | 33.04 | 16.28 | 10.53 | 16.02 | 16.35 | 22.90 | 30.57 | 23.95 |
Remove off-site stored in other protected environment | 1.01 | 8.96 | 10.50 | 2.44 | 0.96 | 13.04 | 0.93 | 11.96 | 5.34 | 3.37 | 1.87 | 3.11 | 5.32 |
Remove off-site stored unprotected | 1.01 | 6.13 | 0.55 | 0.98 | 0.00 | 0.43 | 2.33 | 2.39 | 4.37 | 7.69 | 0.00 | 3.11 | 2.42 |
Remove off-site other (specify) | 4.52 | 1.42 | 7.18 | 6.83 | 4.81 | 6.52 | 1.86 | 1.91 | 5.34 | 0.96 | 5.14 | 1.04 | 3.95 |
Never has sharp waste | 0.50 | 3.30 | 1.10 | 0.00 | 2.40 | 0.43 | 0.00 | 0.48 | 0.00 | 1.44 | 0.47 | 0.00 | 0.85 |
Remove off-site burn incinerator | 0.50 | 5.19 | 0.55 | 1.46 | 0.48 | 26.96 | 0.93 | 5.74 | 0.97 | 0.96 | 0.93 | 1.55 | 4.11 |
Incinerator 2-chamber | 0.00 | 0.47 | 0.55 | 0.98 | 0.96 | 0.87 | 0.93 | 2.87 | 1.46 | 0.96 | 0.93 | 0.52 | 0.97 |
Incinerator 1-chamber | 1.01 | 2.83 | 1.66 | 5.37 | 6.25 | 12.17 | 0.93 | 4.78 | 1.94 | 5.29 | 0.93 | 2.07 | 3.87 |
HCW Disposal | |||||||||||||
Open burning no protection | 19.60 | 25.00 | 27.07 | 15.12 | 17.31 | 26.96 | 11.16 | 21.05 | 12.14 | 8.65 | 28.04 | 10.88 | 18.63 |
Open burning pit or protected ground | 55.28 | 50.94 | 29.83 | 58.05 | 44.23 | 36.96 | 33.49 | 34.93 | 65.53 | 39.90 | 47.20 | 48.19 | 45.36 |
Dump without burning Flat ground - no protection | 1.51 | 8.02 | 4.42 | 2.93 | 2.40 | 2.17 | 4.65 | 9.09 | 4.37 | 0.48 | 1.40 | 3.63 | 3.75 |
Dump without burning covered pit or pit latrine | 3.52 | 11.32 | 3.31 | 6.83 | 3.85 | 7.83 | 1.40 | 8.13 | 6.80 | 2.88 | 4.67 | 6.22 | 5.60 |
Dump without burning Open-pit - no protection | 7.04 | 23.11 | 2.21 | 8.78 | 14.90 | 5.22 | 29.30 | 19.62 | 7.28 | 28.85 | 2.80 | 22.80 | 14.40 |
Dump without burning Protected ground or pit | 17.59 | 20.28 | 4.42 | 17.07 | 6.25 | 2.17 | 6.05 | 12.92 | 16.99 | 15.38 | 1.87 | 30.05 | 12.42 |
Remove off-site stored in covered container | 15.58 | 56.13 | 20.44 | 15.61 | 6.73 | 14.78 | 13.02 | 18.18 | 12.62 | 15.87 | 11.68 | 24.35 | 18.71 |
Remove off-site stored in other protected environment | 1.01 | 7.55 | 9.94 | 4.39 | 1.44 | 7.83 | 0.93 | 12.92 | 3.88 | 4.81 | 2.34 | 4.15 | 5.08 |
Remove off-site stored unprotected | 2.01 | 6.60 | 1.10 | 0.00 | 0.96 | 0.00 | 3.72 | 1.91 | 3.88 | 8.17 | 0.00 | 2.59 | 2.58 |
Remove off-site other (specify) | 3.52 | 1.42 | 8.29 | 3.90 | 3.85 | 3.48 | 1.86 | 1.44 | 4.37 | 0.00 | 3.27 | 0.52 | 2.94 |
Never has medical waste | 2.01 | 0.94 | 1.10 | 2.44 | 2.40 | 0.43 | 0.00 | 0.00 | 0.00 | 0.48 | 0.00 | 0.00 | 0.81 |
Remove off-site burn incinerator | 0.50 | 2.36 | 0.00 | 0.98 | 0.48 | 7.83 | 0.47 | 4.31 | 1.46 | 0.48 | 0.47 | 1.04 | 1.77 |
Disposal incinerator 2-chamber | 0.00 | 2.36 | 1.10 | 3.41 | 3.37 | 10.00 | 0.47 | 4.78 | 1.46 | 5.77 | 0.93 | 2.07 | 3.06 |
Incinerator functional today | 0.00 | 1.89 | 1.10 | 2.44 | 1.92 | 6.52 | 0.93 | 2.39 | 2.91 | 2.40 | 0.47 | 1.04 | 2.06 |
Power source for incinerator available today | 2.51 | 0.94 | 1.66 | 0.98 | 5.29 | 0.00 | 1.40 | 1.44 | 0.97 | 0.48 | 0.47 | 17.10 | 2.66 |
Indices of risky and safe disposal of sharp and non-sharp HCW
Variables | Risky Disposal Index - Sharp | Risky Disposal Index – HCW | Safe Disposal Index - Sharp | Safe Disposal Index – HCW | ||||
---|---|---|---|---|---|---|---|---|
States
| Mean | Std Dev | Mean | Std Dev | Mean | Std Dev | Mean | Std Dev |
Anambra | 0.1392 | 0.9587 | 0.0547 | 0.9145 | −0.3539 | 0.8575 | −0.2202 | 0.8908 |
Bauchi | 0.1892 | 1.4178 | 0.1179 | 1.3550 | 0.6352 | 1.2986 | 0.6769 | 1.4637 |
Bayelsa | 0.3070 | 1.0712 | 0.2868 | 1.1374 | 0.0256 | 0.9500 | −0.0707 | 0.8825 |
Cross River | 0.0128 | 1.0029 | −0.0074 | 0.9194 | −0.1408 | 1.2494 | −0.0689 | 1.1640 |
Ekiti | −0.0720 | 0.9359 | −0.0613 | 1.0031 | −0.3766 | 0.7589 | −0.3418 | 0.7125 |
Imo | −0.0241 | 0.7779 | 0.2345 | 1.0225 | 0.7346 | 1.5517 | 0.2600 | 1.4322 |
Kaduna | −0.1764 | 1.1798 | −0.3023 | 1.0812 | −0.3080 | 0.7678 | −0.3189 | 0.7225 |
Kebbi | 0.2172 | 1.4920 | 0.1317 | 1.2896 | 0.1919 | 1.6565 | 0.3852 | 2.1784 |
Kogi | 0.0146 | 1.0028 | −0.0370 | 0.9942 | −0.1621 | 1.2642 | −0.0982 | 1.2263 |
Niger | −0.4086 | 0.8504 | −0.4511 | 0.8723 | −0.1395 | 1.0727 | −0.0634 | 1.0587 |
Osun | 0.0701 | 0.7732 | 0.2652 | 0.9509 | −0.2903 | 0.8983 | −0.3486 | 0.7751 |
Taraba | −0.2381 | 1.0200 | −0.2349 | 1.0631 | 0.1037 | 1.0291 | 0.1793 | 1.0666 |
Sectors
| ||||||||
Rural | −0.0034 | 1.1337 | −0.0029 | 1.1263 | 0.0560 | 1.1956 | 0.0258 | 1.1977 |
Urban | 0.0051 | 0.9872 | 0.0044 | 1.0099 | −0.0828 | 1.2218 | −0.0383 | 1.3038 |
Ownership Types | ||||||||
Public | −0.0025 | 1.0885 | 0.0010 | 1.0925 | −0.0242 | 1.2120 | −0.0266 | 1.2375 |
Private | 0.0203 | 0.9212 | −0.0216 | 0.9371 | 0.2676 | 1.1501 | 0.2795 | 1.2574 |
Mode of Operation
| ||||||||
Dispensary | 0.0639 | 1.2667 | 0.0039 | 1.1770 | 0.0503 | 0.9586 | 0.1228 | 1.1747 |
Health Centre | −0.0198 | 1.0486 | 0.0079 | 1.0651 | −0.0866 | 1.1958 | −0.1241 | 1.1249 |
District Hospital | −0.0033 | 0.9913 | −0.0038 | 1.0642 | 0.3359 | 1.4942 | 0.4703 | 1.8204 |
Other | −0.0409 | 1.0341 | −0.2056 | 0.9475 | 0.0055 | 1.0141 | 0.0447 | 0.9685 |
Determinants of risky and safe indices HCW disposal
Risky Sharp Disposal Index | Risky Medical Waste Disposal Index | Tolerance | |||||
---|---|---|---|---|---|---|---|
Variables | Coef. | Std. Err. | t-stat | Coef. | Std. Err. | t-stat | 1/VIF |
Staff received training on waste management | −0.0119 | 0.0505 | −0.24 | 0.0676 | 0.0504 | 1.34 | 85.06 |
Southern states | 0.1851 | 0.0481 | 3.85 | 0.2978 | 0.0480 | 6.20 | 80.39 |
Rural healthcare facilities | 0.0269 | 0.0490 | 0.55 | 0.0592 | 0.0489 | 1.21 | 80.45 |
Public healthcare facilities | −0.0043 | 0.0832 | −0.05 | 0.0199 | 0.0831 | 0.24 | 85.84 |
Dispensaries/health center | −0.0976 | 0.0602 | −1.62 | −0.0315 | 0.0601 | −0.52 | 74.19 |
Traveling hours to headquarters | 0.0057 | 0.0345 | 0.17 | −0.0157 | 0.0345 | −0.45 | 85.45 |
Electricity | −0.0661 | 0.0558 | −1.18 | −0.0189 | 0.0557 | −0.34 | 60.47 |
Generators | 0.0937 | 0.0630 | 1.49 | 0.0439 | 0.0630 | 0.70 | 64.17 |
Batteries as second power source | −0.1497 | 0.2574 | −0.58 | −0.5025 | 0.2571 | −1.95 | 97.30 |
Solar panel as second power | 0.0425 | 0.1496 | 0.28 | −0.0659 | 0.1493 | −0.44 | 94.11 |
Other source of power | 0.0223 | 0.1648 | 0.14 | −0.0862 | 0.1646 | −0.52 | 93.97 |
Improved source of water | −0.1254 | 0.0469 | −2.67 | −0.0472 | 0.0468 | −1.01 | 88.90 |
Number of outpatient hours per day | −0.0080 | 0.0034 | −2.38 | −0.0092 | 0.0034 | −2.73 | 77.30 |
Possession of standard waste management guidelines | 0.0357 | 0.0532 | 0.67 | −0.0054 | 0.0531 | −0.10 | 87.39 |
Constant | 0.1776 | 0.1365 | 1.30 | 0.0290 | 0.1363 | 0.21 | |
F(14,2465) | 2.15 | 3.94 | |||||
Prob > F | 0.0075 | 0.0000 | |||||
Adj R-squared | 0.0065 | 0.0163 | |||||
Breusch-Pagan /Cook-Weisberg | 1.28 | 2.42 | |||||
Mean VIF | 1.33 |
Safe Sharp Disposal Index | Safe Non-Sharp Waste Disposal Index | Tolerance | |||||
---|---|---|---|---|---|---|---|
Variables | Coefficients | Robust Std. Error. | t-stat | Coefficients | Robust Std. Error. | t-stat | 1/VIF |
Staff received training on waste management | 0.0870 | 0.0578 | 1.51 | 0.1159 | 0.0576 | 2.01 | 85.06 |
Southern states | −0.1408 | 0.0582 | −2.42 | −0.3251 | 0.0609 | −5.34 | 80.39 |
Rural healthcare facilities | 0.2264 | 0.0560 | 4.04 | 0.0845 | 0.0563 | 1.50 | 80.45 |
Public healthcare facilities | −0.1510 | 0.0860 | −1.76 | −0.1581 | 0.0948 | −1.67 | 85.84 |
Dispensaries/health center | −0.2095 | 0.0658 | −3.18 | −0.2706 | 0.0689 | −3.93 | 74.19 |
Traveling hours to headquarters | −0.0706 | 0.0324 | −2.18 | 0.0104 | 0.0334 | 0.31 | 85.45 |
Electricity | 0.0833 | 0.0563 | 1.48 | 0.0595 | 0.0538 | 1.11 | 60.47 |
Generators | 0.1357 | 0.0723 | 1.88 | 0.1577 | 0.0728 | 2.17 | 64.17 |
Batteries as second power source | 0.3293 | 0.3032 | 1.09 | 0.1991 | 0.3066 | 0.65 | 97.30 |
Solar panel as second power | 0.3885 | 0.2601 | 1.49 | 0.6420 | 0.3006 | 2.14 | 94.11 |
Other source of power | 0.0122 | 0.1500 | 0.08 | 0.0116 | 0.1719 | 0.07 | 93.97 |
Improved source of water | 0.0283 | 0.0474 | 0.60 | 0.0352 | 0.0466 | 0.76 | 88.90 |
Number of outpatient hours per day | −0.0015 | 0.0036 | −0.41 | 0.0024 | 0.0035 | 0.67 | 77.30 |
Waste management guidelines | 0.3281 | 0.0661 | 4.96 | 0.3844 | 0.0681 | 5.65 | 87.39 |
Constant | 0.2095 | 0.1395 | 1.50 | 0.1615 | 0.1469 | 1.10 | |
F(14,2465) | 8.01 | 8.28 | |||||
Prob > F | 0.0000 | 0.0000 | |||||
Adj R-squared | 0.0488 | 0.0686 | |||||
Breusch-Pagan /Cook-Weisberg | 187.35 *** | 553.06 *** | |||||
Mean VIF | 1.33 |