Analysis of healthcare waste management and transition from incineration to sterilisation: the case study of Beira, Mozambique

Purpose Environmentally sound, safe and cost-effective options for the safe treatment of bio-hazardous solid waste (BSW) are currently lacking in low-income contexts (LICs). The purpose of this article is double: to analyse healthcare waste management (HCWM) in Mozambique at a city level and to identify the main benefits of switching from uncontrolled incineration to sterilisation of BSW. Design/methodology/approach The methodologies to analyse the context are qualitative and include: a cross-sectional study with face-to-face interviews and visits of 38 healthcare facilities (HCFs) and 3 health authorities, a round table event with 57 representatives of key stakeholders of the city, regular project meetings with 3 HCFs and a private company expert in BSW treatment, on-site observation and prolonged engagement with incinerator operators. Findings From the interviews and the roundtable event, it emerged that a significant number of HCFs are reporting criticalities regarding their internal HCWM system. With regard to treatment and final disposal, incinerator workers reported many concerns commonly found in literature about the incineration process, which could be improved by a sterilisation process: air emissions, the disposal of unsafe bottom ash versus sterilised waste, health and safety aspects and operating cost recovery. Originality/value The novelty of the present study is to collect the local perceptions on HCWM, developing the first state-of-the-art in Mozambique including all the key stakeholders and filling the literature gap regarding the introduction of more sustainable and advanced BSW treatment technologies in LICs.