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Healthcare Waste Management, West Bengal
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Subject Area="Infrastructure and Equipment." Objective="Clean and hygienic health facilities."
Details for Reform Option "Healthcare Waste Management, West Bengal"

Background: Management of health care waste has been a major concern for many states in India. It becomes all the more serious because of its toxic nature posing a threat to public health and leading to pollution of land, water and air. Action: Under the West Bengal Health Systems Development Project (WBHSDP), an attempt was made to develop a low cost, effective & sustainable health care waste management system. Since the problem was multi-sectoral, the process was carried out by the Project Management Cell of the WBHSDP, under the guidance of the State level advisory committee. This was headed by the Ministers-in-charge of the Department of Health and Family Welfare and Department of Environment, and in consultation with the West Bengal Pollution Control Board. The first tasks were to identify methods that could reduce the volume and toxicity of wastes and its adverse impact on the environment and to assess the institutional needs and capacity-building measures necessary to implement such methods. A number of pilots were conducted in selected health care units and subsequent to their evaluation, an action plan on Health Care Waste Management (HCWM) was developed. It was also decided to contract out sanitary and scavenging services and provide security in larger hospitals (see entry on Privatisation of cleaning services, West Bengal). The action plan which complies with the Bio-medical Waste Management and Handling Rules 1998, provides all the information needed to implement an HCWM system and its implementation within the existing health structure in West Bengal. A strategy was chalked out for its implementation and it was then replicated in other health care units in a phased manner. A training manual was developed and more than 10,000 staff of health and other related departments have been trained. Capacity building for cleaning (Group D) staff was undertaken and awareness programmes were conducted involving the municipalities, the pollution control board and NGOs. This was backed up with IEC material such as posters and leaflets. Other forums such as management and public health engineering institutions were also employed to create awareness amongst stakeholders and students. Results: As on February 2004, the action plan was being implemented in 178 secondary level health institutions in 18 districts. This includes 19 district hospitals, 64 sub-divisional hospitals, and 95 rural hospitals (also known as Community Health Centres or CHCs). Medical treatment equipment (three waste autoclaves and two waste microwaves) have been installed and are working satisfactorily. One autoclave and one of the microwaves have also been made available for private health facilities. Revenues earned from this are used for its operation and maintenance.

Cost Varies from institution to institution and based on technologies adapted. Approximate costs for implementation of HCWM at: 30 bed Rural Hospital: INR 1,37,000 500 bed Rural Hospital( without waste autoclave/ microwave): INR 5,82,000 500 bed Rural Hospital( including waste autoclave/ microwave): INR 23,00,000
Place State of West Bengal since the year 1998.
Time Frame Approximately 4 months to issue the Government order.

Cleanliness: Drastically improves hygiene levels, thus reducing pollution. Efficiency: Setting up such a system increases the efficiency of the staff and improves their awareness of hygiene standards.


Expense: Cost intensive programme. This could pose a challenge to its sustainability. Infrastructure: Needs extensive infrastructure setup. Organisation: It is a complex programme and necessitates close coordination between different sectors.


Involvement and cooperation of all stakeholders. Extensive training of health staff. Systems required to be implemented for regulatory compliance. Regular supply of consumables. Implementing and monitoring agency (in this case the project management cell of the WBHSDP)

Who needs to be consulted

Officials at the departments of health and environment, Pollution control board, municipalities concerned and NGOs.



The World Bank funded West Bengal State Health Systems Development Project has come to an end in February 2004, but the Department of Health & Family Welfare has decided to continue with the system and activities are now undertaken by the public health branch of the Health Directorate.

Chances of Replication

Might be a challenge in the absence of an agency such as the WBHSDP as it requires significant funding and technical expertise as well as close monitoring. However certain elements of this system are replicable such as: - the action plan and training manual - common treatment facility in municipal areas - contracting out of scavenging and non-clinical services - the design of storage and disposal facilities - IEC activities




Submitted By

Sara Joseph, Researcher, ECTA, New Delhi, November 2004.

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