Factors Affecting On Hospital Waste Management and Impact of Awareness A Case Study of Public and Private Hospitals

FACTORS AFFECTING ON HOSPITAL WASTE
MANAGEMENT AND IMPACT OF AWARENESS: A CASE

STUDY OF PUBLIC AND PRIVATE HOSPITALS
By
Amir Abbas
2013-GCUF-05554
Thesis submitted in partial fulfillment of
the requirements for the degree of
MASTER OF SCIENCE
IN
PUBLIC ADMINISTRATION
DEPARTMENT OF PUBLIC ADMINISTRATION

GC UNIVERSITY, FAISALABAD
August 2015
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 Abbas
2013-GCUF-05554
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 Ali
Designation with Stamp____________________
Member of Supervisory Committee
Signature _______________________________
Name: Mr. AdeelAnjum
Designation with Stamp___________________
Member of Supervisory Committee
Signature _______________________________
Name:Ms. Anum Zafar
Designation with Stamp____________________
Chairperson
Signature with Stamp______________________
Dean / Academic Coordinator

Signature with Stamp______________________
2
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 respondents hospital
staff who so willingly participated in the survey and shared their
level of knowledge for this study.
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

5
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
6
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
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.
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 dont have appropriate knowledge and insufficient
practices towards hospital waste management.
1
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.
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 thats makes the real quality hazardous waste is
much higher. Clinical solid waste is a particular challenge in most healthcare 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
2
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.
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),
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
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
3
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 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
4
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
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
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
7
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:

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:

8
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:
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
9
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 organisms 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
10
that they discard sharps squanders in open are 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
11
on hospitals waste management and also made a comparison of public

and private hospitals of Faisalabad which sector is performing well.
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
12
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 thats 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
13
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.
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 its 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.
14
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 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
15
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 dont 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 dont know how to collect and handles
the waste properly, even they also dont 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 and training
programs
are
organize
for
low
level
staff
about
hospital
waste
management. They even dont 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
16
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
17
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 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 dont 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, equipments, and gloves also. Waste handler staff dont have
latest equipments 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
18
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.
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
19
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. Its 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 its
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 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
20
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 doesnt 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.
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
21
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,
Attitude influences an individual's choice of action,
or
situation.
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.
22
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 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
23
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.
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. Awareness
Whenever we are trying to study about awareness then its compulsory
for us to must study for our self, because without studying our self-its 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
24
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 its better not only for a single individuals its 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 doesnt
means you are just done work and its productive. It doesnt 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.
25
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.
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).
26
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 individuals 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 studies led to clarify the relationship
between poor waste administration and level of knowledge, disposition
and
awareness
(Madanay
and
Bugahoos,
1998;
Jensen,
2002;
27
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
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
28
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 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
29
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).
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
30
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,
therapeutic
treatment
or
examination;
vaccination
or
of
underway
individuals
of
or
animals;
inoculations
or
in
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).
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
administrations
the
threat,
workplaces.
both
inside
Acharya
and
and
Singh
outside
(2000)
restorative
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.
31
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 (Pruss 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.

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
32
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,
33
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 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,
34
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.
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
contain values for
certain characteristics of
every part
of
population,
a population.
it
is called a
If
it
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
segregation.
35

segregation.
3.1.3. Hypothesis 3
storage.
storage.
3.1.4. Hypothesis 4
transportation.
transportation.
3.1.5. Hypothesis 5
disposal.
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.
36
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
its 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.
37
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
Neutral
Agree
Strongly Agree
disagree
1
38
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
3.9. Data Analysis

After receiving the filled questionnaire response of the individuals fed in to
Statistical package for social sciences (SPSS). Its necessary to feed all the
responses of individuals with full care and responsibility to minimize the
chances of errors.
3.10.
Theoretical Framework
Attitude
Awareness
Hospital Waste Management

Collection
Segregation
Storage
Transportation
Disposal
39
Level of Knowledge
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
Awareness
about someone.
Knowledge that something exist or understanding of a
situation or subject at the present time based on level of
Knowledge
knowledge and experience.

Knowledge is a familiarity, awareness or understanding of
someone or something, such as facts, level of knowledge,
40
descriptions,
or
skills,
which
is
acquired
through
experience or education by perceiving, discovering, or

level of knowledge.
3.11.2.
Dependent Variable
Hospital
Hospital
Waste
Management
implies
the
Waste
administration of waste delivered by doctor's facilities
Management
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.
41
3.14.
Quantitative Analysis
Reliability analysis
Descriptive analysis
Correlation analysis
Regression analysis
3.14.1.
Reliability analysis
Cronbachs 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 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.
Cronbachs Alpha written as:
=
N.cc / vc + (N-1).cc
N = Number of items
c = Average covariance of the items
v = Average variance of the items
If the number of items are increased then Cronbachs 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
42
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 Cronbachs alpha is more significant.
Cronbachs alpha
0.9
0.9 > 0.8
0.8 > 0.7
0.7 > 0.6
0.6 > 0.5
0.5
Internal consistency
Excellent
Good
Acceptable
Moderate
Satisfactory
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
43
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 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.
44
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
Weak correlation
No correlation
+1
-1
Zero
Positive
Negative
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 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.
45
Value of correlation (r)

0.00 0.30
0.30 0.50
0.50 0.70
0.70 1.00
3.17.
Strength of relationship
Very weak
Weak
Strong
Very strong
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
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
46
Y = + X..e
Where Y is dependent variable
is intercept
is coefficient for the independent variable X
X is the independent variable
E is the error term
Equation 1
Collection= +1 Attitude +2 Awareness + 3 Knowledge + e
Equation2
Segregation = +1 Attitude +2 Awareness + 3 Knowledge +
e
Equation 3
Storage = +1 Attitude +2 Awareness + 3 Knowledge + e
Equation4
Transportation = +1 Attitude +2 Awareness + 3
Knowledge + e
Equation5
Disposal = +1 Attitude +2 Awareness + 3 Knowledge + e
47
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
This study consist a sample of 120 people from government sector.

48
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
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
49
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
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
50
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
51
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.
demonstrating
Respondents
rate
and
having
recurrence
knowledge
of
9.2%
5
(11)
to
year
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
52
Table: 4.2.1
ANOVAa
Model
Sum of
df
Mean
Squares
1
Regressi
3.500
Square
3
on
Residual
4.722
98
Total
8.222
101
Sig.
squa
1.167
24.2
re
.426
.000b
14
.048
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
Standard
Coefficients
ized
Sig.
Coefficie
53
nts
Std.
Beta
(Constant)
2.522
Error
.263
Attitude
-.170
.084
Awareness
.215
Level of
.436
9.593
.000
-.221
-2.032
.045
.049
.399
4.351
.000
.062
.689
7.089
.000
knowledge
collection.
collection.
Table 4.2.2 demonstrates the estimation of P is not exactly . 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
Regressi
on
Residual
9.666
3.222
23.639
98
.241
Total
33.305
101
13.3
57
R
squa
re
.290
Sig.
.000b
a. Dependent Variable: Segregation

54

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 R 2.290. 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
Model
Coefficients
Unstandardized
Standardi
Coefficients
Sig.
zed
Coefficie
Std.
(Constant)
Attitude
1.093
.463
Error
.596
.157
Awareness
-.142
.065
Level of
.362
.129
nts
Beta
.299
1.834
2.951
.070
.004
-.186
.032
.284
2.182
2.808
.006
knowledge
a. Dependent Variable: Segregation

segregation.
segregation.
55
Table 4.2.2.2 demonstrates the estimation of P is not exactly . On the off

4.2.3. Storage
Table: 4.2.3.1
ANOVAa
Model
Sum of
df
Mean
Squares
1
Regressi
11.785
on
Residua
23.493
98
l
Total
35.277
101
Square
squa
3.928
re
.334
16.3
Sig.
.000b
87
.240
a. Dependent Variable: Storage

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 R 2 .334 It
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.
56
Table: 4.2.3.2
Coefficients
Model
Unstandardized
Coefficients
B
1
-1.104
Std.
Error
.586
Attitude
.381
.187
Awareness
.314
(Constant)
Level of
.352
knowledge
Standardi
zed
Coefficien
ts
Beta
Sig.
.063
.239
1.883
2.041
.110
.281
2.847
.005
.137
.269
2.566
.012
.044

storage.
storage.
4.2.4. Transportation
Table: 4.2.4.1
ANOVAa
Model
Sum of
Squares
df
Mean
Square
Sig.
squa
re
57
Regress
20.041
6.680
ion
Residua
11.197
98
.114
l
Total
31.238
101
58.4
.642
.000b
66
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 R 2 .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
Model
Coefficients
Unstandardized
Standardiz
Coefficients
Sig.
ed
Coefficient
s
(Constant)
Attitude
Std.
-.436
-.152
Error
.501
.074
Beta
-.126
-.871
-
.386
.041
2.06
Awareness
Level of
.294
.908
.064
.075
.280
9
4.61
.000
.736
5
12.1
.000
58
knowledge
a. Dependent Variable: transport
10

transportation.
transportation.
Table demonstrates the estimation of P is not exactly . 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
df
Mean
Squares
1
Regressi
on
17.902
Square
3
5.967
Sig.
squa
13.96
re
.299
.000b
3
59
Residual
41.882
98
Total
59.784
101
.427
a. Dependent Variable: Disposal

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
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
B
-2.042
Std.
Error
.961
Attitude
.424
.154
Awareness
.645
(Constant)
Level of
.291
knowledge
a. Dependent Variable: Disposal
Standardi
zed
Coefficien
ts
Beta
Sig.
-2.124
.036
.239
2.747
.007
.124
.443
5.215
.000
.120
.211
2.437
.017

disposal.
60

disposal.
Table 4.2.5.2 Demonstrates the estimation of P is not exactly . On the off
chance that P worth is under 0.05 then Null speculations is rejected and
a critical effect on dependent
4.3. Correlations analysis

Segreg Dispo Stora Trans Collec
ation
sal
ge
port
tion
Attitu
Aware
Level of
de
ness
knowled
ge
Segregat
ion
Disposal
Storage
Transport
Collectio
n
Pearson
Correlation
Pearson
Correlation
Pearson
Correlation
Pearson
Correlation
Pearson
Correlation
.606**
.447**
.607**
.566**
.441**
.179
.446**
.479**
.452**
.114
.295**
.469**
-.082
.359**
.112
.510**
.382**
.391**
.619**
.548**
.254**
.743**
.330**
.282**
.560**
61
Attitude
Awarene
ss
Pearson
Correlation
.449**
.539**
-.025
Pearson
Correlation
Pearson
level of
Correlation
knowledg
e
**. 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)

and attitude (r = 0.441).

There is a positive exceptionally frail relationship exist in the middle
of disposal and awareness (r = 0.179).

and level of knowledge (r = 0.446).

There is a positive powerless connection exist in the middle of
segregation and storage (r = 0.479).
62
There is a positive extremely powerless connection exist in the
middle of segregation and gathering (r = 0.114).

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).

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).

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).
63
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)
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
64
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
65
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
Matric
Intermediate
Frequency
12
12
Percent
10.0
10.0
Graduation
24
20.0
Masters
12
10.0
Professional degree
60
50.0
Total
120
100.0
Fig: 4.4.3.1
66
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
dissemination
are
matric
10%
degree
(12)
with
proportion
individually.
The
and
recurrence
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
67
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
to
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
Awareness
.832
12
68
Knowledge
.642
Collection
.544
Segregation
.862
11
Storage
.713
Transportation
.591
Disposal
.867
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
69
4.6. Correlation analysis

Segreg Disp
Stora Trans Collec
Attit
Aware Level
ation
ge
ude
ness
osal
port
tion
knowle
ge
Pearson
Segregat Correlation
ion
Pearson
Disposal
Correlation
.474**
.743**
.198*
-.282**
-.024
.278**
.054
.700**
-.277**
.343**
-.355**
-.321**
.135
70
Pearson
Storage
Correlation
Pearson
Transpor Correlation
t
Pearson
Collectio Correlation
n
Pearson
Attitude
Correlation
Pearson
Awarene Correlation
ss
-.075
.149
-.382**
-.113
-.060
-.404**
.533**
.609**
-.515**
-.039
-.404**
-.188*
.762**
-.084
.148
Pearson
Levelofk
Correlation
nowlege
**. 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)

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)
71
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).

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).

middle of storage and awareness(r = - 0.113).

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).

transportation and disposition (r = 0.533).

transportation and awareness (r = 0.609).
72
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)
73
4.7. Regression analysis private hospitals

4.7.1 Collection
Table: 4.7.1.1
ANOVAa
Model
Sum of
df
Mean
Square
1
Regressio
Square
s
5.556
1.852
Total
Sig.
squa
21.67
n
Residual
R
re
.359
.000b
5
9.911
116
15.467
119
.085

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 R 2 .359. It
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
74
Table: 4.7.1.2
Coefficients
Model
Unstandardized
Standard
Coefficients
ized
Sig.
Coefficie
nts
(Constant)
Attitude
Awareness
Level of
Std.
Beta
3.841
Error
.352
10.91
.000
.589
.102
.665
0
5.762
.000
-.764
.097
-.906
-7.875
.000
.115
.055
.158
2.107
.037
knowledge

collection.
collection.
75
4.7.2 Segregation
Table: 4.7.2.1
ANOVAa
Model
Sum of
df
Mean
Squares
1
Regressio
21.649
Square
3
n
Residual
67.647
116
Total
89.296
119
Sig.
squa
7.216
12.37
re
24.2
.000b
5
.583
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 R 2 .242. It
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
Model
Coefficientsa
Unstandardized
Standard
Coefficients
Sig.
ized
Coefficie
76
nts
(Constant)
Attitude
Awareness
Level of
B
4.370
-1.328
1.555
-.242
Std. Error
.813
.272
.259
.108
Beta
-.623
.767
-.186
5.374
-4.878
6.005
-2.247
.000
.000
.000
.027
knowledge
a. Dependent Variable: segregation
segregation.
segregation.
4.5.3. Storage
Table: 4.5.3.1
ANOVAa
Model
Sum of
df
Mean
Squares
1
Square
Regressi
6.564
2.188
on
Residual
18.636
116
.161
Total
25.200
119
Sig.
squar
13.62
e
.260
.000b

b. Predictors: (Constant), level of knowledge, attitude, awareness
77
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 R 2 .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
Standardi
Coefficients
zed
Sig.
Coefficie
Std.
(Constant
4.978
Error
.431
)
Attitude
-.911
.147
.573
-.146
Awarenes
s
Level of
knowledg
nts
Beta
11.55
.000
-.805
9
-
.000
.141
.532
6.211
4.073
.000
.060
-.207
.016
2.442
e
78

storage.
storage.
Table: 4.5.3.2demonstrates the estimation of P is not exactly . 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
df
Mean
Squares
1
Square
Regressi
13.802
4.601
on
Residual
4.498
116
.039
18.300
119
Total
Sig.
squar
118.6
e
.754
.000b
45

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
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.
79
Table: 4.7.4.2
Coefficientsa
Model
Unstandardized
Standardi
Coefficients
zed
Sig.
Coefficie
Std.
(Constant
2.522
Error
.205
)
Attitude
-.139
.070
Awarenes
s
Level of
.752
-.388
.069
.029
knowledg
e
nts
Beta
12.29
.000
-.149
5
-
.048
.820
1.998
10.86
.000
-.648
5
-
.000
13.29
4

transportation.
transportation.
Table 4.7.4.2demonstrates the estimation of P is not exactly . On the off
80
4.7.5. Disposal
Table: 4.5.5.1
ANOVAa
Model
Sum of
df
Mean
Squares
1
Square
Sig.
squa
Regressi
4.863
1.621
on
Residual
24.411
116
.210
Total
29.274
119
7.70
re
.166
.000b
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
Model
Coefficients
Unstandardized
Standardi
Coefficients
Sig.
zed
Coefficien
ts
81
Std.
(Constant
3.923
Error
.458
)
Attitude
-.170
.084
Awarenes
s
Level of
-.356
.158
.102
.066
Beta
8.566
.000
-.178
.047
-.307
2.011
-
.001
.208
3.478
2.413
.017
Knowledg
e
disposal.
disposal.
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
82
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

indicates there is negative weak relationship between awareness and
disposal in private hospitals weather the public hospitals have 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
83
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 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
84

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
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
85
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
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
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.
86
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

87
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 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
88
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 comers.

There is a need to recycle the waste on urgent basis.
Every hospital incorporated their own incinerator for hospital waste.
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
89
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.
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
90
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.
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Factors Affecting On Hospital Waste Management and Impact of Awareness A Case Study of Public and Private Hospitals

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FACTORS AFFECTING ON HOSPITAL WASTE

MANAGEMENT AND IMPACT OF AWARENESS: A CASE

DEPARTMENT OF PUBLIC ADMINISTRATION

CERTIFICATE BY SUPERVISORY COMMITTEE

Signature of Supervisor ____________________

Dean / Academic Coordinator

I hereby sincerely thank to my supervisor Dr.Arfan Ali for his true

encouragement and support throughout the writing process of my

Data collection method...........................................................................30

3.11.1. Independent variable.......................................................................33

3.11.2. Dependent Variable..........................................................................33

Hierarchical Linear Regression Analysis...............................................34

3.14.1. Reliability analysis............................................................................ 34

3.16.1. Correlation values.............................................................................37

3.17.1. Multiple regression analysis.............................................................39

4.5. Reliability analysis..................................................................................... 59

According to the reports of World health organization it was observed that

described that the world health

by wellbeing focuses, out of which 75% to 90% are not an excessive

observing assemblage of Government of India, on incinerators in Delhi

disturbance and concealment of the safe framework.

purification/disinfection the waste is transported to a typical treatment

been managed in subtle element, for example, Standards of gathering

significantly satisfactory among doctors and nurses whereas there is lack

Non risk waste

1.1. Risk waste

1.1.1. Infectious waste

Cultures (the growing of microorganisms in a nutrient medium (such

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

1.1.3. Sharps waste

Saws and knives

1.1.4. Pharmaceutical waste

Unused pharmaceutical products.

Contaminated pharmaceutical products.

Surplus drugs, vaccines or sera.

1.1.5. Genotoxic Waste:

Cytotoxic drugs and expired material.

Contaminated materials from the preparation and of the drugs such

Vomiting, urine of patients treated with cytotoxic drugs or chemicals

1.1.6. Chemical Waste:

Chemicals from diagnostic and experiment work

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

tissue/fluid, in vivo (body organ imaging) and tumor localizations and

1.2. Non-Risk Waste:

Paper and cardboard.

1.3. Hazard from Waste

Absorption through a cut in the skin

AkhterNasimaet al., (2002) expressed that irresistible of specific concern

transmission by means of the biomedical waste, are HIV infection and

1.4. Problem Statement

on hospitals waste management and also made a comparison of public

1.5. Objective of the study

To find out the relationship between attitudes, awareness, level of

knowledge and hospital waste management.