factors affecting on hospital waste management and impact of awareness a case study of public and...
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FACTORS AFFECTING ON HOSPITAL WASTE MANAGEMENT AND IMPACT OF AWARENESS: A CASE
STUDY OF PUBLIC AND PRIVATE HOSPITALS
ByAmir Abbas
2013-GCUF-05554
Thesis submitted in partial fulfillment ofthe requirements for the degree of
MASTER OF SCIENCE
IN
PUBLIC ADMINISTRATION
DEPARTMENT OF PUBLIC ADMINISTRATIONGC UNIVERSITY, FAISALABAD
August 2015
I
DECLARATION
I carried out the work reported in this thesis under the supervision of Dr.Arfan Ali/Assistant
professor Department of Public Administration GC University, Faisalabad, Pakistan.
I hereby declare that the title of thesis “factors affecting on hospital waste management and
impact of awareness: a case study of public and private hospitals” and the contents of thesis
are the product of my own research and no part has been copied from any published source
(except the references, standard mathematical or genetic models /equations /formulas
/protocols etc.). I further declare that this work has not been submitted for award of any other
degree /diploma. The University may take action if the level of knowledge provided is found
inaccurate at any stage.
Amir Abbas2013-GCUF-05554
I
CERTIFICATE BY SUPERVISORY COMMITTEE
We certify that the contents and form of thesis submitted by Mr. Amir Abbas. Registration
No: has been 2013-GCUF-05554found satisfactory and in accordance with the prescribed
format. We recommend it to be processed for the evaluation by the External Examiner for the
award of degree.
Signature of Supervisor ____________________Name: DrArfan AliDesignation with Stamp____________________
Member of Supervisory Committee
Signature _______________________________Name: Mr. AdeelAnjumDesignation with Stamp___________________
Member of Supervisory Committee
Signature _______________________________Name:Ms. Anum ZafarDesignation with Stamp____________________
Chairperson
Signature with Stamp______________________
Dean / Academic Coordinator
Signature with Stamp______________________
II
ACKNOWLEDGEMENTS
Firstly, I would like to say thanks and all praise to Almighty Allah for giving me the
drive and strength throughout this work.
Without the help and support I received from the following people I would never
have completed this research:-
I hereby sincerely thank to my supervisor Dr.Arfan Ali for his true dedication and
precious advice in guiding me towards the completion of this thesis. He was
fulltime available when I had queries regarding my research. His constructive
feedback helped to improve my research. Without his constant guidance and advice
I will not be able to complete this research thesis.
I would also like to show my gratitude to my family and especially to my friends
for continuously giving me the strength, encouragement and support throughout the
writing process of my thesis.
And finally, I would also like to thank to the respondent’s hospital staff who so
willingly participated in the survey and shared their level of knowledge for this
study.
III
Table of contents
1.6.1. Dependent variable........................................................................................................10
1.6.2. Independent variable.....................................................................................................10
1.7. Ethical Concerns....................................................................................................................11
1.8. Significance of study.............................................................................................................11
Chapter 2...........................................................................................................................................12
LITERATURE REVIEW......................................................................................................................12
2.1. Attitude.......................................................................................................................................18
2.2. Awareness..................................................................................................................................20
2.2.1. Time awareness...................................................................................................................21
2.3. Knowledge..................................................................................................................................21
2.4. Hospital waste management.......................................................................................................24
Chapter 3...........................................................................................................................................28
METHODOLOGY................................................................................................................................28
3.1. Hypothesis..................................................................................................................................29
3.1.1. Hypothesis 1..................................................................................................................29
3.1.2. Hypothesis 2..................................................................................................................29
3.1.3. Hypothesis 3..................................................................................................................29
3.1.4. Hypothesis 4..................................................................................................................29
3.1.5. Hypothesis 5..................................................................................................................29
3.2. Population..............................................................................................................................30
3.3. Sample...................................................................................................................................30
3.4. Data collection method..........................................................................................................30
3.5. Procedure...............................................................................................................................31
3.6. Type of study.........................................................................................................................31
3.7. Type of questionnaire............................................................................................................31
3.8. Measure.................................................................................................................................31
3.9. Data Analysis........................................................................................................................32
3.10. Theoretical Framework.....................................................................................................32
3.11. Variable Explanation.........................................................................................................33
3.11.1. Independent variable.....................................................................................................33
IV
3.11.2. Dependent Variable.......................................................................................................33
Hospital Waste Management.........................................................................................................34
3.12. Statistical/Arithmetic techniques.......................................................................................34
3.13. Hierarchical Linear Regression Analysis..........................................................................34
3.14. Quantitative Analysis........................................................................................................34
3.14.1. Reliability analysis........................................................................................................34
3.15. Descriptive Statistics.........................................................................................................36
3.16. Correlation analysis...........................................................................................................36
3.16.1. Correlation values..........................................................................................................37
3.16.2. Correlation coefficient...................................................................................................37
3.17. Regression analysis...........................................................................................................38
3.17.1. Multiple regression analysis..........................................................................................39
Chapter 4...........................................................................................................................................40
RESULT AND DISCUSSION..............................................................................................................40
Government Hospitals.......................................................................................................................40
4.1. Descriptive Analysis: Frequency chart.......................................................................................40
4.1.1. Demographic factor: Gender...............................................................................................40
4.1.2. Demographic factor: Age....................................................................................................41
4.1.3. Demographic factor.................................................................................................................42
4.2. Regression analysis....................................................................................................................44
4.2.1. Collection............................................................................................................................44
4.2.2. Segregation..........................................................................................................................46
4.2.3. Storage.................................................................................................................................47
4.2.4. Transportation.....................................................................................................................48
4.2.5. Disposal...............................................................................................................................50
4.3. Correlations analysis..................................................................................................................52
Explanation....................................................................................................................................53
Private Hospitals....................................................................................................................................55
4.4. Descriptive Analysis: Frequency chart.......................................................................................55
4.4.1. Demographic factor: Gender...............................................................................................55
4.4.2.1. Demographic factor: Age.................................................................................................56
4.4.3.1 Demographic factor:..........................................................................................................57
4.4.4.1. Demographic factor: Experience......................................................................................58
V
4.5. Reliability analysis.....................................................................................................................59
4.6. Correlation analysis....................................................................................................................61
4.7. Regression analysis private hospitals.........................................................................................64
4.7.1 Collection.............................................................................................................................64
4.7.2 Segregation...........................................................................................................................66
4.5.3. Storage.................................................................................................................................67
4.7.4. Transportation.....................................................................................................................68
4.7.5. Disposal...............................................................................................................................70
Chapter 5...........................................................................................................................................75
SUMMARY......................................................................................................................................75
5.1. Findings of study............................................................................................................................75
5.2. Recommendations......................................................................................................................76
5.3. Limitations of research...............................................................................................................77
5.4. Conclusion..................................................................................................................................78
References……………………………………………………………………………………………79
VI
ABSTRACT
Hospital staff like doctor, nurses and operating staff play a significant role in hospital waste
management. Their attitude, awareness and knowledge contribute a vital impact on hospital
waste management like collection, segregation, storage, transportation and disposal of waste.
It also protect community from the harmful effect of infectious waste.
The aim of the study to show the direct relationship of attitude, awareness and level of
knowledge with hospital waste management. In this cross sectional study a sample of 240
respondents are selected from public and private hospitals of Faisalabad. Result also shows
the level of awareness, attitude and knowledge of public hospital staff regarding hospital
waste management were better than the private hospital staff.
However there is a need of proper training and awareness required for improving their
knowledge regarding hospital waste management.
VII
Chapter 1
INTRODUCTION
Now a days, hospital waste management is emerging as a big issue in medical field not only
in hospitals but also pharmacies, nursing homes, Medicaid and Medicare centers, family
health centers, alcohol and drug treatment centers, nursing homes but also to the
environment. With the passage of time medical field is entering in new era and used some
extra quality sophisticated instrument in medical field which generally increase per patient
waste in hospitals not only in context of Pakistan but also worldwide.
Sharma RK et al. (2005) described that in developed countries it was found that the waste is
originated 1 to 5 kg per bed per day, but in developing countries the ratio of waste production
is approximately 1 to 2 kg per bed per day. Which is slightly less then developed countries.
Asokanet al. (2007) suggest that there was 960 million tons of solid waste are originated in
India. In which 350 million tones waste are organic in nature from agriculture, remaining 290
million tones waste are inorganic from industrial sector and 4.5 million waste are hazardous
from mining sector.
However the erroneous practices of separation from the origin it has been noticed that due to
low knowledge of staff about segregation and infectious waste are mixed with the non-
infectious waste. It was also observed that there is big gap between knowledge and attitude of
the workers (AnuradhaNischal , 2012)
Begum et al. (2008)conclude that mass number of doctor, nurses and operating staff don’t
have appropriate knowledge and insufficient practices towards hospital waste management.
According to the reports of World health organization it was observed that 85% of hospital
waste are found non-hazardous, 10% are ineffective and outstanding 5% are non-infectious
but it was hazardous pharmaceutical and radioactive waste.
1
Hebel-Ulrich et al. (2005) conclude that large number of responses towards knowledge
shows that the awareness regarding hygiene exist, but in practically it is not practiced. Which
directly or indirectly effect the health of humans.
Mandal S.K. and Dutta J.(2004) described that the world health organization those countries
who has high per capita income generate more hazardous waste as compared to the low per
capita income countries. The ratio of hazardous waste generation in high per capita income
countries is 0.5 kg per hospital bed in one day. But in low per capita income countries
hazardous waste generation is 0.2 kg per hospital bed in one day. Health care waste is not
often separated from hazardous or non-hazardous waste that’s makes the real quality
hazardous waste is much higher. Clinical solid waste is a particular challenge in most health-
care facilities of the developing world. Poor handling practices and inappropriate disposal of
hospital waste is an increasing health hazard in these countries. For example hazardous and
medical waste may be treated and disposal with domestic waste then it not only impose bad
impact not on the waste handler worker but also create damages for health of society and
environment.
Dinesh M.S (2010) clarified nonhazardous waste incorporate non-tainted plastic, bundling
material, paper and so on. Bio dangerous waste comprises of (an) Infectious squanders like
sharps, non-sharps, and plastic disposables, fluid Waste, and so forth and (b) Non-irresistible
squanders like radioactive waste, tossed glass, compound waste, cytotoxic waste and burned
waste. On consistent schedule 4 to 2000 kg waste is delivered by wellbeing focuses, out of
which 75% to 90% are not an excessive amount of unsafe or non-hazard but rather remaining
10-25% waste is irresistible and hurtful for strength of people so there is a need of fitting
segregation.
Gupta (2006) expressed that dishonorable segregation practices of doctor's facility waste
influences the individuals who come in direct contact with it. Waste heaps additionally draw
in a mixed bag of illness vectors, including mosquitoes and flies
Abdulla F. et al., (2008) found that the poor level of knowledge and awareness about
segregation it may prompt transmission of sicknesses like typhoid, cholera, HIV,
Tuberculosis, Hepatitis B and C through wounds from sharps defiled with human blood.
2
Patil A.D. et al., (2005) depicted that the individuals were not mindful the results of
irresistible waste and having less awareness and level of knowledge about segregation of
irresistible waste. A study was led by the Central Pollution Control Board (CPCB), a
pinnacle contamination observing assemblage of Government of India, on incinerators in
Delhi Hospitals, reasoned that the incinerators were found to retch an abnormal state of lethal
buildups and harmful discharges, for example, growth creating dioxins and furans other than
chemicals which cause neonatal variations from the norm, conceptive and skin issue,
endocrine disturbance and concealment of the safe framework.
Patil A.D. et al., (2001) depicted that shameful transportation of waste inside of the healing
center is to be done in shut pushcarts to dodge spillage of waste to a sterilization or treatment
office. After purification/disinfection the waste is transported to a typical treatment office, for
example, an incinerator or controlled area fill. Besides the Rules have not been advertised as
generally as needed. Subsequently, littler HCUs may not be completely mindful of them.
Various issues have not been managed in subtle element, for example, Standards of gathering
and storage gadgets, gear, and so forth. According to Athavale A.V. (2010), TheWorld health
organization 80% waste generated by hospitals are consider as general waste and remaining
20% waste is consider as a hazardous waste. Pokhrel (2005) satisfied that lucrative money
related returns and absence of awareness about the issues connected with biomedical
squanders empower waste-picking and reusing exercises.
Consciousness of fitting taking care of and segregation of medicinal services squanders
among wellbeing work force is a need; it is key that everybody ought to know the potential
wellbeing risks. Customary projects will help avert introduction of human services squanders
and related dangers. Blurb show, legitimate naming, and clarification by staff are powerful
routines. Classes and workshops, and support in instructional classes are additionally key
(Pokhrel, 2005).
It has internationally watched that there are 500 million people groups are contaminated from
Hepatitis and on worldwide there are 350million individuals experiencing Hepatitis. In 2009
world wellbeing association reports that there are 33.4 million individuals experiencing
HIV/AIDS furthermore 2.7 million new cases are additionally reported every year Studies
demonstrated absence of such kind doctor's facility waste administration council or archived
3
waste administration and segregation arrangement in doctor's facilities (World Health
Organization, 2011).
Khattak F.K. (2009) clarified that in Pakistan there are vast number of doctor's facilities
which produce overwhelming waste on regular routine. It is assessed that in Pakistan doctor's
facilities 2.0 kg waste is created per bed every day out of which 0.10 kg waste is dealt with as
danger waste which are extremely hazardous for wellbeing.
A study done on 258 doctors (including consultants, registrars and residents), 159 nurses and
169 Paramedical staff. The awareness was significantly satisfactory among doctors and
nurses whereas there is lack of knowledge and awareness among laboratory personnel and
other members of the paramedical staff, which needs effective teaching and training to
prevent adverse outcome on human health. It was conclude that the effective means of BMW
management involves effective knowledge of the medical and paramedical staff, which needs
to educate them through proper educational program, and provision of resources involving
political intervention is vital for the better outcome in future. While interviewing the staff it
was found that a number of workers suffering from hepatitis B/C, Typhoid, Skin infections,
malaria. Health care wastes are those wastes which are produced by health care center during
providing health care services. It included infectious and noninfectious waste (Qureshi W. et
al., 2007).
Manzurul H.M. (2008) explained that medical wastes are those solid wastes which are
generated in the diagnosis, treatment or immunization of humans in research pertaining there
to, or in the production or testing of biological.
According to Verma L.K. (2010), medical waste has two types.
Risk waste
Non risk waste
1.1. Risk waste
Risk waste is divided in to 7 groups like,
Infectious waste
4
Genotoxic waste
Sharps
Chemical waste
Radioactive waste
Pathological waste
Pharmaceutical waste
1.1.1. Infectious waste
Infectious waste is that waste which directly harmful for humans and that has possibility for
causing infections. This is the waste contaminated by any type of bacterium, virus, parasites
or fungi, which includes:
Cultures (the growing of microorganisms in a nutrient medium (such as gelatin
(Proteins from bone & skin) or agar) from laboratory work.
Waste generated from surgery and autopsies.
Waste generated from infected patients.
Waste generated from infected hemodialysis patients
Infected animals from laboratories.
Anything which is in use with infected patients.
1.1.2. Pathological Waste
These waste are
Organs
Fetuses
Organs
Body fluids
Blood fluids
Tissues
5
1.1.3. Sharps waste
These waste are
Scalpels
Saws and knives
Needles
Surgical blades
Infusion sets
syringes
1.1.4. Pharmaceutical waste
These waste are
Expired products
Unused pharmaceutical products.
Spilled products
Contaminated pharmaceutical products.
Surplus drugs, vaccines or sera.
1.1.5. Genotoxic Waste:
These wastes are
Cytotoxic drugs and expired material.
Contaminated materials from the preparation and of the drugs such as syringes, vials
etc.
Vomiting, urine of patients treated with cytotoxic drugs or chemicals and feces.
1.1.6. Chemical Waste:
6
Chemical waste can include the following;
Chemicals from diagnostic and experiment work
Cleaning processes
Housekeeping and disinfecting procedures.
Mercury waste such as from broken clinical equipment spillage.
Cadmium waste, mainly from discarded batteries
1.1.7. Radioactive Waste:
These wastes include Liquid, solid or gaseous waste contaminated with radio nuclides
generated from invitro (outside) analysis of body tissue/fluid, in vivo (body organ imaging)
and tumor localizations and investigations and therapeutic procedures.
1.2. Non-Risk Waste:
Non-hazard waste is that, which is similar to ordinary residential refuse and shows no more
serious danger, accordingly, than waste from a typical home. This general waste is created by
very nearly everyone in the healing facility, I.e., organization, understanding's danger,
cafeterias rooms, cafeterias and nursing station. Such waste may include:
Paper and cardboard.
Packaging.
Food waste, i. e., left over nourishment, foods grown from the ground peelings.
Aerosols.(spray)
1.3. Hazard from Waste
All parsons presented to the risky biomedical waste are possibly at danger, which
incorporates every one of the individuals who either handle the waste at any stage or are
presented to it as an outcome of inconsiderate administration. Irresistible waste may contain
an incredible mixed bag of pathogenic microorganisms. These pathogens contained in the
waste may taint the human body through diverse ways, which incorporates:
7
Absorption through a cut in the skin
Absorption through the bodily fluid layer.
Through inward breath or ingestion.
AkhterNasimaet al., (2002) expressed that irresistible of specific concern biomedical
nowadays, for which there is an in number confirmation of transmission by means of the
biomedical waste, are HIV infection and Hepatitis B and C. syringes and needles are
particularly exceptionally risky on the grounds that they are regularly polluted with
understanding's blood. Numerous pharmaceuticals utilized as a part of healing facilities are
perilous. They can bring about inebriation from retention through skin, bodily fluid film and
from inward breath or ingestion.
Gayatri V. (2005) described that healing facility continually confronting a threat
circumstance because of therapeutic waste. Since it's excessively unsafe for the patient
furthermore for the waste handler. It's irresistible as well as straightforwardly impact on
environment too. Be that as it may, because of shameful practices of waste administration
noninfectious waste additionally turn out to be more perilous when it blend with the
irresistible waste.
NIOSH/Health Care Workers rules/Chap 6 highlighted that airborne microscopic organism’s
increments in the doctor's facilities in light of the fact that staff was not very much aware and
waste are not legitimately handle and oversaw. Which specifically make awful effect the
clinic environment as well as the group wellbeing.
Murthy V.K. (2010) clarified that in connection of Asia then it was looked forward towards
India on the grounds that it has gigantic populace and in healing center day by day waste
proportion is high. In Indian doctor's facilities waste were not legitimately isolated and
basically seen irresistible waste blend with the ordinary waste which turns out to be more
hurtful. At the point when these irresistible squanders were exchange from healing facility to
segregation locales then transportation are not appropriately secured which is reason a spread
of hazardous expires as well as skin disease confronted by the overall population. Sharps
waste were likewise not arrange around then when it was utilized first time. Most vital piece
of Indian doctor's facility waste carelessness is that they discard sharps squanders in open are
8
which causes a spread OF HIV, hepatitis. They have not level of knowledge about reuse of
syringes, needles and other diverse sorts of sharp waste. Waste handler have not awareness
about reuse of syringes and how these sharps squander straightforwardly impact on human
wellbeing only for recouping their essential needs these sharps sold out by the waste picker
as well as waste handler and doctor's facility staff itself include in it. It gets to be irresistible
when it was utilized by second time.
Krishna V (2010) expressed that administration in the majority of Indian doctor's facilities is
not mindful of expense reserve funds accomplished because of good waste administration
rehearses. It has additionally been assessed that segregation investment funds of somewhere
around 40% and 70% could be acknowledged through the usage of a human services waste
diminish.
1.4. Problem Statement
There are several kind of waste which are produced in hospitals on daily basis. Some waste
are infectious and other are noninfectious. Due to improper waste management these waste
are not treated according to concerned procedures. It becomes very harmful not only for
waste handler but also for other peoples. Waste handling practices are not correctly perform
due to less knowledge and awareness. Trainings programs are held but due to low level of
knowledge and careless attitude and awareness concerned staff are not performing well in
hospitals. This study highlight the areas where careless attitude, low level of knowledge and
awareness directly effect on hospital waste management. There is a need of some important
steps needs to be taken by the top management of the hospitals to save the general public
from harmful effects of waste on health of the public. This study measures the relationship
between attitude, awareness and knowledge and tells how these are directly effect on
hospitals waste management and also made a comparison of public and private hospitals of
Faisalabad which sector is performing well.
9
1.5. Objective of the study
To find out the relationship between attitudes, awareness, level of knowledge and
hospital waste management.
To access the attitude, awareness, level of knowledge of employees towards hospital
waste management.
To make a comparison between public and private hospitals and find out which sector
employees have better knowledge, awareness and attitude about hospital waste
management.
To give recommendations to top management how to improve hospital waste
management and minimize the impacts of poor waste management on health
1.6. Variable of study
1.6.1. Dependent variable
Hospital waste management
Hospital waste management depends upon on some factors which are,
Collection
Segregation
Storage
Transportation
disposal
1.6.2. Independent variable
Attitudes
Awareness
Knowledge
10
1.7. Ethical Concerns
Hospital consent was obtained before conducting questionnaire survey.
This study did not expose the name of the participant it remains confidentially.
The participant were fully involved and shown willing for filling questionnaire.
The participant are fully cooperated.
Participant privacy and confidentiality was respected.
The main purpose of the study was explained in front of each participant and so they
were fully informed.
No pressure was asserted on the individual participant.
Result were as such as they were available for the parties of interest
1.8. Significance of study
Many research articles are written on poor waste management and attitudes awareness and
level of knowledge in different countries like Ghana, South Africa and Nigeria. Where these
three variables are the main problem for the top management of hospitals. Some of the
researcher made comparison of public and private hospitals and give some authentic findings
which are very helpful for future researcher. But when we move in context of Pakistan then
we will find out the situation is really critical. But all these are not so much that’s why we are
trying to find out which factors directly effect on hospital waste management and also fix the
responsibility for the individual who are directly or indirectly responsible for such mistakes.
This study also tells how poor waste management impacts not only the health of patient but
also the whole society. While presenting this research it will help full not only for the top
management but also for the employees. Top management can change their pattern and
procedure according to this study and will improve hospital waste management and also
minimize the bad impacts of hazards on health of patient as well as society. Employees
attitudes, awareness, knowledge can be improved by giving some extra training programs
about hospital waste management. This research also tells how we can improve attitudes of
employees and how they can feel the responsibility towards waste management. It also tells how the
knowledge of employees about the standard procedures of hospital waste management can be
improved.
11
Chapter 2
LITERATURE REVIEW
Waste are created due to human activities. There are several ways to collect, segregate, store,
and dispose of which directly impact on human health and environment also (Zurbrugg
2003).
Yusooff 2010 stated that everything made for a purpose behind, there nothing in this universe
which is made without a purpose its human ignorance that he thinks some things treated as
waste or as a raw material. With the passage of time the types or categories of waste are
changing with the changing environment so it’s necessary the attitude of the humans must be
changed.
Ahmed & Mohammed Al-Mekhlafi, 2009 stated that individual in current era facing many
environmental issues which are required to need to be managed properly it is possible when
individual modified those attitudes which are human health or environment supportive.
Ehrampoushet al. (2005) the level of knowledge of the students towards waste management
was not good. It was examined there are 66% of students have not awareness about
segregation and knowledge about recycling.
Paengkaewet al. (2006) stated that the maximum number of Asians students have not better
knowledge problems and there is a need of positive attitude towards environment protection.
Therefore it is necessary to improve skills, knowledge, attitude and awareness in practice.
Saini et al. (2005) stated that his study measured the attitude of the peoples towards waste
management of doctors, nurses and other supportive staff. He conclude that the people who
have higher education and better knowledge have positive attitude towards waste
management.
Grodzinskaet al. (2002) studied tells that there is correlation between level of knowledge of
students and manually performing activities towards waste management.
Waiet al. (2005) stated that there is a significant relationship exist between knowledge
regarding waste management and waste management practices and also a weak correlation of
0.39 but also a correlation coefficient 0.289 exist between knowledge and attitude which
shows that there is significant very weak correlation between them. It shows that the waste
12
management activities are affected by attitude and knowledge regarding waste management.
He further concluded in his study there is no significant correlation between attitude and
waste management practices.
Lalitaet al. (2011) stated that in her study maximum number of people have poor knowledge
and attitude regarding practices of waste management. Her study tells that attitude and
knowledge have direct impact on waste management like collection, segregation, storage,
transportation and disposal. Unsatisfactory knowledge and poor attitude shows waste
management suffer a lot
Suchitraet al. (2007) found in her study that knowledge, attitude can be improved if proper
education given to everyone. There is a significant impact of education on knowledge and
attitude of the peoples. He suggested that there is a permanently requirement for everyone to
start a education system which give proper education regarding waste management practices.
Hesse et al. (2006) found that there is a proper knowledge towards hospital waste
management and positive attitude are performing very vital role for prevention of HIV
spread.
Saini et al. (2005) concluded in her study there is a meaningful gap exist between knowledge
of people regarding waste management practices and also people don’t have positive attitude
towards waste management practices.
Doctors have better knowledge about collection of waste, how to collect and which kind if
waste are segregated from other waste, if domestic or wards waste like papers, bottles,
needles, syringes, saws and knives, broken glass mix with other infectious or pathological
waste like tissues, organs, body parts, blood and body fluids then it is harmful not only for
operating staff but also environment and society health suffer. Nurses have a good
knowledge but not as so well. They comes from very low level with poor qualification they
don’t know how to collect and handles the waste properly, even they also don’t know which
kinds of these waste are. Few peoples know about segregation, but they mix both types of
domestic and pathological, infectious, pharmaceutical, chemical waste which impose bad
impacts on the health of society and environment.
Lack of awareness the hospital staff ignore the SOP. Waste collection to disposal is the duty
of low level waste handler staff. Due to low level of knowledge about waste management
their health is also on risk as well as society. Because there is no proper educational classes
13
and training programs are organize for low level staff about hospital waste management.
They even don’t know about the proper technique and methods of handling the waste.
Bhatti et al. (2007) stated that the hospital waste is a serious threat for the patient, visitors,
doctors, nurses, and waste handling staff. Different types of waste are found in hospitals,
some waste are not So much dangerous but some waste are too much dangerous for health
and environment. In some cases when domestic or simple waste like paper, broken glass,
syringes, needles mix with infectious waste like human tissues, blood samples, human body
inner parts, then it becomes more dangerous and also a cause of spread different disease like
HIV, Hepatitis b, Hepatitis C. This study tells about the knowledge awareness attitude of
waste handlers, doctors and nurses which perform a very significant role in waste
management and threats from improper handling of waste. Waste handlers have less
knowledge about threats and related infection about waste. Some of the doctors have good
knowledge about waste management and aware about its treats but nurses has less knowledge
as compare to doctors. It conclude that they have less awareness and knowledge about waste
management and due to this reason society and environment suffer.
Nidid (2009) stated that there are different kinds of waste which are generated in hospitals on
every day, during the operations in operation theaters, in wards for health care of patients, in
chemical laboratories where different experiments are done. All these waste directly effects
the health of patient as well as visitors. If proper management is not done then entire
environment suffer. Study done in JOS Metropolis also tells there are lack of awareness and
improper management of waste is carry on in this hospital which directly impacts on the
health of patient as well as worker and environment. When check the waste handling
procedure it was found improper waste management due to lack of awareness and knowledge
which cause different disease like dermatitis, asthma, typhoid, Aids, other different harmful
disease. This study recommend that to give proper training to waste handler staff and create
awareness about hospital waste management. Because due to lack of awareness these peoples
are not performing according to standing procedures.
Sharma (2010) stated in 2010 a study is carried about the hospital waste and its management
and it also explain the methods for the treatment of waste in different hospitals of Agra like
governmental, non-governmental, apex. Take sample from all of these and it was concluded
there are lack of awareness and knowledge of hospitals waste management among staff. Staff
14
have less knowledge about proper collection, segregation, storage, transportation, disposal of
waste. They even have less knowledge about types of waste due to this segregation is not
completed satisfactory which impacts bad impacts not only on the health of peoples but also
environment.
These sharps, needles, syringes when thrown in open are mix with pathological waste and
chemical waste it becomes more infectious and especially for those people who are willing to
use these unbreakable syringes due to excessive use of drugs and disease like HIV, Hepatitis
are spread in society.
Khan and Raza (2011) analyzed the improper disposal of waste is also serious issue in
hospitals. It impose bad impacts on the health of society and also spread different disease
among the health care staff as well as community. This study tells the improper handling of
waste due to less awareness among health care staff and waste handlers in the hospitals. Data
was collected from waste handlers and it was found the have less knowledge about waste
handling all the concerned staff suffering from harmful disease. Waste handler don’t know
how to dispose the waste on which standards. This study tells due to improper handling of
waste and having less knowledge and awareness the hospitals staff facing disease like T.B,
skin infections etc. Some of other factors like lack of facilities, like clothes, equipment’s, and
gloves also. Waste handler staff don’t have latest equipment’s and collect waste with hands
this will also harmful for the workers.
Lekwot (2012 explain in his study about the practices which are perform in hospitals was not
proper. It examines there are not proper ways are adopted by the hospital staff to manage the
waste and also have no awareness in staff to manage hospital waste properly there will be
lack of management in it but also there will lack of awareness and knowledge. Due to these
miss planning and managing behaviors general public suffer from diseases as well as hospital
staff. The poor management and improper handling of waste mot only impact on health of
personal but also deep impact on environment. These waste when poorly handled and miss
managed and disposed of in open are it also effect on health but also cracked the soil as well
as water which directly impact on the environment as well as health of society. According to
general analysis there are 5.2 million peoples are died with the impact of hospital poor
management disease and four millions child also died per year with hospital disease.
15
Anagawet al. (2012)he tells about the disease which are spread due to miss handled the
clinical, pathological, chemical waste. There are several types of disease spread among the
waste handler staff due to lack of awareness and knowledge. These infectious disease are
Hepatitis B, Hepatitis C are very common. One of very harmful disease like HBV transmit in
waste handlers during the improper handling of staff. Because these are low level education
people and not much aware about the harmful effects of miss handling and there are well be
no proper training provide towards hospital waste management. A cross sectional study was
managed in Gondar town health care North Ethiopia it shows that the waste handles staff
have less knowledge and lack of awareness about waste management and also have less
preventive measures to handle the infectious waste generated in hospitals. After getting
sample of medical and non-medical staff it was found that the waste handler staff suffering
from Hepatitis B and Hepatitis C. it was concluded that the lack of awareness, knowledge,
improper waste handling, collection to disposal all these factor are responsible for poor waste
management in hospital.
Radha (2012) tells that the hospitals have different kinds of waste which are produced or
used on daily basis. Hospitals waste are biomedical, biologic or non-biologic that are not
available for further use. One time when it used in hospitals and after that it dispose of.
Hospitals waste are very harmful for general public, patient and also for waste handler.
During the treatment in hospitals in wards, operations theaters, cardiology wards where
infectious waste are generated are not properly handled or managed then it directly impact on
the health of the patients and bright chances of spread infectious disease among patients as
well as waste handling staff. It’s the responsibility of the management to aware the staff
about the harmful effects of poor waste handling they are responsible to guide them then also
the responsibility of the staff to managed the waste proper way. The hospital waste
management depends upon the doctors as well as patient. If doctors are not aware about the
consequences then it’s not possible to control the harmful impacts of hospital waste on health
and environment
Asimet al (2013) a study was carried in Faisalabad hospitals about handling of waste and
awareness about hospital waste management among the sanitary workers. This study tells us
there is low level of knowledge and awareness about collection of waste, segregation of
waste, its storage, color coding, transportation and disposal. They have less knowledge about
16
hospital waste management and not aware how these waste impact on the health of patient as
well as environment. This situation is very critical and alarming for waste handling staff but
also for the patient and their relatives also. This study tells about poor waste management in
Faisalabad hospitals, there is need of proper awareness programs among workers, nurses,
doctors’ etc.
Srishti (1998) explain that the medical waste are those waste which are generated during the
treatment, diagnosis or immunization of humans or animals or in the production and testing
of biological organism. All types of waste which are produced in laboratories, hospitals,
medical centers and research departments are treated as medical.
(Ahmed& Mohammed Al-Mekhlafi, 2009) stated that living in a developing world where
nothing is perfect but doing some extra effort or working to make it perfect. Now a days our
earth also bear many environmental problem. These problem are facing due to the irregular
practices and individual attitude and awareness are one of them. Because we are not aware
about that our attitude work against environment and also for us. We are not focusing why it
happens and which factors behind them we are all have careless attitude. We need some
support to develop that type of attitude which are helpful for environment Attitude can be
modify with the passage of time and requirements, because formation and change of attitude
is interlinked closely. Humans always trying to adopt new attitudes with changing needs and
environments, and also trying to modify it to fulfill the required demands. In some cases
peoples are relinquishing attitudes to avail desire needs and interest. It doesn’t means to
change attitude instantly it cannot be change with simple education, there is a need of some
quality education to change or modify the attitude. For changing attitude or acceptance of
new attitude is always depends on the quality of knowledge, and also it must be noted who is
delivering that knowledge and style of his presentation, what was the feeling of listener about
presentation and how he perceived. The credibility of communicator and grounds conditions
are also play vital role for adopting new attitude.
Our knowledge on any topic can be improved by studying extra material on that topic and
also can be improved by interlinked concept with them, through this we got new ways of
innovation and level of knowledge. People may easily change or adopt new attitude, but
improvement of behavior is depends upon the social and psychological factors.
17
According to Gagne and Skinner (2003) defines that the behaviors, opinions and attitudes are
rewarded and reinforced likely to be repeated and ultimately mix into our personal values and
routine behaviors. The wise use of rewards and reinforcements increases the chance that the
recognized individual will repeat the desirable attitude and may serve also as an incentive for
others to adopt the attitude as well. Often our attitudes about the environment or politics
come from level of knowledge and persuasive communications (Johnston, 2010).
According to the study of Saini et al. (2005) attitude of the staff interlinked with knowledge
and education, it means without having better knowledge and awareness you are not able to
give better response about any matter. He is performing a study on attitude towards
biomedical waste management and found that attitude of the staff like doctors, nurses, and
supportive staff or operating staff having good education and knowledge have better attitude
towards hospital waste management. In simple words we can easily understand through good
education we got better knowledge which aware humans about harmful consequences and
then we show positive attitude about any matter.
2.1. Attitude
A predisposition or a tendency to respond positively or negatively towards a certain
idea, object, person, or situation. Attitude influences an individual's choice of action,
and responses to challenges, incentives, and rewards (together called stimuli).
Four major components of attitude are (1) Affective: emotions or feelings. (2) Cognitive:
belief or opinions held consciously. (3) Conative: inclination for action. (4) Evaluative:
positive or negative response to stimuli.
Grodzinskaet al. (2002) also found that a correlation between the level of students’
knowledge and their activities was found regarding waste management.
A couple of past studies (Dunlap & Gallup, 1993) and the discoveries of Hines, Hugerford
and Tomera (1986) demonstrated that the level of consistency between natural attitudes and
conduct is influenced by a man's level of knowledge and awareness, open verbal duty and
his/her awareness of other's expectations.
A study by AyodejiIfegbesan (2010) inspected the level of awareness, level of knowledge
and practices of optional schools understudies with respect to waste administration in
Nigerian instructive foundations. The study demonstrated that penchant for waste
18
administration practices vary by sex, class and time of understudies. Huge connections were
seen between understudies, sex, age and class and their level of awareness, level of
knowledge and practices of waste administration.
Another overview study, by NalanDemirciogluYildiz (2011) demonstrated that awareness
and sensibility levels of grounds individuals about ecological issues in Erzurum, Turkey was
observed to be 64.4%, which may be taken as moderate. In spite of the fact that individuals
know the issues, they don't offer significance to them. In this regard, the creators recommend
that moves to be made may be the reiteration of the studies on the determination of the
ecological affectability and advancement of approaches in view of their outcomes.
Al-Rabaani and Al-Mekhlafi, (2009) perform a study which lets us know there is a need to
create awareness identified with clinic waste administration it characterizes poor waste
administration have unfavorable impact on wellbeing of individuals and environment
likewise, singular must be mindful about its unsafe impacts and to pick up level of
knowledge about doctor's facility waste which doubtlessly demonstrate positive effects on
the individual wellbeing, so there is have to perform better practices of doctor's facility waste
administration like accumulation, disposal, storage, transportation and segregation. In the
event that every one of these things intensely then certainly singular mentalities show
environment steady.
Bartlett (2002) describes youngsters' abilities as dynamic specialists in recognizing issues in
their environment. Scientists likewise contended throughout the years that school
understudies are proficient about their neighborhood intensely powerless to negative and
positive changes (Malone, 1999; Duan and Fortner, 2005) Furthermore, analysts see youth as
having the storage to both recognize issues that worry them and propose new ones they could
call their own.
However Curzon, (2003) and Johnston, (2010), state that fancied practices and attitudes that
are compensated and fortified are prone to be rehashed and, at last, fused into a singular's
close to home estimation set and routine conduct. It helps build up individuals' awareness,
level of knowledge and dispositions and empowers them to be adequately included in
feasible advancement.
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These fancied practices and states of mind towards feasible improvement are known as
genius natural conduct and allude to conduct that damages the earth as meager as could be
expected under the circumstances, or even advantages the earth (Geller, 2002).
The hypothesis of the conceivable outcomes of shaping star natural conduct through
instruction of school understudies has additionally been proposed by Jensen and Schnack
(1997) &Kollmuss and Agyeman (2002). The segment to take after will develop this thought
of the part youngsters could play in tending to ecological issues and working towards
economic advancement basically with respect to squander.
Palmberg and Kuru (2000) coordinated from their exploration that ecological level of
knowledge and passionate mentalities were observed to be essential variables for assuming
natural liability.
2.2. AwarenessWhenever we are trying to study about awareness then it’s compulsory for us to must study
for our self, because without studying our self-it’s not possible for us to understand about
awareness. We learn from our past, where we perform different kind of works sometime we
enjoy success and sometime we bear loss. But all in these situation we learn a lot, especially
from losing something is the best part for telling us what is the best approach for that work.
We gain experiences and aware about the future coming situations, and we take appropriate
decision in present which are beneficial for future. Level of knowledge start from the initial
stage and with the passage of time with education we are able to understand what is best for
any critical situations. Awareness give others a clear perception about our personality and
people judge us from our actions, strength, weakness, belief and motivation. We cannot read
faces of the people because each humans have a different personality no one can claim about
mutual personality characteristic. People judge us from our actions, which kind of response
we showed in any situation, how we are perform and how much time we are able to strict our
points, people also examine the weakness of persons and then made their verdict. Self-
awareness is very necessary because through we are able to understand the actions,
circumstances, and change our thoughts and emotions. Self-awareness is an attribute through
this we can easily achieve our desire result and no one suffer any loss from us. Because
awareness tells us what is wrong and right and it’s better not only for a single individuals its
20
better in the favor of environment and also for the health of society. Awareness tells us what
we want from our life and what our goal plan is and where we are wants to go.
2.2.1. Time awareness
Many of things we are performing in a day and mostly we are doing on the same pattern, like
we are driving a bike on same route and you are not focusing where we are wants to going,
we are just gear up and move towards our destination. We are just spending our time doing
the same things in a day, but we are not measuring time is gone and we are not improving our
self and not brings in our daily routine task. It doesn’t means you are just done work and it’s
productive. It doesn’t means to spend time with your family is unproductive. All those
moments are unproductive in which you are not intended to work but after that you are
feeling regret.
In context of hospital waste management awareness stands first phase. Without this is not
possible for maintain clean and healthy environment. It seems in mostly cases the peoples
those educations level are higher are much aware about the waste management and perform
their task not exactly 100% but 90% they are performing according to standing procedures
and rules and regulations. Educations not only give knowledge but also able us to choose
which is right or wrong. In case of hospital waste management awareness is very necessary
on each level of hospital waste management. Mostly seen the doctors have a better
knowledge about waste management as compare to nurses and waste handler staff. Doctors
have a higher education background as compare to nurses and waste handler staff. They
perform far better and trying to minimize the bad impacts of waste management on health of
the people as well as environment.
2.3. Knowledge
According to the meaning of oxford lexicon 2013 level of knowledge is the familiar with
something, it incorporate data, depictions or abilities which are increase from past experience
and instruction. It is a hypothetical comprehension of subjects furthermore basically. Level of
knowledge can be certain or express.
21
Level of knowledge concerning a particular subject is personally connected to some type of
training in that subject. Instruction has been perceived to have the storage to meet these
difficulties through advancing awareness and level of knowledge on different natural issues,
changing the states of mind of individuals, creating basic considering, activities and working
towards accomplishing manageable advancement. Instruction ought to likewise mean to
build open awareness about ecological issues and their answers (Barraza et. al., 2003) by
giving obliged skills and level of knowledge (Ballantyne et. al. 2006).
Desaet al. (2010) Chanda (1999) reported that individuals' natural level of knowledge is
profoundly particular to issue and geographic scale and this was upheld through examination
done by Ifegbesan (2010).
Shulze (1993) tells that the explanation for the terrible choice making is absence of level of
knowledge. Because of absence of level of knowledge generally choice are tackled wrong
side. Which is absolutely converse our thinking's.
Level of knowledge is considering a principle part in comprehension the ecological issues
besides is that there is a need of routine of essential strides without level of
knowledgeawareness is unrealistic.
Research by Caduto (1983) found that individual’s activities are judge from their level of
level of knowledge.
Various studies has been carried on this point that the level of knowledge of people are
straightforwardly influenced on the awareness and attitudes of people. It's the obligation of
the people to alter that attitude which are environment steady (Dunlap 1994; Inglehart, 1995).
Practice is the genuine application or utilization of a thought, conviction, or technique instead
of speculations about such application or utilization (Oxford Dictionary, 2013)
It is important to clarify the level of knowledge, awareness and attitude about practices in
light of the fact that in the event that it is not clarify then it's impractical to better practices. It
is additionally essential to illuminate issues like healing facility waste administration on the
grounds that without compelling level of knowledge, awareness and uplifting attitude craving
results can't be accomplished. (Desaet al., 2010; Ifegbesan, 2010; Al-Khatibet al, 2010;
Gebriletet. al, 2010).
Past exploration shows that the school understudies have not proper level of knowledge,
awareness and attitude in regards to waste administration rehearses, and there are a few
22
studies led to clarify the relationship between poor waste administration and level of
knowledge, disposition and awareness (Madanay and Bugahoos, 1998; Jensen, 2002;
Ehrampoush and Maghadam, 2005; Ssenyondoet al 2008; Desaet al 2010).
As indicated by the reports of World wellbeing association it was watched that 85% of
doctor's facility waste are discovered non-dangerous, 10% are inadequate and exceptional 5%
are non-irresistible however it was risky pharmaceutical and radioactive waste (World Health
Organization, Geneva, Switzerland, 1999).
Unsafe waste rate changed starting with one nation then onto the next in Pakistan there are
20% dangerous waste, in Nigeria risky waste proportion is 26.5% and in African nations the
proportion is in the middle of 2% to 10 %. In any case, in Bangladesh the proportion of
dangerous waste are much higher than Pakistan which is 36.03% in healing facilities,
facilities and diagnosing focuses. In Tanzania their wellbeing focuses creates half perilous
waste (Azage&Kumie, 2010).
Medicinal services staff fundamental point is to be control and avoid infections. The greater
part of the exercises which are performing by the medicinal services suppliers just imparting
the person about the outcomes of infections and create awareness about waste administration.
In these concerned exercises the creation of risky and non-unsafe waste is a critical issue for
the human services staff as well as for nature (Azage&Kumie, 2010).
In late year the waste era is quickly expanding with the progression of time and it has
exceptionally unsafe effects on soundness of individuals and also environment. In creating
nations the proportion of waste is expanding step by step. It is expanding because of the
ceaselessly expanded in populace (E. Tesfahunet al., 2004)
In 1995, the provincial office of South-East Asia of the World Health Organization (WHO)
made a study of social insurance waste administration in 9 nations in the area with significant
reactions from Indonesia, Myanmar, Srilanka, Thailand, and Bangladesh. Consequence of the
review demonstrated that most medicinal services foundations don't have any waste
administration arrangement or method. In a few nations there is no enactment by any stretch
of the imagination. There is likewise an absence of waste administration rules.
In March 2009 it was found that in India syringes are sold out in dark. These syringes are
those which are as of now utilized. Which cause a Hepatitis B ailment. Indian condition of
Gujrat found that there are a few individuals are included from therapeutic consideration who
23
sold out utilized syringes on shops and subsequent to repacking it was sold out when all is
said in done open (K. E. Solberg, 2009).
E. Tesfahunet al. (2004) were found that healing facilities or clinical staff in creating nations
have not adequate level of knowledge about the transmission of diseases which are just
because of the despicable waste administration, and the attitude of the staff towards doctor's
facility principles and regulations and discipline and there is no preparation is given to staff
with respect to doctor's facility waste administration.
In 2002 world wellbeing association analyzed that in 22 creating nations are not utilizing the
best possible segregation strategies for doctor's facilities waste which specifically effect on
the strength of open. Its segregation routines range in the middle of 18% to 64%.
Boore, J. (2007) disclose that to make and keep up extraordinary organization aptitudes and
practice, reference support that nursing preparing must continue illustrating and make units
of study for misfortune therapeutic chaperons.
2.4. Hospital waste management
"Waste organization", that is the time, social occasion, get ready, transport, and exchange of
solid waste is discriminating for both natural reasons and general wellbeing. There are
different unmistakable decisions available for the organization and treatment of waste
including minimization, reusing, preparing the dirt, essentialness recovery and exchange. At
present, an extending measure of the benefits contained in waste is reused, yet a broad part is
blazed or always lost in landfills. The distinctive methods for waste organization release
different substances, most in little sums and at to an incredible degree low levels. Then again,
concerns stay about potential wellbeing effects joined with the crucial waste organization
progresses and there are various dangers included in the assessment of wellbeing effects
(Daniela Porta1 2010).
Facilities are wellbeing establishments giving patient thought organizations. It is the
commitment of healing facility and social protection centers to manage the general
wellbeing. This may direct be through patient thought or by suggestion by ensuring a
flawless, strong environment for their representatives and the group (Patil and Pokhrel,
2005).
24
Amid the time spent social insurance conveyance, restorative administrations waste is
delivered which fuses sharps, human tissues or body parts and distinctive powerful materials
(Baveja et al., 2000), in like manner suggested as "Therapeutic Waste" or "Specialist's office
Solid Waste". Medicinal services waste may be orchestrated into diverse sorts as showed by
the source, sort and threat variables associated with their taking care of, storage and amazing
exchange. The European Union has been attempting to systematize waste request through the
establishment of the Waste European Catalog (Alvim-Ferraz and Afonso, 2005). The wide
blend of activities at therapeutic administrations workplaces makes various sorts of waste and
there is reliably a danger of spreading sullying due to abusing of powerful waste or sharps
(Chaerulet al., 2008)
Social protection waste administration incorporates organization of an extent of activities,
which are generally designing capacities, for instance, aggregation, transportation,
operation/treatment of get ready frameworks, and exchange of waste. In any case, all things
considered, early on detachment and limit exercises are the quick commitment of nursing
staff. In case the overpowering part gets blended with the general non-overwhelming waste,
the entire mass ends up being possibly powerful. It is the commitment of facilities and other
social protection foundations to ensure that there are no antagonistic wellbeing and common
results as an outcome of their waste taking care of, treatment and exchange works out (Patil
and Pokhrel, 2005)
Social protection wastes are as solid and liquid misuses made in the diagnosis, treatment or
vaccination of individuals or animals; in therapeutic examination; or underway of
inoculations or diverse substances conveyed from living creatures. They are usually made by
recuperating offices, remedial or examination research offices, focuses, working
environments of doctors and dental experts, veterinarians, whole deal consideration
workplaces (for occasion, nursing homes) and dedication administration homes. These
wastes are anything but difficult to perceive, to specific, and to treat appropriately.
Specialist's office wastes join sharps (for occasion, hypodermic syringes, glass slide, needles,
razor and surgical apparatuses), human or animal tissue or release, therapeutic items
(checking swabs and dressings. (Soncuyaet al., 1997).
25
Social protection waste organization is a methodology that ensures real cleanliness in the
wellbeing foundation and security of therapeutic administrations masters and gatherings
(Sanitation Connection, 2002). Johannessenet al. (2000) slant that real organization of
therapeutic waste can minimize the threat, both inside and outside restorative administrations
workplaces. Acharya and Singh (2000) moreover perceived the remedial waste organization
procedure to incorporate, dealing with, segregation, mutilation, sanitization, storage,
transportation and last exchange. He suggests that these are major steps for shielded and
investigative administration of remedial waste in any establishment.
As demonstrated by Rao et al. (2004), the way to minimization and fruitful organization of
therapeutic waste is disengagement (partition) and recognizing verification of the waste.
They endorse that the most suitable system for sorting in order to perceive the classes of
therapeutic waste is the waste into shading coded plastic packs or holders.
According to legitimate models, the overwhelming misuses in the tropical domain can be
kept in a break storage reach for 24 h in the midst of the hot season and up to 48 h in cooler
seasons (Pru¨ss et al., 1999).
The late climb (subsequent to late 1980s) in the recurrence of such disorders as AIDS, and
Hepatitis B and C opens up the probability of infection of the staff dealing with these wastes,
and risk to general wellbeing rising up out of the vehicle of powerful and perilous misuses
(Almuneef and Memish, 2003).
Biomedical waste organization is an extraordinary case wherein the threats and risks exist not
just for the waste generators and heads, furthermore for the general group (Sandhu and
Singh, 2003). An examination of examples an investigation of patterns identified with
healing center strong squanders administration in Kuwait.
As indicated by fauziazahid 2011 Study passed on in Karachi to survey the present practices
of confinement techniques, storage game plans, gathering and move systems in the
demonstrating recuperating focuses of Karachi. Out of eight recuperating focuses went to
(25%) were disconnecting sharps, psychotic waste, mixture, overpowering, pharmaceutical
and pressurized holders at source.
26
M. Rehmal (2008) finish up for dealing with conceivably dangerous waste, two (25%)
specialist's offices gave key cautious mechanical assemblies to its waste handlers. One and
just (12.5%) recuperating office planned instructional gatherings for its waste dealing with
staff as often as possible. Five (62.5%) specialist's offices had limit regions yet
fundamentally it was not protected from access of scroungers. Five (62.5%) facilities
masterminded off their risky waste by seething in incinerators, two (25%) organized off by
city landfills and one (12.5%) was blasting waste in outside with no specific treatment. No
record of waste was generally kept up. Only 2(25%) specialist's offices had all around
reported guidelines for waste organization and a true blue waste organization bunch. There
should be honest to goodness planning and organization regarding care and practices of
waste exchange. Research must be endeavored to seal existing hole in the finding out about
recuperating office waste organization
In Pakistan a study revealed about Practitioners were met about implantation association and
exchange of waste as a result of mixtures and other sharp material. Twenty general masters
out of 25 were met. All asserted utilizing extra syringes just once. None of them was
orchestrating off syringes in sharp holders in the middle. Of 20, 12(60%) were hurling
syringes at open spots and 5(25%) in city waste compartments. Improper exchange of sharp
waste needs progression of fiscally keen procedures that are applicable at a little scale.
Greater studies are obliged to quantify the gravity of the backer. (Shahida, 2005).
A study done on 258 masters (tallying specialists, enrollment focuses and tenants), 159
therapeutic orderlies and 169 Paramedical staff. The care was in a general sense acceptable
among authorities and chaperons however there is unlucky deficiency of level of knowledge
and care among lab personnel and diverse people from the paramedical staff, which needs
convincing indicating and get ready to thwart hostile result on human wellbeing. It was
reason that the convincing system for BMW organization incorporates effective level of
knowledge of the helpful and paramedical staff, which needs to educate them through fitting
educational project, and acquisition of advantages including political intercession is
fundamental for the better result in future (Qureshi Waseem 2007).
In India, with exceptional case to a few generous centers, the larger part of the more
diminutive recuperating offices and nursing homes don't have any fruitful system to safely
27
mastermind off their waste. In fact, even the Government and city mending focuses are no
better than the private nursing homes in such way. Misuses made in the midst of wellbeing
organizations acquisition, the used swathes, syringes, and human tissues, used society media
containing microorganisms are dumped in the open canisters on the roadsides or low lying
locale or facilitated into the water bodies. Hence, an unapproved reuse of restorative misuses
by fabric pickers is being progressed through dishonest dumping of these dangerous wastes
into open canisters and in this manner supports in spread of various contaminations. Destiny
of healing facility waste in India. (Science and Medicine 2009).
Chapter 3
METHODOLOGY
The main purpose of this study is to investigate the relationship between attitudes, awareness,
level of knowledge with hospital waste management and we are trying to find out what kind
of attitude shown the employees towards waste management and are they aware pros and
cons. What kind of knowledge they possess about hospital waste. This study also investigate
the how the miss use of hospital waste management create bad impacts on health of people.
For that purpose we are also trying to mention the demographic factors like age, gender,
marital status, designation, experience and education. We are trying to analyze which
category people have less knowledge about hospital waste management and what was the
reasons behind they are not performing their duties according to international standards.
Therefore regression analysis is used to measure the relationship between attitude,
awareness, and level of knowledge towards hospital waste management.Connection and
relapse examination is utilized to distinguish the relationship in the middle of dependent and
independent variables.
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3.1. Hypothesis
A supposition that is provisionally accepted in order to explain certain incidents and
to give guidance for further enquiry. A hypothesis can be correct or wrong and should be
refutation. If it remains unrefuted by actuality, it is treated as verified.
An assumption about certain characteristics of a population. If it contain values for every part
of a population, it is called a simple hypothesis; if not, a composite hypothesis. If it
attempts to nullify the difference between two sample means (by suggesting that the
difference is of no statistical significance), it is called a null hypothesis.
3.1.1. Hypothesis 1
HO: Attitude, awareness and knowledge do not have significant effect on collection.
H1: Attitude, awareness and knowledge have a significant effect on collection.
3.1.2. Hypothesis 2
HO: Attitude, awareness and knowledge do not have significant effect on segregation.
H1: Attitude, awareness and knowledge have a significant effect on segregation.
3.1.3. Hypothesis 3
HO: Attitude, awareness and knowledge do not have significant effect on storage.
H1: Attitude, awareness and knowledge have a significant effect on storage.
3.1.4. Hypothesis 4
HO: Attitude, awareness and knowledge do not have significant effect on transportation.
H1: Attitude, awareness and knowledge have a significant effect on transportation.
3.1.5. Hypothesis 5
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HO: Attitude, awareness and knowledge do not have significant effect on disposal.
H1: Attitude, awareness and knowledge have a significant effect on disposal.
3.2. Population
Public and private hospitals were chosen to evaluate the relationship between (attitude,
awareness, and level of knowledge) and hospital waste management. Eighthospitals are
selected four from government and four from private sector. For that purpose the targeted
populations were selected from public and private hospitals.
3.3. Sample
For advocating my theme a specimen of 260 representatives was welcome to finish the
survey. Subsequent to sifting and cleaning the level of knowledge 240 were discovered in
like manner. So the proportion of reaction was 92%. The focused on gathering was chosen
from healing facilities specialists, medical caretakers, and waste administration working
staff. An arbitrary examining system was utilized to give equivalent opportunity to every
person to take part and give his supposition. As Uma Sekaran (2003), said that for doing an
exploration a decent example outline and test size is exceptionally vital. A decent example
will help to legitimize the outcomes acquired from the populace.
3.4. Data collection method
With the end goal of level of knowledge gathering poll study is utilized to gather profitable
level of knowledge from respondents. The configuration of poll relies on the sort of study.
Questionnaire survey is used because it’s very cheap and less efforts are required for its
distribution and response of individual can be easily captured. The pattern of questionnaire is
very simple and everyone can be easily understand and filled. Format of the questionnaire is
very simple and easily understandable. It consist 9 pages with romans numbering. First page
consist of demographic factor like age, gender, education, experience etc. Page number 2 to 6
consist 38 questions about hospital waste management. Seventh pages contain 7 questions
which represent the attitude of individuals towards hospital waste management. Eight
number page consist 12 questions of awareness about hospital waste management. Last page
contain 6 questions on level of knowledge about hospitalwaste management.
30
3.5. Procedure
By following hospitals rules and regulations permission is granted from higher management.
Some of the managements of hospitals did not allow us to distribute questionnaire directly
because they think it leaks its secrecy. For that purpose in these hospitals questionnaire was
hand over to the higher management and after completion of questionnaire collected from
higher management. All the other hospitals who directly allow us to distribute questionnaire
with the permission of hospitals higher management the questionnaire were distributed
among all the individual on same date and also given a time of one week to fill the
questionnaire. On concerned date fill questionnaire was collected from each individual.
3.6. Type of study
The study we are putting in this research is cross sectional study. In the cross sectional study
data is collected on one time for research purpose. This research explain the relationship
between (attitude, awareness, and level of knowledge) and hospital waste management.
Theoretical concepts and statistical tools are used to verify the relationship between
independent and dependent variables.
3.7. Type of questionnaire
Questionnaire was used to collect the primary data from individuals. For that purpose five
points Likert scale was used. To get the general response of individuals.
Strongly
disagree
Disagree Neutral Agree Strongly Agree
1 2 3 4 5
3.8. Measure
The questionnaire used for analysis in this study were taken from the paper of Chudasama
(2014). He were used five point Likert scale. The sample item of questionnaire is “Infectious
waste is taken and separated from other medical wastes”
31
3.9. Data Analysis
After receiving the filled questionnaire response of the individuals fed in to Statistical
package for social sciences (SPSS). It’s necessary to feed all the responses of individuals
with full care and responsibility to minimize the chances of errors.
3.10. Theoretical Framework
32
Hospital Waste Management
Collection
Segregation
Storage
Transportation
Disposal
Level of Knowledge
Awareness
Attitude
3.11. Variable Explanation
3.11.1. Independent variable
Attitude Tendency to respond positively or negatively towards a situation,
thought, idea, person and object. Another definition of attitude is feeling
or opinion of something about someone.
Awareness Knowledge that something exist or understanding of a situation or
subject at the present time based on level of knowledge and experience.
Knowledge Knowledge is a familiarity, awareness or understanding of someone or
something, such as facts, level of knowledge, descriptions, or skills,
which is acquired through experience or education by perceiving,
discovering, or level of knowledge.
3.11.2. Dependent Variable
33
Hospital Waste
Management
Hospital Waste Management implies the administration of waste
delivered by doctor's facilities utilizing such strategies that will help
to check the spread of ailments through.
3.12. Statistical/Arithmetic techniques
Suggestive and inferential insights devices have been utilized to break down the level of
knowledge. For condense of level of knowledge and result measure of focal inclination have
been utilized as an apparatus. These measures speaks to mean & standard deviation.
Inferential measurement are those measurement which are utilized to quantify the
relationship in the middle of reliant and independent variables.
3.13. Hierarchical Linear Regression Analysis
Linear regression analysis is a tool which is used to modeling the relationship between
dependent variable Y and one or more than one independent variables. The case of one
explanatory variable is called simple linear regression and more than one explanatory
variable is called multiple linear regression. Hierarchical linear regression analysis is used to
check the moderating relationship of top management firstly between attitude and hospital
waste management, secondly awareness and hospital waste management, thirdly knowledge
and hospital waste management.
3.14. Quantitative Analysis
Reliability analysis
Descriptive analysis
Correlation analysis
Regression analysis
3.14.1. Reliability analysis
Cronbach’s Alpha value
Edifying estimation are those which fuse mean, standard deviation and relationship were
processed among variables. To setting up the effect of self-ruling variables on dependent and
34
coordinating variable hierarchal various backslide were used. Hypnotizing estimation
included on to courses, most importantly else measure of central inclination and second one
is measure of variability measures. The retribution of mean, center and modes go under
measure of central affinity and the first measures and standard deviation and skewness goes
under measures of alterability or variability. To demonstrate immense data connecting with
estimation frameworks are to a great degree enduring. Unmistakable estimation don't
depends on the probability framework.
Cronbach’s Alpha written as:
α = N.cT / vT + (N-1).cT
N = Number of items
c = Average covariance of the items
v = Average variance of the items
If the number of items are increased then Cronbach’s alpha increases. If the average inter
items covariance correlation is high then alpha value is also high. If the correlation value is
low then alpha value decreases. Alpha value can be increases in one condition if the
correlation between the items are increases. If there is low correlation then the alpha value
decreases. Alpha is appropriate when the items are selected from different sector or areas.
When the items are selected from broad area then the Cronbach’s alpha is more significant.
Cronbach’s alpha Internal consistency
α ≥ 0.9 Excellent
0.9 > α ≥ 0.8 Good
0.8 > α ≥ 0.7 Acceptable
0.7 > α ≥ 0.6 Moderate
35
0.6 > α ≥ 0.5 Satisfactory
α ≤ 0.5 Not acceptable
The values of alpha under 0.5 is treated as not acceptable. The values between 0.6 to 0.5
consider as satisfactory values. The values between 0.7 to 0.6 are moderate. The values
between 0.8 to 0.7 are acceptable. The values between 0.9 to 0.8 are treated as good values
and last but not the least the value of alpha is greater than 0.9 then it is highly acceptable and
excellent.
3.15. Descriptive Statistics
Enlightening measurement are those which incorporate mean, standard deviation and
relationship were computed among variables. To setting up the impact of independent
variables on dependent and directing variable hierarchal numerous relapse were utilized.
Spellbinding measurement included on to courses, above all else measure of focal propensity
and second one is measure of variability measures. The reckoning of mean, middle and
modes go under measure of focal propensity and the first measures and standard deviation
and skewness goes under measures of alterability or variability. To show huge level of
knowledge engaging measurement systems are extremely steady. Unmistakable measurement
don't relies on the likelihood system.
3.16. Correlation analysis
Correlation analysis measures the association between to variables like independent and
dependent. When we are going to find out the correlation between two variables then one
variable is known as dependent variable and other is known as independent variable. We can
also say independent variables are those variables which cause a change in dependent
variable. Now we are going to find out change if there is a change in independent variable
which impact on change in dependent variable or not. Correlation are used to find out the
strength of the relationship between two variables. If they is a weak relationship between two
variables then we can say these two variables are strongly correlated with each other. In case
36
of strong relationship between two variable there is a strong correlation between the
variables. Correlation contains both positive and negative values.
Correlation values stands between +1 and -1. The value between two variables if found +1
then it means they have strong correlation between them. In case of -1 value it means they
have perfect negative relationship between them. When there is a positive relation then it
means they have direct relation between them. It means if one variable like independent
variable is increased then other variable like dependent variable also increase. In case of
negative relationship it means one variable like independent variables increase other variable
like dependent variable is decrease. It shows indirect relationship exist between two
variables. If we found a zero value between two variables then it means they are not
correlated with each other and there is no relationship exist between two variables.
We can also say if there is change brings in one variable and also brings a change in other
variables, it shows change in one variable is caused by change in other variable. It shows
there is correlation between the variables.
3.16.1. Correlation values
Correlation Value Relationship
Strong correlation +1 Positive
Weak correlation -1 Negative
No correlation Zero No Relationship
3.16.2. Correlation coefficient
Relationship Coefficient is a factual apparatus which is utilized to gauge the adjustments in
dependent because of changes in independent variable. On the off chance that the estimations
of one variable changes it will foresee the estimation of other variable. Relationship
coefficient is utilized to gauge the bearing and quality of a straight relationship between the
variables. It is meant by r. its qualities changes in the middle of +1 and - 1. In the event that a
37
definite - 1 worth is discovered then it demonstrates there is a negative relationship. In the
event that esteem is - 0.7 it demonstrates an in number negative relationship. Estimation of -
0.5 shows there is a moderate relationship. Esteem 0.3 demonstrates a feeble negative
relationship. Estimation of 0 shows there is no straight relationship between the variables.
A coefficient of +1 demonstrates an impeccable positive relationship between variables. An
estimation of 0.7 demonstrates an in number straight affiliation. Estimation of 0.5 shows
moderate and 0.30 shows feeble relationship between two variables. Estimations of
connection and quality of relationship in view of these qualities.
Value of correlation (r) Strength of relationship
0.00 – 0.30 Very weak
0.30 – 0.50 Weak
0.50 – 0.70 Strong
0.70 – 1.00 Very strong
3.17. Regression analysis
It is utilized to figure out the presence of relationship between variables. It foresee the
reliance of one variable that is subject to one or more independents. It clarifies how a one
unit change in independent will brings a one unit change in dependent and different things
stay consistent. Relapse gauges the normal estimation of dependent while keeping
independent variable steady. It likewise tells among independents which one is identified
with dependent. Kind of relationship which exist between variables are additionally clarified.
Relapse worth begin from 0 to 1. It likewise used to gauge the relationship in the middle of
dependent and independents. It additionally foresee the estimations of relationship in the
middle of dependent and independents.
3.17.1. Multiple regression analysis
38
The principle reason for numerous relapse investigation is to find out around a few
independent variable and dependents. It is firstly utilized by Pearson as a part of 1908. It is
additionally utilized when we need to discover the estimations of one variable in light of the
estimations of two or more different variables.
Regression Equation
Y = α +β X…..e
Where Y is dependent variable
α is intercept
β is coefficient for the independent variable X
X is the independent variable
E is the error term
Equation 1
Collection= α+β1 Attitude +β2 Awareness + β3 Knowledge + e
Equation2
Segregation = α+β1 Attitude +β2 Awareness + β3 Knowledge + e
Equation 3
Storage = α+β1 Attitude +β2 Awareness + β3 Knowledge + e
39
Equation4
Transportation = α+β1 Attitude +β2 Awareness + β3 Knowledge + e
Equation5
Disposal = α+β1 Attitude +β2 Awareness + β3 Knowledge + e
Chapter 4
RESULT AND DISCUSSION
Government Hospitals
4.1. Descriptive Analysis: Frequency chart
4.1.1. Demographic factor: Gender
Table: 4.1.1
Gender Frequency Percent
Male 77 64.2
Female 43 35.8
Total 120 100.0
Fig: 4.1.1
40
This study consist a sample of 120 people from government sector.
This table 4 and figure 4explain the frequency and percentage of male and female staff. The
percentage and frequency of male staff are 64.2% and 77 respectively. The female staff
percentage and frequency were 35.8% and 43 respectively. This table shows a greater
percentage of male staff as compared to the female staff.
4.1.2. Demographic factor: Age
Table: 4.1.2
Age Frequency Percent
21-30 98 81.7
31-40 22 18.3
Total 120 100.0
Fig: 4.1.2
41
Table 4.2 and figure 4.2 Demonstrates the age dissemination of respondents. It demonstrates
a more prominent number of respondents lie between 21 to 30 years. The respondents lie
between the ages of 21 to 30 years are 81.7 % (98). While following them 18.3 % (22) are in
between 31 to 40 years old.
4.1.3. Demographic factor: Education
Table: 4.1.3
Education Frequency Percent
Intermediate 45 37.5
Graduation 32 26.7
Professional degree 43 35.8
Total 120 100.0
42
Table 4.13 and figure 4.1.3 shows the frequency distribution of education of the respondents.
It shows 37.5 % (45) respondents having intermediate degree. The respondents who having a
graduation degree their ratio and frequency distribution were 26.7% (32). The respondent
having professional degree with ratio and frequency distribution are 35.8% (43) respectively.
4.1.4. Demographic factor: Experience
Table 4.1.4
Experience Frequency Percent
1-3 year 21 17.5
3-5 67 55.8
5-7 11 9.2
above 7 21 17.5
Total 120 100.0
43
Fig: 4.1.4
Table 4.1.4 and figure 4.1.4demonstrates the experience dispersion of the respondents. It
demonstrates that a more noteworthy number of respondents lie in the middle of 3 to 5 years
their rate and recurrence dissemination are 55.8% (67) separately. The respondents who
having background of 1 to 3 years demonstrating a rate and recurrence of 17.5% (21)
individually. Respondents having knowledge 5 to 7 year demonstrating a rate and recurrence
of 9.2% (11) individually. Respondents having experience above 7 year showing a
percentage and frequency of 17.5% (21) respectively.
4.2. Regression analysis
4.2.1. Collection
Table: 4.2.1
ANOVAa
Model Sum of
Squares
df Mean
Square
F R
square
Sig.
1 Regression 3.500 3 1.167 24.214 .426 .000b
44
Residual 4.722 98 .048
Total 8.222 101
a. Dependent Variable: collection
b. Predictors: (Constant), level of knowledge, Awareness, Attitude
Table 4.2.1 demonstrates that the independents attitude, awareness and level of knowledge
clarified the difference of 42.6% in the dependent variable accumulation by demonstrating
the estimation of R2 .426. It demonstrates that attitude, awareness, and level of knowledge
have an incredible effect on accumulation. It demonstrates the criticalness is 0.000 in this
model P worth is under 0.05 demonstrating that the model is essentially anticipating the
result. F = 24.214 it speaks to the relationship is noteworthy. Fit is good
Table: 4.2.2
Coefficientsa
Model Unstandardized
Coefficients
Standardize
d
Coefficients
t Sig.
B Std. Error Beta
1 (Constant) 2.522 .263 9.593 .000
Attitude -.170 .084 -.221 -2.032 .045
Awareness .215 .049 .399 4.351 .000
Level of
knowledge
.436 .062 .689 7.089 .000
a. Dependent Variable: collection
HO: Attitude, awareness and knowledge do not have significant effect on collection.
45
H1: Attitude, awareness and knowledge have a significant effect on collection.
Table 4.2.2 demonstrates the estimation of P is not exactly α. On the off chance that P worth
is under 0.05 then Null speculation is rejected and option is acknowledged. It demonstrates
the independent variables have a critical effect on dependent.
4.2.2. Segregation
Table: 4.2.2.1
ANOVAa
Model Sum of Squares
df Mean Square
F R square
Sig.
1 Regression 9.666 3 3.222 13.357 .290 .000b
Residual 23.639 98 .241
Total 33.305 101
a. Dependent Variable: Segregation
b. Predictors: (Constant), level of knowledge, Awareness, Attitude
Table 4.2.2.1 shows that the independent variables attitude, awareness and knowledge
explained the variance of 29% in the dependent variable segregation by showing the value of
R2.290. It shows that attitude, awareness, and knowledge have a great impact on segregation.
It shows the significance is 0.000 in this model P value is less than 0.05 showing that the
model is significantly predicting the outcome. F = 13.357 it represents the relationship is
significant. Fit is good
Table: 4.2.2.2
Coefficients
Model Unstandardized
Coefficients
Standardize
d
Coefficients
t Sig.
B Std.
Error
Beta
1 (Constant) 1.093 .596 1.834 .070
Attitude .463 .157 .299 2.951 .004
46
Awareness -.142 .065 -.186 -2.182 .032
Level of
knowledge
.362 .129 .284 2.808 .006
a. Dependent Variable: Segregation
HO: Attitude, awareness and knowledge do not have significant effect on segregation.
H1: Attitude, awareness and knowledge have a significant effect on segregation.
Table 4.2.2.2 demonstrates the estimation of P is not exactly α. On the off chance that P
worth is under 0.05 then Null speculation is rejected and option is acknowledged. It
demonstrates the independent variables have a critical effect on dependent.
4.2.3. Storage
Table: 4.2.3.1
ANOVAa
Model Sum of
Squares
df Mean
Square
F R
square
Sig.
1 Regression 11.785 3 3.928 16.387 .334 .000b
Residual 23.493 98 .240
Total 35.277 101
a. Dependent Variable: Storage
b. Predictors: (Constant), level of knowledge, Awareness, Attitude
47
Table 4.2.3.1 demonstrates that the independent variables attitude, awareness and level of
knowledge clarified the difference of 33.4% in the dependent variable showing so as to stock
the estimation of R2 .334 It demonstrates that attitude, awareness, and level of knowledge
have an extraordinary effect on storage. It demonstrates the centrality is 0.000 in this model P
worth is under 0.05 demonstrating that the model is fundamentally anticipating the result. F =
16.387 it speaks to the relationship is critical. Fit is good.
Table: 4.2.3.2
Coefficients
Model Unstandardized Coefficients
Standardized
Coefficients
t Sig.
B Std. Error Beta
1 (Constant) -1.104 .586 -1.883 .063
Attitude .381 .187 .239 2.041 .044
Awareness .314 .110 .281 2.847 .005
Level of knowledge
.352 .137 .269 2.566 .012
a. Dependent Variable: Storage
HO: Attitude, awareness and knowledge do not have significant effect on storage.
H1: Attitude, awareness and knowledge have a significant effect on storage.
Table 4.2.3.2 demonstrates the estimation of P is not exactly α. On the off chance that P
worth is under 0.05 then Null speculation is rejected and option is acknowledged. It
demonstrates the independent variables have a critical effect on dependent.
4.2.4. Transportation
Table: 4.2.4.1
ANOVAa
Model Sum of df Mean F R Sig.
48
Squares Square square
1 Regressio
n
20.041 3 6.680 58.466 .642 .000b
Residual 11.197 98 .114
Total 31.238 101
a. Dependent Variable: Transportation
b. Predictors: (Constant), level of knowledge, Awareness, Attitude
Table 4.2.4.1 demonstrates that the independent variables disposition, awareness and level of
knowledge clarified the fluctuation of 64.2% in the reliant variable transportation by
demonstrating the estimation of R2 .642 It demonstrates that attitude, awareness, and level of
knowledge have an incredible effect on transportation. It demonstrates the essentialness is
0.000 in this model P quality is under 0.05 demonstrating that the model is fundamentally
anticipating the result. F = 58.466 it speaks to the relationship is critical. Fit is good
Table: 4.2.4.2
Coefficients
Model Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
B Std.
Error
Beta
1 (Constant) -.436 .501 -.871 .386
Attitude -.152 .074 -.126 -2.069 .041
Awareness .294 .064 .280 4.615 .000
Level of
knowledge
.908 .075 .736 12.11
0
.000
a. Dependent Variable: transport
HO: Attitude, awareness and knowledge do not have significant effect on transportation.
49
H1: Attitude, awareness and knowledge have a significant effect on transportation.
Table demonstrates the estimation of P is not exactly α. On the off chance that P worth is
under 0.05 then Null speculation is rejected and option is acknowledged. It demonstrates the
independent variables have a critical effect on dependent.
4.2.5. Disposal
Table: 4.2.5.1
ANOVAa
Model Sum of
Squares
df Mean
Square
F R
square
Sig.
1 Regression 17.902 3 5.967 13.963 .299 .000b
Residual 41.882 98 .427
Total 59.784 101
a. Dependent Variable: Disposal
b. Predictors: (Constant), level of knowledge, Awareness, Attitude
Model summery is given in table 4.2.5.1 demonstrates that the independents attitude,
awareness and level of knowledge clarified the change of 29.9% in the reliant variable
segregation by demonstrating the estimation of R2 .299 It demonstrates that attitude,
awareness, and level of knowledge have an extraordinary effect on segregation. It
50
demonstrates the hugeness is 0.000 in this model P worth is under 0.05 demonstrating that
the model is essentially anticipating the result. F = 13.963 it speaks to the relationship is
noteworthy. Fit is good.
Table: 4.2.5.2
Coefficients
Model Unstandardized Coefficients
Standardized Coefficients
t Sig.
B Std. Error Beta
1 (Constant) -2.042 .961 -2.124 .036
Attitude .424 .154 .239 2.747 .007
Awareness .645 .124 .443 5.215 .000
Level of knowledge
.291 .120 .211 2.437 .017
a. Dependent Variable: Disposal
HO: Attitude, awareness and knowledge do not have significant effect on disposal.
H1: Attitude, awareness and knowledge have a significant effect on disposal.
Table 4.2.5.2 Demonstrates the estimation of P is not exactly α. On the off chance that P
worth is under 0.05 then Null speculations is rejected and option is acknowledged. It
demonstrates the independent variables have a critical effect on dependent
51
52
4.3. Correlations analysis
Segregat
ion
Dispos
al
Storag
e
Transp
ort
Collecti
on
Attitud
e
Awarene
ss
Level of
knowledge
Segregation
Pearson Correlation
1 .606** .447** .607** .566** .441** .179 .446**
Disposal
Pearson Correlation
1 .479** .452** .114 .295** .469** -.082
Storage
Pearson Correlation
1 .359** .112 .510** .382** .391**
Transport
Pearson Correlation
1 .619** .548** .254** .743**
Collection
Pearson Correlation
1 .330** .282** .560**
Attitude
Pearson Correlation
1 .449** .539**
Awareness
Pearson Correlation
1 -.025
level of knowledge
Pearson Correlation
1
**. Correlation is significant at the 0.01 level (2-tailed).
*. Correlation is significant at the 0.05 level (2-tailed).
Explanation
The outcome acquired from relationship investigation demonstrates that,
There is a positive solid connection exist in the middle of disposal and segregation (r
= 0.606)
There is a positive feeble connection exist in the middle of disposal and storage (r =
0.447)
There is a positive solid relationship exist in the middle of disposal and transportation
(r = 0.607)
There is a positive solid relationship exist in the middle of disposal and accumulation
(r = 0.566)
There is a positive feeble connection exist in the middle of disposal and attitude (r =
0.441).
There is a positive exceptionally frail relationship exist in the middle of disposal and
awareness (r = 0.179).
There is a positive feeble connection exist in the middle of disposal and level of
knowledge (r = 0.446).
There is a positive powerless connection exist in the middle of segregation and
storage (r = 0.479).
There is a positive extremely powerless connection exist in the middle of segregation
and gathering (r = 0.114).
There is a positive powerless connection exist in the middle of segregation and
transportation (r = 0.452).
There is certain extremely powerless relationship exist in the middle of segregation
and attitude (r = 0.295).
There is a positive frail relationship exist in the middle of segregation and awareness
(r = 0.469).
53
There is a frail negative relationship exist in the middle of segregation and level of
knowledge (r = - 0.082).
There is a positive exceptionally feeble connection exist in the middle of storage and
transportation (r = 0.359).
There is an extremely powerless positive relationship exist in the middle of storage
and accumulation (r = 0.112).
There is a positive solid connection exist in the middle of storage and attitude (r =
0.510).
There is a positive frail connection exist in the middle of storage and awareness(r =
0.382).
There is a positive frail connection exist in the middle of storage and level of
knowledge (r = 0.391).
There is a positive solid relationship exist in the middle of transportation and
gathering (r = 0.619).
There is a positive solid relationship exist in the middle of transportation and attitude
(r = 0.548).
There is a positive exceptionally feeble connection exist in the middle of
transportation and awareness (r = 0.254).
There is a positive exceptionally solid relationship exist in the middle of
transportation and level of knowledge (r = 0.743).
There is a feeble positive relationship exist in the middle of accumulation and attitude
(r = 0.330).
There is an exceptionally powerless positive connection exist in the middle of
accumulation and awareness (r = 0.282).
There is an in number positive relationship exist in the middle of accumulation and
level of knowledge (r = 0.560).
There is a positive frail relationship between attitude and awareness. (r = 449)
There is a positive solid connection between attitude and level of knowledge (r = 539)
There is a negative exceptionally powerless relationship between awareness and level
of knowledge (r = - 0.25)
54
Private Hospitals
4.4. Descriptive Analysis: Frequency chart
4.4.1. Demographic factor: Gender
Table: 4.4.1.1
Gender Frequency Percent
Male 72 60.0
Female 48 40.0
Total 120 100.0
Fig: 4.4.1.1
55
This study consist of a sample of 120 people from private sector.
This table 4.4.1.1and figure 4.4.1.1explain the frequency and percentage of male and female
staff. The percentage and frequency of male staff are 60% and 72 respectively. The female
staff percentage and frequency were 40% and 48 respectively. This table shows a greater
percentage of male staff as compared to the female staff.
4.4.2.1. Demographic factor: Age
Table: 4.4.2.1
Age Frequency Percent
21-30 72 60.0
31-40 24 20.0
41-50 24 20.0
Total 120 100.0
Fig: 4.4.2.1
56
Table 4.4.2.1and figure 4.4.2.1 demonstrates the age dispersion of respondents. It
demonstrates a more noteworthy number of respondents lie between 201 to 30 years. The
respondents lie between the ages of 21 to 30 years are 60% (72).While following those 20 %
(24) are in between 31 to 40 years old. The respondent lie between the age of 41 to 50 with
the percentage and frequency of 20% (24) respectively.
4.4.3.1 Demographic factor:Education
Table 4.4.3.1
Education Frequency Percent
Matric 12 10.0
Intermediate 12 10.0
Graduation 24 20.0
Masters 12 10.0
Professional degree 60 50.0
Total 120 100.0
Fig: 4.4.3.1
57
Table 4.4.3.1and figure 4.4.3.1demonstrates the recurrence dissemination of training of the
respondents. It demonstrates half (50) respondents having proficient degree. The respondents
who having a graduation degree their proportion and recurrence dissemination were 20%
(24). The respondent having matric degree with proportion and recurrence dissemination are
10% (12) individually. The respondent having intermediate degree with ratio and frequency
distribution are 10% (12) respectively.
4.4.4.1. Demographic factor: Experience
Table 4.4.4.1
Experience Frequency Percent
1-3 year 48 40.0
3-5 24 20.0
5-7 12 10.0
above 7 36 30.0
Total 120 100.0
Fig: 4.4.4.1
58
Table 4.4.4.1 figure 4.4.4.1demonstrates the experience dissemination of the respondents. It
demonstrates that a more prominent number of respondents lie in the middle of 1 to 3 years
their rate and recurrence dispersion are 40% (48) individually. The respondents who having
knowledge of 3 to 5 years demonstrating a rate and recurrence of 20% (24) individually.
Respondents having knowledge 5 to 7 year demonstrating a rate and recurrence of 10% (12)
separately. Respondents having experience above 7 year showing a percentage and frequency
of 30% (36) respectively.
4.5. Reliability analysis
Table: 4.5.1
Variables Cronbach's Alpha No of items
Attitude .659 7
Awareness .832 12
Knowledge .642 6
Collection .544 3
Segregation .862 11
59
Storage .713 7
Transportation .591 3
Disposal .867 5
Table 4.5.1 shows the Cronbach alpha of attitude is .659. The internal consistency of 7 items
attitude questionnaire showing a moderate consistency and reliability. Cronbach alpha of
awareness is .832. The internal consistency of 12 items awareness questionnaire showing a
good consistency and reliability. Cronbach alpha of knowledge is .642. The internal
consistency of 6 items knowledge questionnaire showing a moderate consistency and
reliability. Cronbach alpha of collection is .544. The internal consistency of 3 items
collection questionnaire showing a satisfactory consistency and reliability. Cronbach alpha of
segregation is .862. The internal consistency of 11 items segregation questionnaire showing a
good consistency and reliability.
Cronbach alpha of storage is .713. The internal consistency of 7 items storage questionnaire
showing an acceptable consistency and reliability. Cronbach alpha of transportation is .591.
The internal consistency of 3 items transportation questionnaire showing a satisfactory
consistency and reliability. Cronbach alpha of disposal is 0.867. The internal consistency of 5
items disposal questionnaire showing a good consistency and reliability
60
4.6. Correlation analysis
Segregati
on
Dispos
al
Storag
e
Transp
ort
Collecti
on
Attitu
de
Awarene
ss
Level of
knowledge
Segregation
Pearson Correlation 1 .474** .743** .198* -.282** -.024 .278** .054
Disposal
Pearson Correlation 1 .700** -.277** .343** -.355** -.321** .135
Storage
Pearson Correlation 1 -.075 .149 -.382** -.113 -.060
Transport Pearson Correlation 1 -.404** .533** .609** -.515**
61
Collection
Pearson Correlation 1 -.039 -.404** -.188*
Attitude
Pearson Correlation 1 .762** -.084
Awareness
Pearson Correlation 1 .148
Levelofkno
wlege
Pearson Correlation 1
**. Correlation is significant at the 0.01 level (2-tailed).
*. Correlation is significant at the 0.05 level (2-tailed).
Explanation:
The outcome acquired from connection investigation demonstrates that,
There is a powerless connection exist in the middle of disposal and segregation (r =
0.474)
There is an extremely solid connection exist in the middle of disposal and storage (r =
0.743)
62
There is an extremely frail connection exist in the middle of disposal and
transportation (r = 0.198)
There is an extremely frail negative connection exist in the middle of disposal and
gathering (r = - 0.282)
There is an extremely frail negative connection exist in the middle of disposal and
attitude (r = - 0.24).
There is an extremely frail positive connection exist in the middle of disposal and
awareness (r = 0.278).
There is an in number positive connection exist in the middle of disposal and level of
knowledge (r = 0.54).
There is an extremely solid positive connection exist in the middle of segregation and
storage (r = 0.70).
There is a positive powerless connection exist in the middle of segregation and
accumulation (r = 0.343).
There is a negative exceptionally powerless connection exist in the middle of
segregation and transportation (r = - 0.277).
There is negative feeble connection exist in the middle of segregation and attitude (r =
- 0.355).
There is a feeble negative connection exist in the middle of segregation and
awareness (r = - 0.321).
There is a positive feeble connection exist in the middle of segregation and level of
knowledge (r = 0.135).
There is an exceptionally powerless negative connection exist in the middle of storage
and transportation (r = - 0.075).
There is an exceptionally powerless positive connection exist in the middle of storage
and accumulation (r = 0.149).
There is a feeble negative connection exist in the middle of storage and attitude (r = -
0.382).
There is an exceptionally powerless negative connection exist in the middle of storage
and awareness(r = - 0.113).
63
There is an exceptionally powerless negative connection exist in the middle of storage
and level of knowledge (r = - 0.06).
There is a feeble negative connection exist in the middle of transportation and
accumulation (r = - 0.404).
There is a positive solid relationship exist in the middle of transportation and
disposition (r = 0.533).
There is a positive solid relationship exist in the middle of transportation and
awareness (r = 0.609).
There is an in number negative relationship exist in the middle of transportation and
level of knowledge (r = - 0.515).
There is an exceptionally frail negative relationship exist in the middle of
accumulation and attitude (r = - 0.039).
There is a frail negative relationship exist in the middle of gathering and awareness (r
= - 0.404).
There is an exceptionally frail negative relationship exist in the middle of
accumulation and level of knowledge (r = - 0.188).
There is an exceptionally solid positive relationship exist in the middle of attitude and
awareness (r = 0.762).
There is exceptionally frail negative relationship exist in the middle of attitude and
level of knowledge (r = - 0.084).
There is a positive exceptionally frail relationship exist in the middle of awareness
and level of knowledge (r = 0.148)
64
4.7. Regression analysis private hospitals
4.7.1 Collection
Table: 4.7.1.1
ANOVAa
Model Sum of
Squares
df Mean
Square
F R
square
Sig.
1 Regression 5.556 3 1.852 21.675 .359 .000b
Residual 9.911 116 .085
Total 15.467 119
a. Dependent Variable: collection
b. Predictors: (Constant), level of knowledge, awareness, attitude
Table 4.7.1.1Demonstrates that the independent variables attitude, awareness and level of
knowledge clarified the fluctuation of 35.9% in the dependentvariable showing so as to gather
the estimation of R2 .359. It demonstrates that attitude, awareness, and level of knowledge have
an extraordinary effect on collection. The hugeness is 0.000 in this model P worth is under 0.05
demonstrating that the model is essentially foreseeing the result. F = 21.675 it speaks to the
relationship is huge. Fit is great
Table: 4.7.1.2
65
Coefficients
Model Unstandardized
Coefficients
Standardize
d
Coefficients
t Sig.
B Std. Error Beta
1 (Constant) 3.841 .352 10.910 .000
Attitude .589 .102 .665 5.762 .000
Awareness -.764 .097 -.906 -7.875 .000
Level of
knowledge
.115 .055 .158 2.107 .037
a. Dependent Variable: collection
HO: Attitude, awareness and knowledge do not have significant effect on collection.
H1: Attitude, awareness and knowledge have a significant effect on collection.
Table 4.7.1.2 Demonstrates the estimation of P is not exactly α. On the off chance that P
worth is under 0.05 then Null speculation is rejected and option is acknowledged. It
demonstrates the independent variables have a critical effect on dependent.
4.7.2 Segregation
66
Table: 4.7.2.1
ANOVAa
Model Sum of
Squares
df Mean
Square
F R
square
Sig.
1 Regression 21.649 3 7.216 12.375 24.2 .000b
Residual 67.647 116 .583
Total 89.296 119
a. Dependent Variable: segregation
b. Predictors: (Constant), level of knowledge, awareness, attitude
Table 4.5.2.1 demonstrates that the independents attitude, awareness and level of knowledge
clarified the difference of 24.2% in the dependentvariable disposal by demonstrating the
estimation of R2 .242. It demonstrates that attitude, awareness, and level of knowledge have
an extraordinary effect on disposal. The essentialness is 0.000 in this model P worth is under
0.05 demonstrating that the model is fundamentally foreseeing the result. F = 12.375 it
speaks to the relationship is noteworthy. Fit is good
Table: 4.7.2.2
Coefficientsa
Model Unstandardized
Coefficients
Standardize
d
Coefficients
t Sig.
B Std. Error Beta
1 (Constant) 4.370 .813 5.374 .000
Attitude -1.328 .272 -.623 -4.878 .000
Awareness 1.555 .259 .767 6.005 .000
Level of
knowledge
-.242 .108 -.186 -2.247 .027
a. Dependent Variable: segregation
HO: Attitude, awareness and knowledge do not have significant effect on segregation.
H1: Attitude, awareness and knowledge have a significant effect on segregation.
67
Table 4.7.2.2 Demonstrates the estimation of P is not exactly α. On the off chance that P
worth is under 0.05 then Null speculation is rejected and option is acknowledged. It
demonstrates the independent variables have a critical effect on dependent.
4.5.3. Storage
Table: 4.5.3.1
ANOVAa
Model Sum of
Squares
df Mean
Square
F R
square
Sig.
1 Regression 6.564 3 2.188 13.620 .260 .000b
Residual 18.636 116 .161
Total 25.200 119
a. Dependent Variable: Storage
b. Predictors: (Constant), level of knowledge, attitude, awareness
Table 4.5.3.1demonstrates that the independents attitude, awareness and level of knowledge
clarified the change of 26% in the dependent variable showing so as to stock the estimation
of R2 .26 It demonstrates that attitude, awareness, and level of knowledge have an
extraordinary effect on storage. It demonstrates the noteworthiness is 0.000 in this model P
quality is under 0.05 demonstrating that the model is fundamentally foreseeing the result. F =
13.620 it speaks to the relationship is noteworthy. Fit is good
Table: 4.7.3.2
Coefficients
Model Unstandardized Standardize
d
t Sig.
68
Coefficients Coefficients
B Std. Error Beta
1 (Constant) 4.978 .431 11.559 .000
Attitude -.911 .147 -.805 -6.211 .000
Awareness .573 .141 .532 4.073 .000
Level of
knowledge
-.146 .060 -.207 -2.442 .016
a. Dependent Variable: Storage
HO: Attitude, awareness and knowledge do not have significant effect on storage.
H1: Attitude, awareness and knowledge have a significant effect on storage.
Table: 4.5.3.2demonstrates the estimation of P is not exactly α. On the off chance that P
quality is under 0.05 then Null speculation is rejected and option is acknowledged. It
demonstrates the independents have a noteworthy effect on dependent
4.7.4. Transportation
Table 4.7.4.1
ANOVAa
Model Sum of
Squares
df Mean
Square
F R
square
Sig.
1 Regression 13.802 3 4.601 118.645 .754 .000b
Residual 4.498 116 .039
Total 18.300 119
a. Dependent Variable: Transportation
b. Predictors: (Constant), level of knowledge, Attitude, Awareness
Table 4.7.4.1demonstrates that the independents disposition, awareness and level of
knowledge clarified the difference of 75.4% in the reliant variable transportation by
demonstrating the estimation of R2 .754 It demonstrates that attitude, awareness, and level of
69
knowledge have an extraordinary effect on transportation. It demonstrates the essentialness is
0.000 in this model P worth is under 0.05 demonstrating that the model is altogether
anticipating the result. F = 118.645 it speaks to the relationship is huge. Fit is good.
Table: 4.7.4.2
Coefficientsa
Model Unstandardized
Coefficients
Standardize
d
Coefficients
t Sig.
B Std. Error Beta
1 (Constant) 2.522 .205 12.295 .000
Attitude -.139 .070 -.149 -1.998 .048
Awareness .752 .069 .820 10.865 .000
Level of
knowledge
-.388 .029 -.648 -
13.294
.000
a. Dependent Variable: Transportation
HO: Attitude, awareness and knowledge do not have significant effect on transportation.
H1: Attitude, awareness and knowledge have a significant effect on transportation.
Table 4.7.4.2demonstrates the estimation of P is not exactly α. On the off chance that P worth
is under 0.05 then Null speculation is rejected and option is acknowledged. It demonstrates
the independent variables have a critical effect on dependent.
4.7.5. Disposal
70
Table: 4.5.5.1
ANOVAa
Model Sum of
Squares
df Mean
Square
F R
square
Sig.
1 Regression 4.863 3 1.621 7.703 .166 .000b
Residual 24.411 116 .210
Total 29.274 119
a. Dependent Variable: disposal
b. Predictors: (Constant), level of Knowledge, Awareness, Attitude
Table 4.7.5.1 demonstrates that the independent variables attitude, awareness and level of
knowledge clarified the change of 16.6% in the indigent variable segregation by
demonstrating the estimation of R2 .166 It demonstrates that attitude, awareness, and level of
knowledge have an awesome effect on segregation. It demonstrates the importance is 0.000
in this model P worth is under 0.05 demonstrating that the model is fundamentally foreseeing
the result. F = 7.703 it speaks to the relationship is critical. Fit is good.
Table: 4.7.5.2
Coefficients
Model Unstandardized
Coefficients
Standardized
Coefficients
t Sig.
B Std. Error Beta
1 (Constant) 3.923 .458 8.566 .000
Attitude -.170 .084 -.178 -2.011 .047
Awareness -.356 .102 -.307 -3.478 .001
Level of
Knowledge
.158 .066 .208 2.413 .017
HO: Attitude, awareness and knowledge do not have significant effect on disposal.
71
H1: Attitude, awareness and knowledge have a significant effect on disposal.
Table 4.7.5.2 demonstrates the estimation of P is not exactly α. On the off chance that P
worth is under 0.05 then Null speculation is rejected and option is acknowledged. It
demonstrates the independent variables have a critical effect on dependent.
Discussions
Correlation between attitude and segregation in private hospitals represents the value of -0.24
as compared to public hospitals 0.441. It indicates there is negative weak relationship
between attitude and segregation in private hospitals weather the public hospitals have
positive weak relationship. Public hospitals staff attitude towards segregation are far better
than the private hospitals.
Correlation between awareness and segregation in private hospitals represents the value of
0.278 as compared to public hospitals 0.179. It indicates both hospitals staff showing the
same weak relationship towards awareness and segregation. Both hospitals staff showing the
same response towards awareness.
Correlation between knowledge and segregation in private hospitals represents the value of
0.54 as compared to public hospitals 0.446. It indicates there is strong positive relationship
between knowledge and segregation in private hospitals weather the public hospitals have
positive weak relationship. Private hospitals staff knowledge towards segregation are far
better than the public hospitals.
Correlation between attitude and disposal in private hospitals represents the value of -0.355
as compared to public hospitals 0.295. It indicates there is negative weak relationship
between attitude and disposal in private hospitals weather the public hospitals have positive
weak relationship. Public hospitals staff attitude towards disposal are far better than the
private hospitals.
Correlation between awareness and disposal in private hospitals represents the value of -
0.321 as compared to public hospitals 0.469. It indicates there is negative weak relationship
between awareness and disposal in private hospitals weather the public hospitals have
72
positive weak relationship. Public hospitals staff awareness towards disposal are far better
than the private hospitals.
Correlation between knowledge and disposal in private hospitals represents the value of
0.135 as compared to public hospitals -0.082. It indicates there is positive very weak
relationship between knowledge and disposal in private hospitals weather the public hospitals
have negative very weak relationship. Private hospitals staff knowledge towards disposal are
far better than the public hospitals.
Correlation between attitude and storage in private hospitals represents the value of -0.382 as
compared to public hospitals 0.510. It indicates there is negative weak relationship between
attitude and storage in private hospitals weather the public hospitals have positive strong
relationship. Public hospitals staff attitude towards storage are far better than the private
hospitals. Correlation between awareness and storage in private hospitals represents the value
of -0.113 as compared to public hospitals 0.382. It indicates there is negative very weak
relationship between awareness and storage in private hospitals weather the public hospitals
have positive weak relationship. Public hospitals staff awareness towards storage are far
better than the private hospitals. Correlation between knowledge and storage in private
hospitals represents the value of -0.06 as compared to public hospitals 0.391. It indicates
there is negative very weak relationship between knowledge and storage in private hospitals
weather the public hospitals have positive weak relationship. Public hospitals staff
knowledge towards storage are far better than the private hospitals. Correlation between
attitude and transportation in private hospitals represents the value of 0.533 as compared to
public hospitals 0.548. It indicates there is positive strong relationship between attitude and
transportation in private hospitals and public hospitals have also positive strong relationship.
Both hospitals staff have showing same attitude towards transportation. Correlation between
awareness and transportation in private hospitals represents the value of 0.609 as compared
to public hospitals 0.254. It indicates there is positive strong relationship between awareness
and transportation in private hospitals and public hospitals have positive weak relationship.
Private hospitals staff awareness towards transportation are far better than the public
hospitals. Correlation between knowledge and transportation in private hospitals represents
the value of -0.515 as compared to public hospitals 0.743. It indicates there is negative strong
73
relationship between knowledge and transportation in private hospitals weather the public
hospitals have positive very strong relationship. Public hospitals staff knowledge towards
transportation are far better than the private hospitals. Correlation between attitude and
collection in private hospitals represents the value of -0.039 as compared to public hospitals
0.330. It indicates there is negative weak relationship between attitude and collection in
private hospitals weather the public hospitals have positive weak relationship. Public
hospitals staff attitude towards collection are far better than the private hospitals.Correlation
between awareness and collection in private hospitals represents the value of -0.404 as
compared to public hospitals 0.282. It indicates there is negative weak relationship between
awareness and collection in private hospitals weather the public hospitals have positive very
weak relationship. Public hospitals staff awareness towards collection are far better than the
private hospitals. Correlation between knowledge and collection in private hospitals
represents the value of -0.188 as compared to public hospitals 0.560. It indicates there is
negative very weak relationship between knowledge and collection in private hospitals
weather the public hospitals have positive strong relationship. Public hospitals staff
knowledge towards collection are far better than the private hospitals. The impact of
independent variable like attitude, awareness and knowledge on dependent variable like
collection then we find the value of R2 in public hospitals is .426 and private hospitals
are .359 it is 7% higher than private hospitals. It indicates the impact of independent
variables on dependent variable in public hospitals are better than private hospitals. Public
hospitals are far better than private hospitals. In second part of hospitals waste management
the impact of independent variables attitude, awareness and knowledge on dependent
variable segregation it shows the value of R2 in public hospitals are .290 and private
hospitals .242 it is 5% higher than the private hospitals. It indicates the impact of
independent variable on dependent variable 5% better than private hospitals. Public hospitals
are far better than private hospitals. Third part indicates the impact of independent variable
attitude, awareness and knowledge impact on dependent variable storage like storage. It
shows the value of R2 in public hospitals are .334 and private hospitals are .260 it is 7%
higher than the public hospitals. It indicates the impact of independent variable on dependent
variable 7% higher than private hospitals. Public hospitals are far better than private
hospitals. Fourth part indicates the impact of independent variable attitude, awareness and
74
knowledge impact on dependent variable transportation. It shows the value of R2 in public
hospitals are .63 and private hospitals are .754 it is 12% higher than the private hospitals. It
indicates the impact of independent variable on dependent variable 12% higher than public
hospitals. Private hospitals are far better than public hospitals. Fifth part indicates the impact
of independent variable attitude, awareness and knowledge impact on dependent variable
disposal. It shows the value of R2 in public hospitals are .299 and private hospitals are .16 it
is 13% higher than the private hospitals. It indicates the impact of independent variable on
dependent variable 13% higher than public hospitals. Private hospitals are far better than
public hospitals.
75
Chapter 5
SUMMARY
The reason for this study to look at the relationship between attitude, awareness and level of
knowledge it additionally portray the similar investigation of open and private healing
facilities. Factual device SPSS were utilized to dissected the level of knowledge. The
outcome speaks to the unmistakable rule for future analyst to do some further study in this
theme. There are five speculation are tried. Consequence of this study demonstrates that
every one of the theory expound a huge association with free and dependents.
Every one of the speculation are steady and estimations of R expanding out in the open
healing facilities as contrast with the private clinics which demonstrates that the general
population doctor's facilities staff attitude, awareness and level of knowledge have a
noteworthy relationship as contrast with private doctor's facilities. All the three independents
are tried with dependent. In result the P estimation of the considerable number of variables
are critical it is under 0.05.
5.1. Findings of study
This study shows the direct relationship of attitude, awareness and knowledge towards
hospital waste management like collection, segregation, storage, transportation and disposal.
It also describe if the staff have positive attitude, level of awareness is good and have
sufficient knowledge about hospital waste management then it is not only good for the health
of staff but also for the environment. It also shows that the attitude towards segregation of
public hospitals staff are better than the private hospitals it means public hospitals staff aware
the drawbacks of waste but awareness level towards segregation in both are same.
Knowledge of private hospitals staff towards segregation is better than public hospitals.
Attitude of private hospitals staff towards disposal is weak as compare to public hospitals
staff. Private hospitals staff showing negative attitude while the public hospitals staff
showing weak but positive attitude. In private hospitals level of awareness towards disposal
is negative but in public hospitals staff awareness level towards disposal are positive and
76
good. Knowledge about disposal in private hospitals staff are better than public hospitals
staff. Attitude of public hospitals staff about storage of waste are better than the private
hospitals. In private hospitals staff showing a negative attitude as compare to public hospitals
staff which are showing very positive attitude towards storage of waste. Public hospitals staff
are much aware about storage of waste but in contrast the awareness level of private hospitals
staff are very low and negative. Private hospitals staff have not proper knowledge about
storage of waste in contrast public hospitals staff have sufficient knowledge about the storage
of waste.
Attitude of both hospitals staff showing the same level. They are showing strong and positive
attitude about transportation of waste. It means both hospitals have proper sources
transportation of waste are available. Awareness about the drawbacks of waste related to
transportation in private hospitals are much positive and strong in contrast in public hospitals
staff level of awareness is poor. We can also mention here the knowledge of staff about
transportation waste showing the same level in public and private hospitals. In public
hospitals people have maximum knowledge about transportation of waste and also in private
hospitals showing almost the same level. Attitude of public hospitals staff have positive bout
collection of waste as compared to private hospitals staff have negative attitude. It means the
public hospitals staff performing good in contrast to private hospitals. Awareness level of
private hospital staff are negative which is not good for the health of people and environment
also. But in public hospitals staff awareness level is pretty good as compared to private
hospitals staff. People in public hospitals much aware about the drawbacks of collection. The
level of knowledge about hospital waste in public hospitals staff are better than the private
hospitals staff. Public hospitals staff have sufficient knowledge about collection of waste.
5.2. Recommendations
There is a need of proper training of staff required hospital waste management and a
special fund allocated for the training of current employees and new comer’s.
There is a need to recycle the waste on urgent basis.
Every hospital incorporated their own incinerator for hospital waste.
77
Government need to take attention about medical waste re user, its harmful for the
society.
A special ordinance passed from the legislature against the manufacturer of used
waste.
There is need to establish a waste management board in each city of Pakistan.
Each hospital need to establish a special cell which deliver basic guide line about
waste management to staff on weekly basis.
5.3. Limitations of research
5.3.1. Lack of Time and resources
Due to lack of time and resources this research are not more expand. This research consist of
240 respondent which are not enough. Data collected from different public and private
hospitals of Faisalabad. There is need of maximize the number of respondent and also
expand the universe of the research towards all the hospitals of Punjab.
5.3.2. Unwillingness of respondents
During the research when data is collected from the respondents which are belong from
public and private hospitals of Faisalabad, respondents are not showing their willingness due
to strict management of the hospitals. They feel hesitation to showing their exact response
towards the questionnaire. They were their hospital secrecy will be reviled.
5.3.3. Small area of research
This research is done in small area of Faisalabad hospitals. There is a need to expand the area
of research it must be expand to province level.
5.3.4. Lack of positive attitude of respondents
During the research it was found that the most of the respondent were not showed the
positive attitude and non-serious behavior towards research, they were not focusing on the
purpose of the study and not considering positive gesture towards the research.
78
5.4. Conclusion
This study elaborate the relationship of attitude, awareness and knowledge with hospital
waste management. It shows that attitude of people have direct impact on hospital waste
management Positive attitude not only beneficial for the health of concerned people but also
for the environment. Awareness about hospital waste management is critically serious issue.
People level of awareness about the pros and cons of hospital waste is very necessary if the
level of awareness is not good then it dent the image of hospital waste management and also
very harmful for the society. Knowledge related to hospital waste play a vital role in waste
management without this level of awareness and attitude of the people cannot be improved.
This study also conclude that the waste management of public hospital are far better than the
private hospitals. There are some serious steps must to be taken to improve private hospitals
waste management.
79
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