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IMPACT OF POOR WASTE MANAGEMENT ON PUBLIC HEALTH: A CASE STUDY OF UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL

ABSTRACT

Poor waste management constitutes a critical environmental and public health challenge in Nigeria, particularly in densely populated urban and peri-urban communities in the Niger Delta region where rapid population growth, inadequate infrastructure, and industrial pollution compound the health risks associated with domestic and hospital waste mismanagement. This study investigates the impact of poor waste management on public health outcomes among patients and communities served by the University of Port Harcourt Teaching Hospital (UPTH). A cross-sectional study employing both quantitative and qualitative methods was conducted among 420 participants including UPTH patients, community residents, environmental health officers, and healthcare workers. Data collection involved structured questionnaires, key informant interviews, environmental sampling, and review of hospital disease surveillance records. The findings demonstrating significant associations between inadequate waste disposal practices and prevalence of diarrhoeal diseases, malaria, respiratory infections, and skin diseases. It concludes with recommendations for integrated waste management reform, community health education, hospital waste disposal protocols, and environmental regulatory enforcement. This study provides compelling evidence for policy and programmatic reform of waste management systems in Rivers State and the broader Niger Delta region.

 

1.0 INTRODUCTION

1.1 BACKGROUND OF THE STUDY

One of the most basic determinants of environmental health and populace welfare is waste management, including the collection, transportation, treatment, and disposal of solid, liquid, and hazardous wastes (Guerrero et al., 2013). The inability to create and sustain efficient waste management systems creates a cascade of public health impacts, such as outbreaks of waterborne diseases, breeding habitats of vectors, air pollution, soil pollution, and direct exposures to toxic and infectious organisms (Giusti, 2009). Poor waste management has become a dominant environmental health risk factor contributing to the preventable morbidity and mortality in low- and middle-income countries (Hoornweg and Bhada-Tata, 2012).

In Nigeria, it is estimated that every year, about 32 million tonnes of municipal solid waste are generated, but less than 40% of this waste is collected through formal waste management systems (Oyelola & Babatunde, 2019). The rest is discarded in unregulated dumping, open burning, and illegal landfills, posing severe risks to the public health, especially in densely populated urban and peri-urban communities where population density increases the exposure risks. The capital of Rivers State and the commercial centre of the Niger Delta, Port Said, is an acute expression of this crisis. The high rate of population and oil industry-provided jobs opportunities, inefficient investment in waste management facilities, and an effective lack of environmental regulation have all come together to create a substantially degraded urban environment characterised by uncollected waste, illegally dumped waste, and widespread open burning (Mmom & Aifesehi, 2013).

The University of Port Harcourt Teaching Hospital (UPTH) is the pioneer tertiary health care facility in Rivers State with the mission of providing comprehensive tertiary health care to a population of more than seven million of the state residents. Being a large teaching Hospital which produces significant amounts of healthcare waste, UPTH is also a strategically important location to examine the correlation between waste management and public health outcomes. The patient catchment area of the hospital incorporates many communities where the waste management infrastructure is grossly inadequate to create interrelationships between environmental conditions of the community at the community level and hospital disease burden.

The paper will review the effects that poor waste management has on the health outcome of the population in communities where the study is carried out using the University of Prague Hospital (UPTH) as the community. The results should guide the evidence-based reforms in waste management policy and practice in Rivers State and the Niger Delta region.

Urbanisation is increasing in parallel with the global waste management crisis in which the World Bank anticipates a 70 percent rise in global solid waste generation between 2016 and 2050, by 2.01 billion tonnes to 3.40 billion tonnes of solid waste annually in 2050 (Kaza et al., 2018). The health effects of poor waste management work through a variety of pathways: through direct exposure to pathogenic microorganisms in organic waste, chemical exposure of industrial and electronic waste, transmission of diseases through vectors like mice bred in the landfill, air pollution due to the burning of waste, and groundwater contamination through unlined landfills (Rushton, 2003).

Rapid urbanisation, population explosion, institutional deficiency to manage the challenge and lack of a holistic national policy of waste management coupled with strong enforcement mechanisms further compound the waste management challenge in Nigeria (Ogwueleka, 2009). Rivers State, one of the most dense populated and economically active states in Nigeria faces specific challenges regarding waste management due to the combination of a large urban population, a large volume of industrial waste generated by oil and gas activities and limited areas of waste collection coverage and especially in informal settlements (Mmom & Aifesehi, 2013).

Isolated studies have reported the health impacts of poor waste management in Port Harcourt, with particularly high burdens of diarrhoeal diseases, malaria, respiratory infections, and skin conditions (Ogbeibu & Victor, 2022). A large percentage of paediatric morbidity and mortality in the state is caused by waterborne diseases which are driven by the contamination of surface and groundwater by the leachate of the illegal dump sites and untreated sewage (UNICEF Nigeria, 2019).

At UPTH and other teaching hospitals in Nigeria, there are other challenges that affect healthcare waste management. Specific disposal is necessary in medical waste such as sharps, pharmaceutical waste, pathological waste, and chemical waste to prevent nosocomial infections, environmental pollution, and occupational health risks to the health care worker and the waste handlers (Ogbo et al., 2018). The lack of healthcare waste segregation, storage, treatment and disposal in Nigerian hospitals has been reported in numerous studies with considerable implications to patient safety and community health (Abah and Ohimain, 2010).

1.2 STATEMENT OF THE PROBLEM

The waste management crisis in Port Harcourt has reached a critical point, with quantifiable effects on the population of Port Harcourt in terms of their impact on the overall health of the population of Port Harcourt which is manifested in the disease profile of patients attending UPTH. Although there are evident linkages between waste mismanagement and preventable diseases, specific health effects of poor waste management in the hospital catchment communities have not been systematically quantified through rigorous epidemiological studies. This disconnect of evidence undermines the creation of specific interventions in environmental health and leads to weakening the process of advocacy to promote the urgency of the waste management change.

Moreover, although UPTH produces large amounts of healthcare waste on a daily basis, the sufficiency of the hospital waste management policies and their potential effects on the staff, patient, and community health have not been properly evaluated. There are still potential exposures of healthcare workers and community members living near the hospital to improperly managed medical waste, but there is no characterisation of the health risks of such exposure.

The fact that there is no systematic data on the disease burden associated with waste management practices in Port Harcourt communities implies that the policy makers in the Rivers State do not have the evidence base they require to prioritise the reform of waste management practices in the Port Harcourt communities, allocate resources efficiently and justify the investment in modern waste management and disposal technology. This paper fills these very important gaps by conducting an in-depth epidemiological and environmental health research.

 

1.3 OBJECTIVES OF THE STUDY

The broad objective of this study is to investigate the impact of poor waste management on public health outcomes in communities served by UPTH. The specific objectives are to:

1. Assess the waste management practices and environmental health conditions in communities served by UPTH.
2. Determine the prevalence of waste management-associated diseases (diarrhoeal diseases, malaria, respiratory infections, and dermatological conditions) among patients attending UPTH.
3. Examine the association between household and community waste management practices and disease prevalence in the study population.
4. Evaluate the adequacy of healthcare waste management protocols at UPTH and their implications for staff and community health.
5. Recommend evidence-based interventions for improving waste management and reducing associated public health burdens in Port Harcourt.

 

1.4 RESEARCH QUESTIONS

The following research questions guide this study:

1. What are the dominant waste management practices and environmental health conditions in communities served by UPTH?
2. What is the prevalence of waste management-associated diseases among patients attending UPTH?
3. Is there a significant association between household and community waste management practices and disease prevalence in the study population?
4. How adequate are the healthcare waste management protocols at UPTH, and what are their implications for staff and community health?
5. What interventions can effectively improve waste management and reduce associated public health burdens in Port Harcourt?

1.5 RESEARCH HYPOTHESES

The following null hypotheses are formulated for testing in this study:

H01: There is no significant association between household waste disposal practices and the prevalence of diarrhoeal diseases among patients attending UPTH.

H02: There is no significant relationship between proximity to illegal dump sites and the prevalence of vector-borne diseases in communities served by UPTH.

H03: There is no significant difference in the prevalence of waste management-associated diseases between communities with adequate and inadequate solid waste collection services.

 

1.6 SIGNIFICANCE OF THE STUDY

This study is significant for multiple reasons. For the Rivers State Government, the Ministry of Environment, and the Port Harcourt City Local Government Area, the study’s findings provide the empirical foundation for prioritising waste management reform as a core public health intervention. Quantifying the disease burden attributable to poor waste management in UPTH’s catchment area creates a compelling economic and health argument for urgent investment in modern waste collection, treatment, and disposal infrastructure.

For UPTH’s management, infection control team, and occupational health units, the study’s assessment of healthcare waste management practices and protocols will identify specific gaps requiring immediate remediation, contributing to improved patient safety, staff health protection, and regulatory compliance. The findings will be directly applicable to the revision and strengthening of the hospital’s waste management standard operating procedures.

For environmental health practitioners, urban planners, and public health professionals working in Port Harcourt and the broader Niger Delta, the study provides a detailed epidemiological portrait of waste management-health linkages that can guide community-level environmental health interventions, sanitation campaigns, and advocacy for stronger environmental regulation and enforcement.

Academically, the study enriches the growing body of environmental epidemiology research in sub-Saharan Africa, addressing a documented gap in systematic evidence on waste management-health relationships in Nigerian urban settings. The mixed-methods approach provides rich quantitative and qualitative data that can serve as a reference point for future research in this field.

 

1.7 SCOPE OF THE STUDY

This study is conducted among patients and community residents in the catchment area of the University of Port Harcourt Teaching Hospital, encompassing selected communities in Obio/Akpor, Port Harcourt City, and Eleme Local Government Areas in Rivers State. The study focuses on the health impacts of domestic solid waste, healthcare waste, and open drainage/sewage management. Industrial and petroleum-related waste is noted as a contextual factor but is not the primary focus of investigation. Data collection was conducted between April and September 2023. The study employs a cross-sectional design, and the findings represent a snapshot of conditions at the time of data collection.

 

1.8 DEFINITIONS OF TERMS

Waste Management: The collection, transportation, treatment, recycling, and disposal of waste materials, encompassing the entire lifecycle from generation to final disposal.

Municipal Solid Waste (MSW): Everyday items discarded by the public, including food scraps, packaging, paper, glass, and other household and commercial refuse.

Healthcare Waste: All waste generated within healthcare facilities, including infectious waste, sharps, pharmaceutical waste, chemical waste, and non-hazardous general waste.

Poor Waste Management: The inadequate, irregular, or absent collection, treatment, and disposal of wastes, resulting in uncontrolled dumping, open burning, and environmental contamination.

Public Health: The science and art of preventing disease, prolonging life, and promoting human health through organised efforts and informed choices of society, organisations, public and private communities, and individuals.

Vector-Borne Disease: A disease caused by pathogens and parasites transmitted to humans through the bites of infected arthropod species such as mosquitoes, ticks, and flies, which commonly breed in waste environments.

Leachate: Liquid that has percolated through solid waste and extracted dissolved or suspended materials, which may contaminate groundwater and surface water when inadequately managed.

 

REFERENCES

Abah, S. O., & Ohimain, E. I. (2010). Healthcare waste management in Nigeria: A case study. Journal of Public Health and Epidemiology, 2(7), 166–170.

Giusti, L. (2009). A review of waste management practices and their impact on human health. Waste Management, 29(8), 2227–2239. https://doi.org/10.1016/j.wasman.2009.03.028

Guerrero, L. A., Maas, G., & Hogland, W. (2013). Solid waste management challenges for cities in developing countries. Waste Management, 33(1), 220–232. https://doi.org/10.1016/j.wasman.2012.09.008

Hoornweg, D., & Bhada-Tata, P. (2012). What a waste: A global review of solid waste management. World Bank Urban Development Series Knowledge Papers, No. 15. World Bank.

Kaza, S., Yao, L., Bhada-Tata, P., & Van Woerden, F. (2018). What a waste 2.0: A global snapshot of solid waste management to 2050. World Bank Publications.

Mmom, P. C., & Aifesehi, P. E. E. (2013). Environmental and public health implications of solid waste management in Rumuola Community, Port Harcourt, Nigeria. Journal of Geography and Earth Sciences, 1(1), 1–10.

Ogbeibu, A. E., & Victor, R. (2022). Public health burden of poor waste management in Niger Delta communities: A survey of diarrhoeal and vector-borne disease incidence. Environmental Health Insights, 16, 1–12. https://doi.org/10.1177/11786302221082349

Ogbo, P. U., Ibe, S. N. O., & Offordile, A. C. (2018). Assessment of healthcare waste management in a tertiary hospital in Southeast Nigeria. Nigerian Postgraduate Medical Journal, 25(1), 42–47. https://doi.org/10.4103/npmj.npmj_13_18

Ogwueleka, T. C. (2009). Municipal solid waste characteristics and management in Nigeria. Iranian Journal of Environmental Health Science and Engineering, 6(3), 173–180.

Oyelola, O. T., & Babatunde, A. I. (2019). Characterisation of domestic and market solid wastes at source in Lagos metropolis, Lagos, Nigeria. African Journal of Environmental Science and Technology, 2(5), 115–119.

Rushton, L. (2003). Health hazards and waste management. British Medical Bulletin, 68(1), 183–197. https://doi.org/10.1093/bmb/ldg034

UNICEF Nigeria. (2019). Water, sanitation and hygiene (WASH) in Nigeria: Situation analysis. UNICEF Nigeria Country Office.