Only 11% of healthcare waste was treated with segregation in Bangladesh and 34% was only segregated in 2019, according to a joint report of the World Health Organisation (WHO) and the United Nations Children's Fund (Unicef).
In addition, 76% of total healthcare waste was disposed of safely, but a large portion of waste remained untreated or was segregated without treatment.
Bangladesh's waste treatment percentage of total waste was second lowest in South Asia – just above Nepal – among five countries, including Bangladesh, Bhutan, the Maldives, Nepal, and Sri Lanka.
In terms of waste treatment with or without segregation, Bangladesh was placed at the bottom in the region, said the report titled "Global progress report on WASH in health care facilities: Fundamentals first". It was published on Monday.
In urban areas of Bangladesh, waste segregation was better compared to rural areas. 54% of waste was segregated in 2019 in urban areas against 26% in rural areas.
However, waste treatment management was very poor in both areas. Urban areas treated 15% of waste while it was 10% in rural areas.
Commenting on the figures, WaterAid Bangladesh Country Director Hasin Jahan said hospital waste management system is handled inadequately in the country.
Since the Covid-19 outbreak, stakeholders in the health sector, along with the government, have become more serious about improving the situation, she said.
"Government hospitals at least maintain a system but many private ones, particularly newly established small clinics, do not even have a proper monitoring system. Also, their waste management quality is very poor."
Hasin further said, "For example, there is a rule to incinerate hospital waste for proper management, but many private clinics have no incinerators and they mix the waste with normal waste for disposal. So, we need to do a lot of work to manage it in a proper way."
Waste management in South Asia
Nepal treated only 1% of healthcare waste with segregation in 2019, which was the lowest in the region.
Bhutan treated the highest percentage of healthcare waste. The landlocked country treated 36% of waste with segregation, followed by the Maldives (30%) and Sri Lanka (27%).
Moreover, Bhutan segregated the highest percentage of healthcare waste (80%) in South Asia, followed by Sri Lanka (51%) and the Maldives (47%).
Nepal only segregated 5% of waste and was placed at the bottom in this category.
Excluding Bangladesh, all other South Asian countries treated some part of waste without segregation. The Maldives treated the highest percentage of waste (59%) with or without segregation, followed by Bhutan (50%), Sri Lanka (44%) and Nepal (21%).
More than one-third of Bangladeshi healthcare facilities lacked basic water services
About 36% or more than one-third of healthcare facilities in Bangladesh did not have any basic water services in 2019. Moreover, 23% had no hand hygiene facilities at points of care.
Hasin said, "Findings on hand hygiene in the report exactly matches that of the National Hygiene Survey 2018 conducted by the Bangladesh Bureau of Statistics. So, I think the report presents representative data and there is no confusion about it."
Basic water service means a healthcare facility has water available from an improved water source, which is located on its premises.
The report said although 96% of healthcare centres in Bangladesh had sanitation facilities in 2019, 36% was improved and usable. Moreover, 84% of healthcare centres had dedicated toilets for women and 31% had menstrual hygiene management facilities.
According to the report, toilets should be available for patients with limited mobility. However, only 38% of healthcare centres were equipped with such facilities in Bangladesh in 2019.