Healthcare Waste Generation Rates in the Three Categories of Public Healthcare Facilities in Malawi

ABSTRACT Background The assessment of the waste generation rate is an initial and critical step in addressing poor healthcare waste management practices. Aim This study aimed to determine the healthcare waste generation rates in primary, secondary, and tertiary healthcare facilities in Malawi. Methods This cross‐sectional quantitative study was conducted in two tertiary (Kamuzu and Mzuzu Central Hospital [MCH]), secondary (Nkhata Bay and Rumphi), and primary (Bolero and Chintheche Rural) healthcare facilities. The broad categorization of healthcare waste into hazardous (sharps, infectious, general, and expired drugs) and nonhazardous (general) wastes was adopted. The waste was measured using a digital scale, and the waste generation rate was subsequently determined. The waste generation measurements were conducted for 28 days. The data were analyzed using R version 4.2.0. MANOVA was used to compare the waste generation means among the healthcare categories at a 5% level of significance. Results The results showed that the overall waste generation rates based on bed occupancy and the number of patients seen were varying. MCH (1.07 kg/bed/day) had the highest, whereas Bolero Rural Hospital (0.06 kg/bed/day) had the lowest waste generation rates. The tertiary hospitals generated more waste (35,659.68 kg), including hazardous (22,223.33 kg) and nonhazardous (13,447.09 kg) waste, than the other healthcare categories. There was a significant difference ( p < 0.001) in the waste generation rate based on the category of healthcare facility. Conclusion The waste generation rate was within the range reported for most low‐income countries. However, hazardous wastes (62.26%) were generated, above the World Health Organization (WHO) recommended amount (<25%), thereby posing a risk for increased waste management costs and occupational hazard occurrence. This study highlights the need for concerted efforts to reduce the amount of hazardous waste generated.