Waste generation and management compliance in five selected healthcare institutions in Dinajpur, Bangladesh

Healthcare waste has become an escalating threat worldwide, especially in developing and densely populated countries such as Bangladesh. The purpose of the study is a measurement of present medical waste generation, handling techniques and observation of disposal methods in surveyed hospitals. A mixed-methods study was conducted from November 2025 to January 2026 in five healthcare facilities in Dinajpur city, purposively selected to represent public hospitals, private hospitals, and diagnostic centers, with the largest facilities by patient load chosen in each category. Each facility was visited for two to three days, during which waste was segregated and weighed with a digital scale during the day shift, including the waste accumulated from the preceding night shift, management practices were directly observed, and a structured questionnaire was administered to facility authorities. The five surveyed healthcare facilities generated a combined mean of 2,406.085 kg/day during the measurement period. Substantial deficiencies were observed in segregation, collection, treatment, and disposal practices. All untreated waste from the facilities was dumped at the Matasagor dumping site, where open burning was observed. The maximum rate of generated medical waste is 2,250 kg/day at ARMCH which is the principal healthcare center of Dinajpur city. The average medical waste generated in Abdur Rahim Medical College and Hospital (ARMCH), Dinajpur Diabetic O Swasthoseba Hospital (DDSH), Sadar Hospital (SH), Zia Heart Foundation (ZHF), and Labaid Diagnostic clinic (LD) is 2.81, 0.77, 0.34, 4.00, and 0.02 kg/patient/day, respectively. Total waste generation was positively correlated with average patient load. The linear model yielded R² = 0.94; however, the relationship was strongly influenced by the largest facility (ARMCH). Compliance scores of the surveyed facilities were below 50%, where ZHF scored highest (47.62%) and ARMCH and SH scored the lowest with 23.81% and 14.29%, respectively. Observed deficiencies included open vehicles for off-site transport at all facilities, uncovered bins during internal transport at ARMCH and SH, non-adherence to color coding, and cleaners working without protective clothing. Waste segregation and collection methods, off-site transportation systems, temporary storage sites, and labor safety and training programs all need to be managed by healthcare authorities.