KILIFI COUNTY HEALTH CARE WASTE TRANSPORTATION PLAN 2019-2030

1.TITLE
Kilifi County Health Care Waste Management Transportation Plan-2019-2030
2.INTRODUCTION
Health care waste management (HCWM) is described as “a process to help ensure proper
hospital hygiene and the safety of health care workers and communities. It includes planning and
procurement, construction, staff training and behavior, proper use of tools, machines
pharmaceuticals proper disposal methods inside and outside the hospital, and evaluation.
Health care waste management systems enable health care waste to be managed responsibly,
without harming the community or the environment.

3.BACKGROUND INFORMATION
The common practice in most health facilities is transportation of waste using wheelbarrows and
trolleys .this leads to spillage within the compound thus posing a risk to human and the
environment. Within the primary health(Level 2 & 3) facilities they lack disposal sites and
adequate space for storage of waste thus require offsite disposal. For this reason this
transportation will be necessary for this facilities to
The project encourages transportation of health care waste from health centers/dispensaries to
functional NEMA licensed incinerators using approved transportation
4.HCWM POLICY, LEGAL AND INSTITUTIONAL FRAMEWORK
The country is gradually moving from burn to non-burn technologies, hence construction/repair
and purchase of burning chambers should be discouraged therefore transportation of health care
waste from health centers/dispensaries to functional NEMA licensed incinerators using approved
transportation systems is recommended. The county is using the national environmental rules
and regulations as well as the environmental and social safeguard policies of the World Bank.
Several international agreements have been concluded which lay down fundamental principles
concerning public health, environmental protection and the safe management of hazardous
wastes. Among the relevant policies and regulations that are relevant to the project include:
a) Constitution of Kenya, 2010
b) Environmental Management and Coordination Act (EMCA), 1999
c) Environmental (Impact Assessment and Audit) Regulations, 2003
d) EMCA (Waste Management Regulations), 2006
e) MCA (Noise and Excessive Vibration Pollution Control) regulations 2009
f) EMCA (Air Quality) regulation, 2009
g) Occupational Safety and Health Act, 2007
h) Public Health Act (Cap 242)
i) Penal Code Act
j) Building Code By-Laws.

5.THE WORLD BANK’S EFFORT IN STRENGTHENING HCWM IN KENYA.

In line with the World Bank Operational Policy on Environmental Assessment the project is
rated as category B. Provision of essential health care services (e.g., family planning, antenatal
care, skilled delivery and postnatal care, etc.) under the project will likely lead to generation of
health care waste that may present potential adverse impacts to the environment if not properly
managed. It is a world bank lending options to ensure that any negative environmental impacts is
identified, avoided and mitigation measures put in place. For this reason the transportation of
health care waste to a central place is for purposes of avoiding environmental degradation in
rural areas thus protect communities including vulnerable marginalized groups in Magarini and
Ganze sub counties.

6.THS-UC PROJECT SUPPORT FOR HEALTH CARE WASTE MANAGEMENT

TRANSPORTATION VEHICLE.
The approved budget for the 2 vehicles is 10 million thus each is 5 million. Model is a single cab
pick up that can easily move in the rural health facilities following a schedule.
7. SITUATIONAL ANALYSIS OF THE HCW TRANSPORTATION INTERVENTION.
The county has been zoned in to two regions ie the Southern region (Kilifi North, South,
Kaloleni & Rabai) and Northern region(Malindi, Magarini and Ganze).Northern region waste
will be transported to Malindi Sub County Hospital HCWM plant for disposal while Southern
region will be at KEMRI Welcome Trust
8.GOAL, OBJECTIVES AND EXPECTED ACHIEVEMENTS OF THE HCW
TRANSPORTATION INTERVENTION.
GOAL: Strengthening the management of Health care waste within the Hospitals, healthcare
and Community setting in order to improve and safeguard public health and realize a sustainable
safe environment.
OBJECTIVES:
 Promote the best available technologies and practices for handling health care waste.
  Improve infrastructure for health waste management in the county
 Safe and prompt transport of contained waste to a point of safe disposal.
EXPECTED ACHIEVEMENTS
 Streamlined HCWM system by all healthcare settings
 Improved transportation of infectious waste from rural health facilities
 Increased awareness of HCWM in Kilifi County
 Improved compliance to HCWM legal and policy guidelines
9.PROPOSED ACTIVITIES
For the objectivity of off-site disposal all the facilities will be mapped in to various zones
There will be a route map for each zone with schedules
Training and mentorship of waste handlers that include cleaners and the drivers on infection
prevention control when handling waste.
The primary health care facility producing the waste will be responsible for packaging and
labelling the waste being transported out of the facility. Packaging and labelling must be in
conformity with national legislation on the transport of dangerous substances.
Other activities include:

 Mapping and zoning of rural health facilities

 Risk profiling health products
 Continuous training of all health care workers including drivers and subordinate staff on
healthcare waste management and infection prevention control.
 Awareness creation to the community on clean and healthy environment
10.STAKEHOLDER ANALYSIS
Identification of all the stakeholders including government bodies like NEMA ,Department of
environment, private facilities ,FBOs and other public private partnerships will be mapped
using a matrix and all shall be fully involved in waste management stream
11. MONITORING OF TRANSPORTATION.
An effective monitoring and evaluation system has been established that with reporting
documents that will be used. This will include tracking system against the schedules, support
supervision, registers as per the set NEMA guidelines and standards.
Logistics for process monitoring include fuels, Personal protective lists ,registers and transport
reports against the work tickets as per the route schedules. Equally monitoring on spills reports
will be done. Periodic assessment will be done to establish the viability of the transportation as
a measure to safeguard public Health and environment and were necessary make adjustments.
12.CONCLUSION
To achieve safe and sustainable management of health care waste, advocacy is necessary for all
stakeholders so as to get support by all. Waste management has not been given the importance it
deserves despite being a key indicator in infection prevention and control, in this regard funding
for all aspects of HCWM from generation to final disposal should be addressed.

I. SPECIFICATIONS
KILIFI COUNTY GOVERNMENT
SPECIFICATIONS FOR A HEALTH CARE WASTE PICK UP
1) Have totally enclosed car body with the driver seat separate from the loader,
meaning that there should be a bulkhead between the driver’s cabin and the
vehicle body that is designated to retain the load if the vehicle is involved in a
collision.
2) Should be easy to clean -internal finish of the vehicle should allow it to be steam
cleaned and the internal angles should be rounded. The transport part should be
made of stainless-steel material with smooth surface which can be easily cleaned
and disinfected
3) Body should be robust, durable and enclosed leak proof whereby the design
should be able to prevent accumulation of fluid in the conveying section, the
intersecting surfaces are joined together with a soft turn so that there are no
vertical corners
4) Have a specified cabinet to carry suitable protective clothing and cleaning
equipment
5) Marked with international hazard emblem and the vehicle color is orange
6) Have fixed equipment for the measurement of the weight of wastes
7) Have an automated load platform which has tipping mechanism
8) Vehicle should not be equipped or fitted with compaction/compression
mechanism
9) Separate compartment in the vehicle should have empty plastic bags, suitable
personal protective equipment, cleaning equipment, tools and disinfectant,
together with special kits for dealing with liquid spills

ENGINE DETAILS AND BODY REQUIREMENTS

Model NO.
Drive Wheel 4×2
Models Small
Condition New
Steering Right hand
Overall Dimension 4290X1480X1860mm(L×w×h)
Cabin Driver and 2 crew
Transmission4 MT
Emmission standards Euro 3
Mileage 00
Displacement 1012ml
Tire 165/70r13lt
Fuel Diesel
Seats 3
Usage / Type Dump/ Dumper
Maximum Carry 3000kg/ Lts
Wheelbase 2750mm
Suspension Leaf Spring Suspension
Fuel Type Diesel
Horsepower 70HP
Specification CCC, ISO9001
Loading Self-loading rear :- automated load platform which has tipping
mechanism
Weight measure Should be mounted with fixed equipment for the measurement of the
weight of wastes
Compaction Not to be fitted with Compacting/ Compression mechanism
Off - loading Tipping mechanism
Body Totally enclosed. Bulk head between driver’s seat and loader, to
retain load in the case of accident. Be robust and durable
Internal of body Coved angles and leak proof, easy to clean inclusive of steam
cleaning-stainless steel. Not to retain fluids.
Color Orange with bio-hazard emblem
Certification ISO9000, CCC, TS16949, EPA, EEC, RoHS, CE
Separate compartment Have separate space to carry empty plastic bags, suitable personal
protective equipment, cleaning equipment, tools and disinfectant,
together with special kit

II. TRACKING DOCUMENT: 03CG263A

A,TRANSPORTER Registered name of transporter-Kilifi department of Health

Usual operation: Kilifi County Northern Zone
License Number-009303
Issuing Authority-NEMA
 CONSIGNMENT NOTE FOR CARRIAGE AND DISPOSAL OF WASTE
B Area Collected- Primary facilities within Malindi and
Description of waste Magarini subcounties
Type of Waste- infectious biomedical waste
Description and physical nature-sharps and hazardous waste
Quantity of waste-To be determined on site per route
Number of containers-to be determined on site per route
Disposers certificate Vehicle-03CG 263A
Driver-Evans Karisa
Public Health officer-Tony Zoka

III. TRACKING DOCUMENT: 03CG266A

A,TRANSPORTER Registered name of transporter-Kilifi department of Health

Usual operation_ Kilifi County Southern zone
License Number-009305
 Issuing Authority-NEMA
CONSIGNMENT NOTE FOR CARRIAGE AND DISPOSAL OF WASTE
B Area Collected- Primary facilities within Kilifi North/South,
Description of waste Kaloleni and Ganze sub counties
Type of Waste- infectious biomedical waste
Description and physical nature-sharps and hazardous waste
Quantity of waste-To be determined on site per route
Number of containers-to be determined on site per route
Disposers certificate Vehicle-03CG 266A
Driver-Ibrahim Kazungu Shujaa
Public Health officer-Penina Kamau

1V, VEHICLE LICENCES