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124 Healthcare Essay Topic Ideas & Examples

Inside This Article

Healthcare is a diverse and complex field that encompasses a wide range of topics, issues, and challenges. Whether you are studying healthcare as a student, working in the healthcare industry, or simply interested in learning more about this important area, there are countless essay topics that you can explore. To help you get started, here are 124 healthcare essay topic ideas and examples that you can use for inspiration:

• The impact of healthcare disparities on patient outcomes
• Strategies for improving access to healthcare in underserved communities
• The role of technology in transforming healthcare delivery
• The ethics of healthcare rationing
• The importance of diversity and inclusion in healthcare organizations
• The rise of telemedicine and its implications for patient care
• The impact of the opioid epidemic on healthcare systems
• The role of nurses in promoting patient safety
• The challenges of providing mental health care in a primary care setting
• The future of healthcare: personalized medicine and precision healthcare
• The role of healthcare providers in addressing social determinants of health
• The impact of climate change on public health
• The role of public health campaigns in promoting healthy behaviors
• The challenges of healthcare delivery in rural areas
• The impact of healthcare reform on the uninsured population
• The role of healthcare informatics in improving patient outcomes
• The importance of cultural competency in healthcare delivery
• The ethical implications of genetic testing and personalized medicine
• The impact of healthcare costs on patient access to care
• The role of healthcare administrators in shaping the future of healthcare delivery
• The challenges of implementing electronic health records in healthcare settings
• The impact of healthcare privatization on patient care
• The role of healthcare providers in promoting patient autonomy
• The challenges of providing end-of-life care in a healthcare setting
• The impact of healthcare disparities on maternal and child health outcomes
• The role of healthcare providers in addressing the opioid crisis
• The challenges of providing healthcare to undocumented immigrants
• The impact of the COVID-19 pandemic on healthcare systems
• The role of healthcare providers in promoting vaccination uptake
• The challenges of healthcare delivery in conflict zones
• The impact of healthcare disparities on LGBTQ+ populations
• The role of healthcare providers in promoting healthy aging
• The challenges of providing healthcare to homeless populations
• The impact of healthcare disparities on rural communities
• The role of healthcare providers in addressing food insecurity
• The challenges of providing healthcare to refugees and asylum seekers
• The impact of healthcare disparities on people with disabilities
• The role of healthcare providers in promoting mental health awareness
• The challenges of providing healthcare to incarcerated populations
• The impact of healthcare disparities on immigrant populations
• The role of healthcare providers in promoting sexual health education
• The challenges of providing healthcare to indigenous populations
• The impact of healthcare disparities on veterans' health outcomes
• The role of healthcare providers in promoting healthy lifestyles
• The challenges of providing healthcare to low-income populations
• The impact of healthcare disparities on minority populations
• The role of healthcare providers in promoting preventive care
• The challenges of providing healthcare to elderly populations
• The impact of healthcare disparities on women's health outcomes
• The role of healthcare providers in promoting maternal health
• The challenges of providing healthcare to children and adolescents
• The impact of healthcare disparities on mental health outcomes
• The role of healthcare providers in promoting substance abuse treatment
• The challenges of providing healthcare to homeless youth
• The impact of healthcare disparities on LGBTQ+ youth
• The role of healthcare providers in promoting healthy relationships
• The challenges of providing healthcare to LGBTQ+ youth
• The impact of healthcare disparities on transgender populations
• The role of healthcare providers in promoting gender-affirming care
• The challenges of providing healthcare to LGBTQ+ elders
• The impact of healthcare disparities on people of color
• The role of healthcare providers in promoting racial equity
• The challenges of providing healthcare to immigrant populations
• The impact of healthcare disparities on refugee populations
• The role of healthcare providers in promoting cultural competency
• The challenges of providing healthcare to non-English speaking populations
• The role of healthcare providers in promoting disability rights
• The challenges of providing healthcare to people with mental illnesses
• The impact of healthcare disparities on people experiencing homelessness
• The role of healthcare providers in promoting housing stability
• The challenges of providing healthcare to people living in poverty
• The impact of healthcare disparities on incarcerated populations
• The role of healthcare providers in promoting criminal justice reform
• The challenges of providing healthcare to veterans
• The impact of healthcare

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Healthcare Professionals Essays

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Home Essay Samples

Essay Samples on Health

The healthcare college majors belong to those students that have to compose a great number of essays that include reflective journals, shadowing experience reports, lab analysis explorations, argumentative papers, and assignments on theorists. Since these are quite complex, it’s important to know the difference between these essay types. You should check twice with your grading rubric and always ask questions if you are in doubt. As a way to provide you with some guidance, we have compiled a collection of free health essay examples. These focus on various branches of nursing, healthcare administration, pharmacology, international issues, and the basic health subjects that every medical student may face. Take your time to analyze at least five health essay samples by starting with the introduction section. Your first essay paragraph must provide information about the problem before coming up with your thesis statement. Remember that you should have at least five reliable sources that support your argument or the basic facts that you may require for debates. Speaking of medical lab reports, you can use various assignments below as a template that will help you structure your health paper. Take your time to explore free samples and it will always pay off!

Unveiling My Career Goals in the Healthcare Field

What are your career goals related to the healthcare field? This question unveils my aspirations to contribute to the well-being of individuals, families, and communities by venturing into the dynamic and impactful realm of healthcare. A career in healthcare is not only a path to...

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The Nursing Discourse Community: Shared Knowledge and Collaboration

Nursing is a noble and demanding profession that thrives on collaboration, empathy, and the exchange of knowledge. Within the vast healthcare landscape, the concept of a nursing discourse community emerges as a dynamic network of professionals who share a common language, values, and goals. This...

• Discourse Community

Pursuing Public Health: Navigating a Path to Achieve Career Goals

Public health career goals reflect the aspirations of individuals committed to safeguarding and improving the well-being of communities on a large scale. In a world where health challenges are diverse and ever-evolving, a career in public health offers a unique opportunity to make a lasting...

• Public Health

How Does Community Influence You: Shaping Identity, Values

How does community influence you? This question delves into the multifaceted impact that the communities we are a part of have on shaping our identity, values, aspirations, and the lens through which we perceive the world. Whether we realize it or not, the influence of...

• Under The Influence

Effects of Drugs on Community: Unraveling the Impact

The effects of drugs on community are far-reaching and profound, touching every aspect of society. This essay explores the significance of drug-related issues, the multifaceted impact on communities, the challenges they pose, and the importance of collaborative efforts to mitigate the harm caused by drugs....

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Community Health Nursing: Bridging Care and Empowerment

Community health nursing is a vital branch of nursing that plays a pivotal role in promoting the well-being of individuals, families, and communities at large. This essay delves into the significance of community health nursing, its core principles, the role of community health nurses, and...

My Future Career as a Nurse: Way for Compassionate Healing

The journey toward a future career as a nurse is one that intertwines empathy, expertise, and the unwavering commitment to provide compassionate care. In this essay, I take you on a voyage through my aspirations, motivations, and the profound impact I intend to make as...

What Motivates You to Pursue a Career in Medicine

The world of medicine is a tapestry of compassion, science, and unwavering commitment. In this essay, we embark on an exploration of the question: what motivates you to pursue a career in medicine? By delving into the layers of empathy, fascination, and the desire to...

Why You Choose Nursing as a Career: A Comprehensive Analysis

The decision to pursue a nursing career is often rooted in profound motivations and a desire to make a meaningful impact on the lives of others. In this essay, we embark on a thorough analysis of why individuals choose nursing as a career, exploring the...

Cell Phone Addiction: Unraveling the Digital Dilemma

In the modern age of technology, cell phones have become an integral part of our lives, offering convenience, connectivity, and access to a world of information at our fingertips. However, the rapid proliferation of cell phones has given rise to a concerning phenomenon: cell phone...

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Why Smoking is "Good" for You: Unraveling the Enigma

The Complex Landscape of Smoking: An Exploration Observing the individual engrossed in his smoke, one can't help but notice the allocated space designated exclusively for smokers. Evidently, his financial prosperity allows him to indulge in this habit, as smoking tends to be associated with those...

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Why Should We Legalize Abortion: Empowering Women's Choice and Safety

The debate over legalizing abortion has been a subject of intense discussion and controversy for decades. In this essay, we will explore the compelling reasons why many advocate for the legalization of abortion, focusing on the importance of women's rights, public health, and the reduction...

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Why Should Abortions Be Made Legal: Advancing Women's Rights

The topic of why should abortions be made legal has sparked heated debates around the world. In this essay, we will delve into the compelling reasons why abortion should be legal, highlighting the importance of women's rights, public health, and the avoidance of unsafe practices....

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Why I Agree: Abortion from a Supportive Perspective

This essay focuses on arguments in favor of abortion, highlighting reproductive rights, autonomy, health considerations, and societal benefits. Introduction Abortion is a topic that has sparked intense debate and has led to differing viewpoints across societies. This essay takes a stance in favor of abortion,...

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Why Abortion Should Not Be Banned: Preserving Choice

The debate over whether abortion should be banned is a deeply complex and emotionally charged one. In this essay, we will explore the reasons why many argue against banning abortion, highlighting the importance of women's rights, healthcare access, and the potential consequences of prohibition. By...

The Life of a Doctor: Challenges, Commitment, and Compassion

This essay delves into the multifaceted life of a doctor, exploring the demands of their profession, the impact they have on patients and communities, and the personal fulfillment that comes from their vocation. Introduction The life of a doctor is often revered and admired, symbolizing...

The Importance of Doctors: Nurturing Health and Healing

This essay highlights the significance of doctors in society as healers, innovators, advocates, and compassionate caregivers. Doctors play a crucial role in diagnosing and treating diseases, preventing health issues, leading medical advancements, advocating for public health, and nurturing human connections. Their contributions extend far beyond...

The Evolution and Controversy of Abortion Laws

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The Controversy Surrounding Abortion Rights

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The Case for Legal Abortion: Balancing Women's Rights and Health

The question of whether abortion should be legal is a subject of profound ethical, medical, and social importance. In this argumentative essay, we will explore the reasons why many advocate for legalizing abortion, highlighting the importance of women's rights, access to safe medical procedures, and...

The Argumentative Discourse About the Legalization of Abortion

The topic of the legalization of abortion has ignited passionate and contentious debates worldwide, touching on issues of ethics, women's rights, healthcare, and government intervention. This essay delves into the argumentative discourse surrounding the legalization of abortion, exploring its ethical implications, women's agency, healthcare access,...

The Argumentative Case for Legalizing Abortion

The contentious topic of legalizing abortion has been at the center of heated debates for decades, drawing on a multitude of ethical, societal, and personal considerations. In this argumentative essay, we delve into the rationale behind legalizing abortion, highlighting how it empowers women's autonomy, safeguards...

The Argument for Legalizing Abortion: Safety and Reproductive Rights

Introduction The debate surrounding the legalization of abortion is a contentious and complex issue that touches upon ethics, women's rights, and societal norms. This essay aims to present a comprehensive argument in favor of legalizing abortion, highlighting the importance of empowerment, safety, and reproductive rights...

The Abortion Proposal: A Constructive Approach to a Polarizing Issue

Introduction Abortion remains one of the most divisive topics in many societies, consistently sparking passionate debates. The complexities surrounding the issue necessitate an approach that transcends political, religious, and cultural lines. This abortion proposal essay seeks to outline a multi-faceted strategy that combines education, access...

The Abortion Problem: A Deep Dive into Its Complexities

Introduction The abortion problem has been a matter of intense debate for centuries. This complex issue intertwines medical, ethical, cultural, and political facets. As societies have evolved, so have the perceptions and policies regarding abortion. The discussions often diverge into two primary perspectives: pro-choice, emphasizing...

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The Abortion Issue: Exploring Diverse Perspectives

The abortion issue remains one of the most contentious and emotionally charged debates in modern society. This essay aims to provide a comprehensive overview of the multifaceted aspects surrounding the abortion issue, examining the historical, legal, ethical, and societal dimensions that shape individual viewpoints and...

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The Abortion Discussion: Diverse Perspectives and Complex Considerations

Introduction The abortion discussion is a contentious and deeply nuanced discourse that engages individuals, communities, policymakers, and societies across the globe. This essay aims to delve into the multifaceted dimensions of the abortion discussion, considering the range of perspectives, ethical considerations, legal frameworks, and societal...

The Abortion Debate: Exploring Both Sides of the Argument

Introduction The issue of abortion has long been a topic of fervent debate, stirring impassioned arguments from various corners of society. This essay aims to provide a comprehensive examination of the arguments on both sides of the abortion debate. By delving into the viewpoints of...

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The Abortion Controversy: Navigating Complex Ethical Arguments

Introduction The abortion controversy stands as one of the most polarizing and emotionally charged debates in society. This abortion controversial argumentative essay seeks to delve into the multifaceted dimensions of the abortion controversy, analyzing the diverse arguments and perspectives that shape this ongoing discourse. The...

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Teenage Pregnancy and Abortion: Navigating Complex Choices

The issue of teenage pregnancy and abortion is a multifaceted topic that intersects with issues of sexuality, education, health, and personal choices. In this essay, we will explore the challenges posed by teenage pregnancy, the implications of abortion for young women, and the importance of...

• Teenage Pregnancy

Supporting Abortion: Empowering Women's Rights and Health

The issue of abortion is a topic that invokes a range of emotions and opinions. In this essay, we will delve into the reasons for supporting abortion, emphasizing the importance of women's rights, bodily autonomy, and the advancement of public health. By exploring these facets,...

Should Abortion Be Made Legal? A Comprehensive Examination

The question of whether abortion should be made legal is a deeply divisive and complex issue that elicits passionate arguments from individuals on both sides of the debate. This essay aims to explore the arguments for and against legalizing abortion, considering a range of ethical,...

Should Abortion Be Legalized? Argument for Reproductive Freedom

This essay presents a comprehensive argument in favor of legalizing abortion, focusing on reproductive freedom, women's health, and societal impact. Introduction The question of whether abortion should be legalized is a topic that generates intense debates worldwide. This essay aims to provide a comprehensive examination...

Should Abortion be Legal or Illegal: Legalization vs. Criminalization

The question of whether abortion should be legal or illegal is at the heart of a contentious and deeply complex debate. In this argumentative essay, we will examine the merits and drawbacks of both sides of the argument, exploring the ethical, medical, and societal considerations...

Should Abortion Be Illegal? The Controversial Debate

The question of whether abortion should be illegal is a contentious and morally charged issue that revolves around conflicting beliefs about the value of life, women's rights, and societal well-being. In this argumentative essay, we will explore the reasons why some argue that abortion should...

Roe vs. Wade and the Abortion Debate

The landmark Supreme Court case of Roe v. Wade in 1973 marked a pivotal moment in the ongoing abortion debate, shaping the legal landscape surrounding reproductive rights in the United States. This essay examines the Roe v. Wade decision, delving into its historical context, ethical...

Research about Abortion: The Complex Landscape

The topic of abortion is one that elicits passionate debates and encompasses a myriad of ethical, medical, social, and legal dimensions. In this research essay, we will delve into the multifaceted nature of abortion, exploring its historical context, ethical considerations, medical practices, legal frameworks, and...

Reasons Why Abortion Should Be Legalized: A Comprehensive Exploration

The debate over whether abortion should be legalized is a complex and contentious issue, raising ethical, medical, and societal considerations. In this essay, we will delve into the compelling reasons why abortion should be legalized, focusing on the importance of women's autonomy, safeguarding public health,...

Reasons Abortion Should Be Legal

The question of whether abortion should be legal is a deeply divisive and complex issue, intertwining ethical, medical, and societal factors. In this essay, we will delve into the compelling reasons why abortion should be legal, focusing on the ethical importance of women's autonomy, public...

Persuasive Writing: The Imperative of Legal Abortion

The topic of legal abortion has been a point of intense contention, evoking impassioned debates on ethics, women's rights, and the role of government in personal decisions. In this essay, we will explore the compelling reasons why legal abortion is not only a necessity but...

Navigating the Complex Issue of Abortion: Ethics, Rights, and Choices

The issue of abortion has long been a subject of profound ethical, legal, and social debate, spanning cultural, religious, and philosophical landscapes. With divergent perspectives and deeply held beliefs, this complex issue encompasses questions about the sanctity of life, individual autonomy, medical ethics, and the...

Is Abortion Morally Wrong? Unpacking Moral Perspectives

The moral status of abortion has long been a contentious and complex issue, eliciting impassioned debates that touch on ethics, religion, philosophy, and individual beliefs. The question of whether abortion is morally wrong stands at the heart of these discussions, prompting diverse viewpoints and thought-provoking...

Is Abortion Morally Right? Exploring the Moral Dilemma

Abortion has been a topic of intense ethical and moral debate for decades, sparking discussions on the rights of women, the sanctity of life, and the role of government in personal decisions. The question of whether abortion is morally right elicits strong opinions from individuals...

In Defense of Abortion: Exploring the Argument for Reproductive Rights

The essay presents a comprehensive argument in favor of abortion, focusing on reproductive rights, women's autonomy, and the complexities of individual circumstances. Introduction The topic of abortion is one of the most debated and controversial issues in society. This essay seeks to present a strong...

How Do You Show Empathy to Patients: The Heartfelt Approach

**How do you show empathy to patients?** This question lies at the core of providing patient-centered care that goes beyond medical treatment to touch the realms of emotional support and understanding. Empathy is the art of connecting with patients on a human level, acknowledging their...

For Abortion: An Argumentative Analysis

The issue of abortion has been a subject of intense controversy and debate for decades, with individuals and societies holding contrasting viewpoints on its moral, ethical, and legal implications. This argumentative essay aims to explore the various perspectives surrounding abortion, delving into the arguments both...

Exploring the Anti-Abortion Perspective: Values and Ethics

Introduction The topic of abortion has long been a contentious and deeply divisive issue, sparking intense debates worldwide. This essay delves into the anti-abortion perspective, also known as the pro-life stance, which emphasizes the sanctity of human life from conception and opposes the practice of...

Exploring Abortion Solutions: A Comprehensive Examination

Introduction The complex issue of abortion prompts a search for practical and ethical solutions that balance women's rights, societal values, and the well-being of all involved. This essay delves into a range of abortion solutions, exploring approaches that address the diverse challenges surrounding this contentious...

Empowering Choice and Advancing Women's Health

The topic of abortion remains a subject of impassioned discourse, with diverse viewpoints rooted in ethics, religion, personal beliefs, and women's rights. In this persuasive essay, we will explore the critical arguments in favor of legalizing abortion, focusing on how it empowers women's agency, protects...

Disadvantages of Abortion: Navigating Ethical and Emotional Challenges

Introduction The topic of abortion is a contentious and emotionally charged subject that sparks debates around the world. While discussions about abortion often focus on individual rights, women's health, and legal considerations, it's crucial to also explore the disadvantages associated with this complex decision. This...

Arguments Against Abortion: The Ethical and Moral Debate

The topic of abortion has long been a subject of passionate debate, with opinions ranging from staunch support to vehement opposition. This essay will delve into the arguments against abortion, exploring the ethical, moral, and religious perspectives that contribute to this contentious issue. The Sanctity...

Anti-Abortion Argument: Protecting Life and Ethical Considerations

Introduction The debate over abortion is characterized by deeply held beliefs and passionate arguments from both sides. This essay delves into the anti-abortion argument, also known as the pro-life stance, which asserts that the fetus has a right to life and should be protected from...

Agreeing with Abortion: Upholding Reproductive Rights and Autonomy

Introduction The topic of abortion is marked by passionate debates, with various perspectives and viewpoints coming to the forefront. This essay explores the arguments in favor of abortion, specifically focusing on the principles of reproductive rights, bodily autonomy, and the importance of providing individuals with...

Agree with Abortion: Exploring the Rationale and Ethical Perspectives

This essay has explored the rationale behind agreeing with abortion, shedding light on the ethical and contextual factors that contribute to this perspective. While the topic of abortion remains contentious, understanding the arguments of those who support it is essential for engaging in informed and...

Agree to Abortion: Exploring a Pro-Choice Perspective

Introduction The topic of abortion has been a subject of intense debate, sparking impassioned arguments from both proponents and opponents. This essay delves into the reasons and arguments for agreeing with the practice of abortion, focusing on women's autonomy, reproductive rights, and the complex circumstances...

Against Abortion: Examining the Argument for Protecting Fetal Life

The essay presents a comprehensive argument against abortion, focusing on fetal rights, ethical considerations, and alternatives to abortion. Introduction The debate surrounding abortion is one that elicits strong emotions and differing viewpoints. This essay delves into the argument against abortion, also known as the pro-life...

Against Abortion: Examining Ethical Concerns

Introduction The issue of abortion has long been a subject of intense debate, with passionate arguments on both sides. This essay delves into the arguments against abortion, focusing on ethical concerns and moral perspectives that drive opposition to this practice. By analyzing the sanctity of...

Against Abortion: Examining Ethical and Moral Considerations

Introduction The topic of abortion is inherently complex and evokes strong emotions from various perspectives. This essay delves into the arguments against abortion, focusing on ethical and moral considerations that underlie the opposition to this practice. It acknowledges the nuanced nature of this issue and...

Against Abortion Persuasive Arguments: Voicing Opposition

Introduction The topic of abortion is one that evokes strong emotions and polarizing opinions. In this persuasive essay, we will delve into the reasons why one might take a stance against abortion. By exploring the sanctity of life, the potential for alternatives, and the potential...

Advantages of Abortion: Exploring Benefits and Complexities

Introduction The topic of abortion is one of the most contentious issues in society, sparking debates and discussions on ethics, morality, and women's rights. While the debate often focuses on the disadvantages and challenges associated with abortion, it's important to also consider the potential advantages...

Advantages and Disadvantages of Abortion: Weighing the Pros and Cons

Introduction The topic of abortion is a complex and sensitive issue that elicits strong opinions from individuals across the globe. While the debate often centers around the ethical, moral, and legal aspects of abortion, it's important to consider both the advantages and disadvantages associated with...

About Abortion: Exploring a Complex Topic

Introduction Abortion is a complex and contentious topic that elicits strong emotions and differing viewpoints. It revolves around the termination of a pregnancy, raising significant ethical, legal, and societal questions. This essay provides an overview of abortion, exploring its history, methods, legal status, and the...

Abortion: Navigating the Ethical and Personal Choice

The topic of abortion is an ethical and emotional minefield that sparks passionate debates on both sides. The central issue revolves around a woman's right to choose and the moral status of the unborn fetus. This short argumentative essay will delve into the key points...

Abortion: Navigating Complex Choices in 1000 Words

Introduction The topic of abortion is both intricate and polarizing, encompassing a multitude of moral, ethical, legal, and personal considerations. This essay will explore the various dimensions of abortion, ranging from its historical context to the current debates surrounding it. While no concise essay can...

Abortion: Arguments For and Against

The topic of abortion is one that elicits strong opinions and impassioned debates. While some individuals firmly believe in a woman's right to choose, others advocate for the sanctity of unborn life. This essay will examine the arguments both for and against abortion, highlighting the...

Abortion: An Examination of Yes and No Arguments

Introduction The debate over abortion has polarized societies, sparking impassioned arguments from both proponents and opponents. This essay delves into the arguments for and against abortion, exploring the complexities and ethical considerations that underlie the "yes" and "no" perspectives on this divisive issue. Proponents of...

Abortion: An Argumentative Examination of a Complex Issue

The topic of abortion is a contentious and deeply divisive subject that elicits strong emotions and stirs heated debates. At the heart of this issue lies the clash between the right to bodily autonomy and the sanctity of life. This essay seeks to provide an...

Abortion: A Complex and Controversial Issue in 500 Words

Abortion, the termination of a pregnancy, is a deeply divisive topic that elicits strong emotions and diverse perspectives. The controversy surrounding abortion arises from the collision of moral, ethical, religious, and societal values, making it one of the most complex issues in contemporary discourse. The...

Abortion Should Not Be Banned

Introduction The topic of abortion is one of deep ethical, moral, and societal significance. The question of whether abortions should be banned is a highly debated issue, with differing perspectives on both sides. This essay argues that abortion should not be banned, highlighting the importance...

Abortion Should Be Legal: An Argumentative Perspective

Introduction The legalization of abortion is a deeply polarizing issue that sparks debates encompassing ethics, human rights, women's autonomy, and societal well-being. This essay presents a comprehensive argument in favor of legalizing abortion, addressing both the practical and moral considerations surrounding this complex topic. Historical...

Abortion Should Be Legal: A Persuasive Argument

Introduction The topic of abortion has long been a subject of heated debate, sparking conversations about ethics, women's rights, and societal values. This persuasive essay aims to present a compelling case for the legalization of abortion, highlighting the importance of respecting women's autonomy, safeguarding their...

Abortion Should Be Allowed: Ensuring Women's Autonomy and Health

Introduction The question of whether abortion should be allowed is a complex and highly debated topic that revolves around women's rights, medical ethics, and societal values. This essay argues in favor of allowing abortion, highlighting the importance of women's autonomy over their bodies, protecting their...

Abortion Rights: Complexities of an Argumentative Landscape

Introduction The debate over abortion rights remains one of the most contentious and emotionally charged issues in modern society. The clash of ideologies and moral beliefs has led to a multifaceted discussion that touches upon ethical, legal, religious, and personal considerations. The focus of this...

Abortion Rights: Balancing Autonomy and Ethics

Introduction Abortion rights, the subject of ongoing debates, involve the intersection of women's autonomy, medical ethics, and societal values. This essay explores the complexities surrounding abortion rights, delving into the historical, legal, ethical, and social dimensions that shape this contentious issue. Historical Evolution The history...

Abortion Legalization: Examining the Complex Issue

The legalization of abortion is a topic that evokes strong emotions and opinions from individuals on all sides of the debate. This essay delves into the multifaceted discussions surrounding the legalization of abortion, exploring the arguments presented by proponents and opponents and the broader implications...

Abortion Laws and Reproductive Rights: Argumentative Debate

The issue of abortion laws has been a hotly debated topic that touches on ethical, moral, and legal considerations. This argumentative essay explores the opposing viewpoints surrounding abortion laws and the broader implications for reproductive rights and women's autonomy. Proponents of Restrictive Abortion Laws Advocates...

Abortion Information: Exploring the Complexities and Perspectives

Abortion is a deeply contentious and multifaceted topic that touches upon matters of ethics, human rights, public health, and personal beliefs. This informative essay aims to provide a comprehensive overview of abortion, shedding light on its historical context, legal landscape, medical procedures, and the various...

Abortion in America: A Complex and Controversial Issue

The topic of abortion in America is one that remains deeply divisive and emotionally charged. As a fundamental issue of women's rights, personal choice, and ethical considerations, the debate over abortion laws and access continues to shape the social, political, and legal landscape of the...

Abortion Facts for an Argument

Abortion is a complex and emotionally charged topic that elicits strong opinions from individuals across society. When constructing an argumentative essay on abortion, it is essential to base your points on accurate and well-researched facts. Here are several key abortion facts that can serve as...

Abortion Disagree: Ethical Concerns and Alternative Perspective

Introduction The topic of abortion is a highly contentious and morally complex issue that evokes deeply-held beliefs and diverse perspectives. This "Abortion Disagree" essay aims to present arguments against abortion by exploring the ethical concerns and alternative viewpoints held by those who do not agree...

Abortion as a Social Issue: Navigating Perspectives and Impacts

Introduction Abortion is a multifaceted social issue that intertwines ethics, women's rights, religion, public health, and societal values. This essay delves into the complexities surrounding abortion as a social issue, exploring its historical context, the diverse viewpoints it elicits, and the broader implications for individuals...

Abortion Argumentative: Navigating the Complex Ethical Debate

Introduction The topic of abortion is a deeply contentious and ethically charged subject that has sparked heated debates for years. This abortion argumentative essay aims to provide an in-depth analysis of the complex ethical considerations surrounding abortion. The discourse on abortion is multifaceted, involving discussions...

Abortion and the Moral Debate: Is It Murder?

The topic of abortion sparks intense moral and ethical debates, with one of the central questions being whether abortion can be equated with murder. This essay aims to delve into the complexities of this debate, examining the perspectives of both pro-life advocates who contend that...

Abortion and Philosophy: Navigating Ethical and Moral Dimensions

The topic of abortion is a philosophical dilemma that challenges individuals to grapple with complex ethical and moral questions. This essay delves into the philosophical underpinnings of the abortion debate, examining the various perspectives and philosophical arguments that contribute to the discourse. The Moral Status...

• Personal Philosophy

Abortion and Euthanasia: Ethical and Moral Dilemmas

Introduction The ethical debates surrounding abortion and euthanasia are among the most contentious and complex issues in contemporary society. Both topics touch on deeply personal and profound matters related to life, death, autonomy, and the value of human existence. This essay delves into the ethical...

Abortion Analysis: Exploring Complex Factors and Perspectives

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Writing the Personal Statement for Health Professions Applications

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The personal statement gives you the opportunity to present a compelling snapshot of who you are and perhaps why you want to be a doctor. Use your personal statement to say what others can’t. The personal statement can be a tricky genre to master. On the one hand, you want to give the admissions committee a sense of your personality and who you are. On the other hand, you must sound focused and professional, which sounds like it might impede your ability to capture your personality.

But this does not have to be the case. What you need to do is figure out how to say what drives you to want to become a healthcare professional in as specific a way as possible. The more specific you can be, the more the admissions committee will feel as if they have a sense of who you are.

You don’t need gimmicks, jokes, artificial drama, or hyperbole to express who you are or why you would make a good medical student or doctor. All you need are carefully selected details that you can craft into a unique and compelling story that conveys a sense of purpose and motivation.

What Makes a Good Personal Statement?

• There is no exact template for an effective personal statement. Often, however, strong personal statements combine a concise description of a personal experience with reflection on how this experience either led the writer to pursue medicine or indicates the writer’s character or commitment.
• Good personal statements often have a strong sense of narrative. This does not mean that they read like short stories, though they can relate a few scenes or anecdotes from your life. They have a strong sense of narrative, rather, in how they convey the writer’s sense of dedication to medicine. Strong personal statements often give readers an idea of how applicants see their experiences as leading to the decision to pursue medicine.

How to Get Started

The personal statement is an exercise in self-reflection. Questions to consider:

• Who are you?  I am driven to… I have learned to… I believe…
• What are your most passionate interests or concerns?  What problem(s) most occupy your thinking and your efforts?
• How did you develop those interests?  (Not just the story, but what drives you.)
• What errors or regrets have taught you something important about yourself?
• When does time disappear for you?  What does this tell you about your passions, your values?
• What ideas, books, courses, events have had a profound impact on you?  How so?
• To what extent do your current commitments reflect your most strongly held values?
• When have you changed?  Consider yourself before and after; what does this change mean?
• How do your interests and who you are relate to your goals in medical school and as a doctor?

Start a “shoebox”; a place to keep random notes for your personal statement; be ready to write at any time. Review these items occasionally; let them tell you more about what you want your personal statement to say. Start writing drafts, experiments; you will know when a paragraph begins to gel.

A Suggested Writing Process

Everyone writes differently, so these are potential strategies rather than rules.

• Make a list of some of your most defining experiences – extracurricular activities, specific classes, volunteer work, research, hobbies, etc. Try not to include overly personal experiences (breakups, trouble with parents, illnesses in the family, and so on). It’s difficult to write about such things without being sentimental or cliché. You want experiences in which you did something and had to make a choice.
• From this list, try to select an experience that particularly demonstrates your intellectual curiosity, your dedication to service, your composure under pressure, your leadership ability, or any other personal trait that you think is particularly relevant to your case that you would make a good doctor or medical student.
• Start writing a draft based on this experience. You want to be specific, but don’t get bogged down with an abundance of anecdotes or minutiae. Try to use your draft to craft a succinct story that demonstrates your character and your motivations.
• Set the draft aside for some time (a number of days or weeks), and then revisit it with fresh eyes. Be as honest with yourself as you can be: What works in this draft? What doesn’t work? What sounds cliché or unspecific? Would a reader who doesn’t know me at all get a sense of my personal character and dedication?
• Revise, revise, revise: tighten the structure, add new things to make your point clearer, take away sentences or sections that now seem unnecessary, use the active voice as much as possible, and anything else that needs to be done. If what you have just doesn’t seem to be coming together, do not be afraid to start over.
• Solicit feedback from a couple of trusted readers and revise again based on the suggestions that you find most useful. Don’t solicit feedback from too many people though – too many responses can be overwhelming.
• Edit your work for grammatical mistakes, typos, clumsy repetitions, and so on. Make your prose impeccable before you submit your statement. Asking help from other readers can be especially helpful with editing, as sometimes it gets difficult to read your work with fresh eyes.

Things to Do

• Use the experience that you describe to tell a story of personal progress, particularly progress towards your commitment to medicine.
• Write with active verbs as much as possible.
• Strive for concision.
• Sound humble but also confident.

Things Not to Do – Common Pitfalls

• Don’t talk in hyperbolic terms about how passionate you are. Everyone applying to medical school can say they are passionate. Instead, show your readers something you have done that indicates your passion.
• Don’t adopt an overly confessional or sentimental tone. You need to sound professional.
• Don’t treat the personal statement like a piece of creative writing.
• Don’t put your resume in narrative form.
• Don’t use jargon, abbreviations, slang, etc.
• Don’t use too many qualifiers: very, quite, rather, really, interesting…
• Don’t write in overly flowery language that you would normally never use.
• Don’t include famous quotations. If you must quote, use something that shows significant knowledge.
• Don’t write about yourself in an overly glorifying or overly self-effacing manner.

What to Remember

• They are read by non-specialists, so write for an intelligent non-medical audience.
• Actions sometimes speaks louder than words so give examples of experiences rather than describing them.
• All information must be accurate – don’t pad, but don’t be falsely modest either.
• The personal statement, in part, serves as a test of your communication skills.  How well you write it is as important as the content.

Writing Resources

• AAMC: 7 Tips for Writing your AMCAS Personal Statement
• Graduate Admission Essays: What Works, What Doesn’t and Why , Donald Asher, Ten Speed Press
• On Writing Well , William Zinsser
• Elements of Style , Strunk and White, Macmillan
• Article :  2 Med School Essays that Admissions Officers Loved
• Guidance for Writing Personal Statements, Work & Activities Section, Secondary Applications

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Home — Essay Samples — Nursing & Health — Health Care Policy — Why Healthcare Should Be Free

Why Healthcare Should Be Free

• Categories: Health Care Policy Healthcare Crisis

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Published: Aug 31, 2023

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Mastering the Art of Writing a Health Care Essay on a Good Topic

'A healthy nation is a wealthy nation' - this famous proverb inspires many young people to pursue a career in healthcare, becoming nurses, physicians, therapists, etc. However, some of them fail to realize the responsibility that comes with such occupations. This may bring about a situation whereby colleges and universities turn out unqualified healthcare and nursing experts. To prevent it from happening, professors who teach respective disciplines assign their students the task of writing a health care essay. Being either an essay or research paper, it presents the students with a choice: to examine the problem on their own using various tools and equipment or analyze all available sources on the given research question, offering some personal findings.

14 Amazing Health Care Essay Topics with Introduction Examples

In your essay about health care, you may either talk about various diseases, symptoms, diagnosis, treatment, or methods used by doctors to help their patients, as well as their roles in general. In most cases, students should criticize the modern healthcare system as it really is in need of improvement. It is necessary that they provide some vivid real-life examples if they wish to convince their audience of their point of view.

Approaches to healthcare in the US, UK, and Australia differ, so you may focus on discussing their pros and cons in the essays about health care.

To help you understand which issues to discuss, we have listed the best health care essay topics below. You can also find short answers to each question.

Why is Healthcare Important to Society?

"Healthcare and medicine is a broad term that refers to a system involving maintenance and enhancement of medical services to cater to the health demands of human beings and other living creatures. The quality of healthcare services is one of the most critical factors that predetermines a country's well-being. The system usually varies depending on the healthcare policies of the region. In highly industrialized countries (i.e.countries of the First World), the system is advanced, with almost every citizen having unrestricted access to healthcare services. The low economic level in underdeveloped countries exerts an adverse impact on the healthcare system of these nations."

Is Healthcare a Right or a Privilege

"In the countries of the Third World, healthcare and medicine are not developed enough to save the lives of all of their citizens. Most of them cannot afford quality services, and that is the main difference between developed and underdeveloped countries as far as healthcare is concerned. Unlike poor people, the rich should make health their priority. However, they often neglect to do so, wasting almost all their money on things that harm their body, such as tobacco, alcoholic beverages, drugs, etc. In other words, they tend to have more bad habits, and they value their health less."

Overweight is Putting Strain on the Health Care in the United States

"Childhood obesity in the United States has reached epidemic proportions. This type of disorder has adverse effects on both physical and mental health, as obese kids tend to fall victim to school bullies. The worst consequence of being overweight is Diabetes Type II, and, unfortunately, more and more US children are facing this problem. The pivotal role in the increase in fat intake is played by environmental factors, tastes and preferences, and culture. Highly stressful activities like homework assignments may cause the child to eat more sweets, while their parents do nothing to restrict their consumption of sugar-rich foods. And finally, the lack of physical exercises also takes its toll."

Is Healthcare a Human Right?

"According to NCBI, healthcare is not a human right. To understand why it is important to define both terms. 'Human right' refers to a moral right of great significance that each human being should be entitled to. Dictionaries define healthcare as 'the act of taking prevention or important procedures to make a person's well-being better.' Healthcare is even more complex and confusing to define. Its meaning is too broad to be considered a human right. So, is there a person ultimately responsible for providing healthcare to the entire world? Insisting that healthcare is a human right is, therefore, wrong and pointless."

Should the Government Provide Health Care Insurance?

"The US government is not the only one responsible for providing healthcare insurance to all its citizens. It is only typical of the representatives of the political left to believe that the government should do that. All parties agree that health care is a valuable service, but the government has other important things to take care of. Rather than take care of medicine and nursing, the government's main goal should be to monitor and control the political and economic situation in the country. In fact, each organization has its goals, and so does the government. The government may protect the customer's freedom to buy goods and services by putting in place the corresponding laws and regulations. That is the best thing the US government can do as far as healthcare is concerned."

Causes and Effects of Health Care Crisis in America

"While urban population is more or less OK with its healthcare system, the rural areas of the US keep on suffering from what they call an American healthcare crisis. Hospitals in these regions continue to close down, while those that remain operational provide services of increasingly poor quality. More than 80 rural hospitals have shuttered during the last eight years because their personnel lacked the qualifications to cure patients properly. More than 700 hospitals are at high risk of being closed down, as they lack qualified healthcare professionals. Therefore, emergency medical services are becoming very important, because this is the only way of providing help to patients suffering from strokes, heart attacks, and other heart-related conditions."

Professionalism in Healthcare

"Being a doctor is the most responsible job in the world. It is also the most in-demand one, even though not always properly remunerated. In the underdeveloped countries, the doctor's salaries are among the lowest. In the US, the situation is much better, but still needs improvement in many respects. Medical personnel in this country are granted a license to invest long hours in research and diligent evaluation. Licensure is the way to guarantee the doctor's excellent skills and rich experience in a specific field. It is their willingness to place personal needs after the needs of the patient."

What Has Been the Impact of Medicare on the Healthcare System?

"Quality medicare and teamwork are the essential prerequisites of professional attitude and behavior. The most essential qualities of any medical expert are integrity, accountability, motivation, altruism, and empathy. This way the crucial trust between the patient and professionals is developed. Advanced interpersonal and communication skills impact the quality of medicare as well. Over the past 20 years, we have been witnessing the resurgence of interest in professional training and fair evaluation in the US. It is, therefore, experienced doctors' job to support and guide young professionals on their way to success."

Why Do You Want to Pursue a Career in Healthcare?

"Several factors, the salary being probably the most important one, motivate a lot of young people to choose a career in healthcare. Everyone knows that good medical experts are valued extremely high in the United States. Jobs in healthcare guarantee great opportunities and full security. Quite a few students consider helping other people their priority because they lost their loved ones to fatal diseases. They want to contribute to the medical field by finding a cure to the most complicated disorders some day. And finally, a career in healthcare provides an excellent opportunity to live and work in different parts of the world."

Cultural Diversity in Healthcare

"The purpose of this research paper is to identify basic nuances and issues of cultural diversity in the context of medical treatment, as well as offer solutions aimed at preventing said issues. The main focus is on communication as a culture-based phenomenon, correlation between the patient's progress and expert's treatment, and possible communication characteristics that act as obstacles between healthcare staff and patients. Of the two theoretical approaches used in the study, the first one relates to the information processing, while the second one concerns changing behaviors and interpretation."

Healthcare in America

"Though considered one of the best in the world, the American health care system still has some catching up to do with other countries, including the US's closest neighbor Canada. The US lacks a uniform health system that could offer universal healthcare coverage. Its healthcare system can be referred to as hybrid as it is funded from different sources, such as private funds (48%), households funds (28%), and private businesses funds(20%). The majority of medical and nursing services in this country are privately-owned, even if they are financed by the government. What makes this system stand out from the rest of the world is its great professional staff."

Healthcare in Canada

"Canada has implemented one of the best healthcare reforms in the world. Over the past 4 decades, the country has introduced a number of improvements, making medical treatment affordable for almost every citizen. Urgent and essential health care services are provided based on the needs rather than financial opportunities. This fact alone shows how generous the Canadian government and its healthcare professionals are. When it comes to healthcare, they value fairness and equality more than other nations do. The local healthcare system keeps getting improved as the nation's population increases. It is also important to acknowledge that the very essence of healthcare is also undergoing change."

Public vs. Private Healthcare Sectors

"When comparing the public and private healthcare sectors, it is impossible to ignore the NHS or the National Health Service. The organization, whose staff is made up mostly of primary care nurses or emergency care nurses, provides free health care services to the UK population. That is the reason why the job of Registered Nurse is so prevalent in local healthcare institutions. Specialized caregivers account for another sizeable portion of the healthcare sector. Each young professional is provided with a lot of opportunities for professional development and further career growth.

Communication in Healthcare

"Communication is one of the most important factors in healthcare. Without knowing the details of the patient's conditions and their medical history, the doctor will not be able to make a proper diagnosis. The evidence obtained in the course of this study indicates that there's a direct correlation between the medical representative's communication skills and the patient's willingness to follow the doctor's advice. The doctor's duty is to help the patient control their chronic condition all by themselves, if needed, as well as acquire preventive behaviors. The doctor should not simply cure the patient, but rather teach them some significant lessons to help them remain healthy."

Hopefully, these samples of papers on medicine and nursing will help you choose the hottest topics and best introductions to your essays and research papers. Still having problems? We can offer affordably-priced assistance with any sort of academic writing, including an essay on health care! Try our services at any time, and you won't be disappointed!

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Students in UNLV's Radiographic Procedures Skill Lab course learn how to properly position patients for imaging before heading out on clinical rotations. (Josh Hawkins/UNLV)

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• By Steven Slivka

As the Las Vegas Valley continues to grow, UNLV and Desert Radiology are working together to keep up with the demand radiologic technologists.

UNLV’s radiography program, housed within the Department of Health Physics and Diagnostic Sciences in UNLV’s School of Integrated Health Sciences , has been educating future front-line health care workers for more than 50 years. “The legacy we have for graduating well-qualified technologists in the valley is well known,” said Chad Hensley , director of UNLV’s radiography program. “This benefits patient care, elevates the profession, and helps to supply not only the Las Vegas Valley and all of Nevada, but the entire country with future leaders in the profession.”

Matt Grimes , chief operating officer of Desert Radiology , graduated with his degree in radiography administration from UNLV in 1996. While that particular degree track is no longer offered, Grimes has always been committed to partnering with his alma mater by providing an enhanced educational experience for students in the radiography program.

“I think we owe it to our community to build and cultivate a strong skill set of technologists,” he said.

Grimes worked within the Valley Health System for almost 15 years before joining Desert Radiology nearly a decade ago. While they didn’t know each other at the time, Grimes and Hensley were students together in UNLV’s radiography program almost 30 years ago.

One of his first priorities as head of Desert Radiology was to re-institute a collaboration that allowed UNLV’s second-year radiography students to get more experience in the imaging and outpatient setting at Desert Radiology’s clinics.

UNLV’s radiography program graduates about 24 students each year. According to Hensley, every student is able to complete clinical rotations at Desert Radiology’s multiple locations.

“With Matt wanting to give back to the program that gave him his career, this close relationship makes it easier for him to give us a call and let us know that he wants to help,” Hensley said. “It speaks volumes of the quality of students we’re able to graduate.”

Hensley said having current students complete their clinical rotations with the technologists at Desert Radiology is paramount to producing highly skilled professionals ready to enter the workforce after graduation.

“Having a partner like Desert Radiology, which is a very strong force in outpatient imaging, gives our students a better experience to work in a variety of settings like outpatient imaging, acute care hospitals, trauma centers, and other additional settings,” Hensley said.

Michelle Webb, ’24 BS Radiography, works as a radiologic technologist at Desert Radiology. She said the peer-mentor opportunities provided by the collaboration bolstered her skills as a student, which eventually led to full-time employment after she graduated.

“Learning from the technologists at Desert Radiology opened a new level of appreciation for the field. The technologists were very understanding that as a student, I did not have much experience taking x-rays,” she said. “My clinical time at Desert Radiology allowed me to perform all the complete views for imaging different body parts. I was able to perform special views that, up to that point, I had only read from my textbook and learned in anatomy and positioning.” Desert Radiology also recently donated two pieces of equipment to the radiography program: a portable x-ray unit and a C-Arm fluoroscopy machine, most commonly used in operating rooms, surgery centers, and endoscopy suites.

“The radiologists rely on the technologists more than other modalities, so I think that’s the benefit of having that equipment for students to use in the lab. It makes them more comfortable,” Grimes said.

Webb said the combination of learning in the classroom and the hands-on opportunities afforded at the clinic have given her the confidence she needs to feel successful in her role as a full-time technologist.

“I truly enjoy the patient interactions I have,” she said. “I can do a chest x-ray and in those 2 to 5 minutes I'm with my patient. I'm able to listen to their brief history as to why they're doing the exam, and then keep the conversations going to complete the exam with ease. I credit my patient-care skills to what I've learned in the multiple classes I took while in the radiography program. Through and through, I've had a pretty good experience transitioning from student to rad tech.”

Grimes is encouraged hearing stories from Webb and other UNLV graduates who have benefited tremendously from the partnership with Desert Radiology. As an alumnus, he takes pride in seeing the program, and ultimately the Las Vegas Valley’s slate of healthcare professionals, flourish from this collaboration.

“Having students here with our technologists fosters a very strong and loyal work environment,” he said. “We’ve found that students who start with us are 20- to 30-year teammates. If they start out with us, they’re more likely to stay.”

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Fact Sheet for Mental Health Care Professionals:

Supporting individuals' social security disability claims.

Information from you, as a mental health professional, is vitally important to support claims for Social Security Disability Insurance and for Supplemental Security Income benefits. Form SSA-827 (Authorization to Disclose Information to the Social Security Administration) (PDF) legally permits you to make the necessary disclosures of information consistent with applicable laws, including the Health Insurance Portability and Accountability Act (HIPAA), the Substance Abuse Act and the Family Educational Rights and Privacy Act (FERPA). 1

Social Security’s Release Form Authorizes Your Disclosure Individuals or their authorized representatives complete and sign the SSA-827 when they file a disability application. This form legally authorizes you and other professionals to release medical records, even if your name(s) are not specifically listed. 2 A copy, facsimile or electronically transmitted version of this signed form is acceptable. 3 You are complying with all relevant federal and state laws and regulations when you release your patient’s (or student’s) medical records as authorized by the SSA-827.

The request for your records will most often come from a state agency that makes disability determinations for the Social Security Administration (SSA). These agencies are usually called Disability Determination Services (DDS) but the agency name may be different in your state. If the claimant has appealed a decision, you may receive a request for evidence from an Administrative Law Judge in SSA’s Office of Disability Adjudication and Review. When evaluating mental disorders, information from treating sources is essential to accurately assess the onset and severity of claimants’ impairments and their effect on functional capacity. This applies to new claims, determinations of continuing eligibility for current beneficiaries, and appeals. With your timely response to requests for information, your patients may more quickly start (or continue) to receive cash benefits and Medicare or Medicaid. Without your records, the decision may be made based on the results of a one-time consultative examination by a medical professional unfamiliar with your patient. You can also help assure more accurate and timely decisions for your patients by submitting your records electronically as described below. Electronic processes can make it quicker and easier for medical and other claimant records to be transferred securely, eliminating mail time and automating handling.

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Full Disclosure Is Permitted

The signed SSA-827 specifies that the authorization permits you to disclose all of your patient’s medical or educational information to Social Security and DDS offices for the time period requested. That means you do not have to apply the “minimum necessary standard” before disclosing medical records. 4 Social Security must consider the claimant’s complete, relevant medical record for at least 12 months prior to the claim, including assessment of the combined effect of multiple impairments that individually may not be severe. In addition, both HIPAA and the SSA-827 permit you to disclose “information created within 12 months after the date (the release is) signed.” 5 (Providers in Puerto Rico should also refer to local law for guidance.)

Psychotherapy Notes, as Defined by HIPAA, Can Be Protected

Social Security recognizes the sensitivity and extra legal protections that concern psychotherapy notes (also called “process” or “session” notes) and does not need the notes. As HIPAA defines the term, “psychotherapy notes means notes recorded in any medium by a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.” If you keep psychotherapy notes separate from your other medical records, you can send the set of records without the psychotherapy notes. If you do not keep psychotherapy notes separate from other parts of the medical records, you can legally disclose all of the records. However, you can choose to black out or remove the parts of the records that would be considered psychotherapy notes if kept separately. Another option is to prepare a special report detailing the critical current and longitudinal aspects of your patient’s treatment and their functional status. 6

HIPAA Permits Electronic Transmission of Records HIPAA was intended to encourage the efficient electronic exchange of health information. Social Security record gathering procedures support HIPAA safeguards for transmitting medical records. 7 Records can be uploaded to Social Security’s Electronic Records Express secure website or safely faxed via Social Security’s dedicated lines directly into your patient’s electronic claim file. The secure website meets all HIPAA-related security requirements. It uses confidential usernames and passwords and sophisticated encryption to protect records submissions.

Your Information Will Not Be Re-Disclosed Without Consent Social Security will not re-disclose medical records it receives to other entities or individuals, without prior written consent, except in the very limited manner permitted or required by federal law and regulations. 8

Additional Information Sources

Please see www.socialsecurity.gov/disability/professionals for more information on the SSA-827. This also provides a list of DDS Professional Relations Officers and their contact information for specific questions. See www.hhs.gov/ocr/hipaa for HIPAA privacy rules, HHS formal guidance and FAQs. Visit www.ssa.gov/ere for general information about Electronic Records Express and a demonstration of how to use the secure website. If you would like to register to use Social Security’s secure website to send patient records, send an E-mail to [email protected] , call 1-866-691-3061 or contact one of your state’s Professional Relations Officers (see link above). Publication No. 64-103 Unit of Issue - HD (one hundred) ICN available Spring 2008 January 2008

1 See www.socialsecurity.gov/disability/professionals/ssa827_informationpage.htm for the form, reference material, and other legal points. The SSA-827 fully complies with HIPAA (45 CFR 164), and other federal and state laws and regulations including the Substance Abuse Act (42 CFR Part 2), FERPA (34 CFR Parts 99 and 300) and applicable state law. 2 Both HIPAA and 42 CFR Part 2 permit authorization forms to include "the . general designation of the program or person permitted to make the disclosure" [45 CFR 164.508(c) (1) (ii)]. "This. will permit a patient to consent to disclosure from a category of facilities or from a single specified program" [42 CFR Part 2, 52 Federal Register 21799 (June 9, 1987)]. 3 See Health and Human Services (HHS) frequently asked questions (FAQs) at: www.hhs.gov/hipaafaq/use/index.html . 4 Providers can rely on the authorization to define what can be released (45 CFR 164.502(b) (2) (iii)). The signed SSA-827 permits full disclosure of all requested information. See the HHS FAQs . 5 See the HHS FAQs . 6 See www.socialsecurity.gov/disability/professionals/greenbook/index.htm . Select adult or pediatric and scroll down to the heading for Mental Disorders. 7 45 CFR 164 Subpart C. 8 Privacy Act of 1974, Freedom of Information Act, and federal regulations per 20 CFR 401.

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How Is Diabetes Different for Older Adults?

• Type 1 Diabetes
• Complications of Diabetes

Learn about some of the unique challenges for older adults with diabetes and how health care professionals can help them manage their care.

Experts expect the number of older adults—people ages 65 and older—in the United States living with type 1 or type 2 diabetes to increase rapidly in the coming decades. Dennis T. Villareal, MD, a physician-scientist with specialty training in geriatrics and endocrinology, discusses the medical, psychological, functional, and social needs of older adults with diabetes, and the role of emerging technologies.

Q: What is the current prevalence of diabetes—type 1 and type 2—in older adults in the United States?

A: More than a quarter of people over age 65 have diabetes. Although type 2 diabetes is the most common type of diabetes in older adults, type 1 diabetes is becoming more common as people with the disease are living longer because of improved insulin delivery, technology, and care. We expect the number of older adults living with type 1 or type 2 diabetes to increase markedly in the coming decades.

Q: What are some issues to consider when managing diabetes in older adults? Why is it important to tailor how health care professionals manage diabetes in older adults?

A: Health care professionals and health care teams not only need to regularly assess medical care, but also psychological function and social challenges to ensure quality of life. For example, it’s imperative to accurately identify the type of diabetes patients have, how long they’ve had diabetes, their diabetes complications , and their treatment priorities.

Older adults with diabetes are more likely to have health problems related to diabetes, such as chronic kidney disease, congestive heart failure, and stroke. They also may have memory and cognitive challenges, higher rates of functional and physical issues, and other health problems such as geriatric syndromes. Unique features of known health conditions like incontinence and frailty also occur in older patients. In addition, older adults may need more caregiver support.

Q: How do physical activity, following healthy eating patterns, adequate sleep, and social support change as adults with diabetes become older?

A: Getting enough sleep and regular physical activity and consuming healthy foods and drinks are crucial for managing blood glucose levels, preserving muscle strength, and preventing diabetes health problems. Older adults with diabetes may face limits to mobility, such as joint pain and fear of falling. They may have to follow multiple dietary guidelines if they have other health problems, which could result in more restricted eating habits. Certain medicines they take could interact with foods or cause changes in appetite, which also affects diet. Older adults may also have dental issues that restrict what they are able to eat. Having social connections with available family, friends, or neighbors is also important for helping older adults manage their diabetes.

In the Lifestyle Intervention for Seniors with Diabetes (LISD) study, we found that a lifestyle intervention strategy is highly successful in improving the diabetes management and physical function of older adults with diabetes. It may never be too late in life to begin lifestyle changes that include healthy eating habits and regular physical activity. Lifestyle changes can complement or even reduce the need for medical therapy. We also found that lifestyle interventions directly counter the increase in body fat and lack of physical activity that are primarily responsible for the age-related rise in insulin resistance that leads to type 2 diabetes.

Q: What are the unique challenges in managing blood glucose levels for older adults with diabetes? How can we balance the need for meeting blood glucose level targets while avoiding hypoglycemia and its associated risks?

A: There are certainly greater risks for hypoglycemia in older adults due to polypharmacy—or managing multiple medicines that might interact with each other. The signs of hypoglycemia might also be misread as neurologic symptoms of dementia. Health care professionals should tailor diabetes treatment using medicines that are less likely to cause low blood glucose and are proven safe or protective for the heart.

Medicines such as sulfonylureas, for example, have not been proven safe for the heart. They might also increase the risk for hypoglycemia because they are insulin secretagogues, which stimulate insulin release. Medicines such as the SGLT2 inhibitors, GLP-1 agonists, and metformin are less likely to cause hypoglycemia.

Q: What are ways that health care professionals can help patients address potential medicine interactions and simplify medicine regimens?

A: Health care professionals should regularly review the number of medicines their patients are taking to identify potential interactions. They should also consider reducing the number of medicines prescribed whenever possible, which may help reduce too many medicines or ones that aren’t necessary. Enlisting the expertise of pharmacists to review medicines can be very helpful, especially during transitions of care.

Health care professionals might also consider tools, such as reminder applications that can help patients track their medicines and take them as prescribed. Using the information from electronic health records can also help health care professionals manage their patients’ medicines. Finally, simplify their medicine regimens and instructions as much as possible, and do regular follow ups.

Q: How can the growing role of technology affect outcomes for older adults with diabetes? What are the barriers?

A: Technologies such as continuous glucose monitors (CGMs), insulin pumps, and smart pens can empower older adults with diabetes and their caregivers. These technologies may reduce complications and enhance quality of life. Many older adults with diabetes, especially if they take insulin, use CGMs. That’s straightforward, but they do need to work with their diabetes care team to learn how to take full advantage of CGMs to change health behaviors and adjust insulin doses. Insulin pumps could be challenging for older adults with diabetes who have cognitive problems. For example, older adults with cognitive problems may not remember all the steps to change tubing and cannula or give repeat insulin boluses.

Q: Are there specific social determinants of health barriers for older adults with diabetes that affect access to care? How can we address these barriers?

A: Racial disparities, social barriers, housing and food insecurity, transportation challenges, and isolation can all affect access to care as well as overall wellbeing. Health care professionals, regardless of their own background, should acknowledge these disparities and provide culturally competent care—which is care that meets the social, cultural, and language needs of their older adult patients with diabetes.

Addressing these barriers needs to be a comprehensive and multidisciplinary approach. So, we need to involve social workers, diabetes educators, and others who are part of health care teams.

Q: What lessons are we learning from research on managing the care and treatment of older adults with diabetes? Have we identified areas for future research?

A: Current research shows that older adults with diabetes are a varied group with many different types of people. We need to tailor care and treatment according to their health status. Some patients could be relatively healthy, others might be less healthy, and still others might have trouble with physical tasks or thinking skills. So, the goals should be to improve the quality of life. Some of these goals could include reducing the chance of having to go to the hospital and managing problems that come with getting older, such as falling and getting weaker.

We’ve learned that relaxing the target goal for managing blood glucose might be more important in people who have many other health problems. We also know that it’s key to regularly review medicines, reduce them as much as possible, and engage help from pharmacists and social workers.

Finally, culturally competent care is a challenge and should be a topic of more investigation. This is a promising area that could empower older adults with diabetes—particularly in a context of technology—and improve the quality of care. In addressing racial disparities, we need to identify culturally and clinically diverse treatments for older adults with diabetes. We also need to pinpoint the specific subgroups and care settings where diabetes technologies can be most effectively implemented.

What have you learned about managing the care of older adults with diabetes? Share below in the comments.

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Solid health care waste management practice in Ethiopia, a convergent mixed method study

• Yeshanew Ayele Tiruneh 1 ,
• L. M. Modiba 2 &
• S. M. Zuma 2  

BMC Health Services Research volume  24 , Article number:  985 ( 2024 ) Cite this article

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Metrics details

Introduction

Healthcare waste is any waste generated by healthcare facilities that is considered potentially hazardous to health. Solid healthcare waste is categorized into infectious and non-infectious wastes. Infectious waste is material suspected of containing pathogens and potentially causing disease. Non-infectious waste includes wastes that have not been in contact with infectious agents, hazardous chemicals, or radioactive substances, similar to household waste, i.e. plastic, papers and leftover foods.

This study aimed to investigate solid healthcare waste management practices and develop guidelines to improve solid healthcare waste management practices in Ethiopia. The setting was all health facilities found in Hossaena town.

A mixed-method study design was used. For the qualitative phase of this study, eight FGDs were conducted from 4 government health facilities, one FGD from each private health facility (which is 37 in number), and forty-five FGDs were conducted. Four FGDs were executed with cleaners; another four were only health care providers because using homogeneous groups promotes discussion. The remaining 37 FGDs in private health facilities were mixed from health professionals and cleaners because of the number of workers in the private facilities. For the quantitative phase, all health facilities and health facility workers who have direct contact with healthcare waste management practice participated in this study. Both qualitative and quantitative study participants were taken from the health facilities found in Hossaena town.

Seventeen (3.1%) health facility workers have hand washing facilities. Three hundred ninety-two (72.6%) of the participants agree on the availability of one or more personal protective equipment (PPE) in the facility ‘‘ the reason for the absence of some of the PPEs, like boots and goggles, and the shortage of disposable gloves owes to cost inflation from time to time and sometimes absent from the market’’ . The observational finding shows that colour-coded waste bins are available in 23 (9.6%) rooms. 90% of the sharp containers were reusable, and 100% of the waste storage bins were plastic buckets that were easily cleanable. In 40 (97.56%) health facilities, infectious wastes were collected daily from the waste generation areas to the final disposal points. Two hundred seventy-one (50.2%) of the respondents were satisfied or agreed that satisfactory procedures are available in case of an accident. Only 220 (40.8%) respondents were vaccinated for the Hepatitis B virus.

Hand washing facilities, personal protective equipment and preventive vaccinations are not readily available for health workers. Solid waste segregation practices are poor and showed that solid waste management practices (SWMP) are below the acceptable level.

Peer Review reports

Healthcare waste (HCW) encompasses all types of waste generated while providing health-related services, spanning activities such as diagnosis, immunization, treatment, and research. It constitutes a diverse array of materials, each presenting potential hazards to health and the environment. Within the realm of HCW, one finds secretions and excretions from humans, cultures, and waste containing a stock of infectious agents. Discarded plastic materials contaminated with blood or other bodily fluids, pathological wastes, and discarded medical equipment are classified as healthcare waste. Sharps, including needles, scalpels, and other waste materials generated during any healthcare service provision, are also considered potentially hazardous to health [ 1 ].

Healthcare waste in solid form (HCW) is commonly divided into two primary groups: infectious and non-infectious. The existence of pathogens in concentrations identifies infectious waste or amounts significant enough to induce diseases in vulnerable hosts [ 1 ] If healthcare facility waste is free from any combination with infectious agents, nearly 85% is categorized as non-hazardous waste, exhibiting characteristics similar to conventional solid waste found in households [ 2 ]. World Health Organization (WHO) recommends that appropriate colour-coded waste receptacles be available in all medical and other waste-producing areas [ 3 ].

Solid waste produced in the course of healthcare activities carries a higher potential for infection and injury than any other type of waste. Improper disposal of sharps waste increases the risk of disease transmission among health facility workers and general populations [ 1 ]. Inadequate and inappropriate handling of healthcare waste may have serious public health consequences and a significant environmental impact. The World Health Organization (2014) guidelines also include the following guidance for hand washing and the use of alcohol-based hand rubs: Wash hands before starting work, before entering an operating theatre, before eating, after touching contaminated objects, after using a toilet, and in all cases where hands are visibly soiled [ 4 ].

Among the infectious waste category, sharps waste is the most hazardous waste because of its ability to puncture the skin and cause infection [ 3 ]. Accidents or occurrences, such as near misses, spills, container damage, improper waste segregation, and incidents involving sharps, must be reported promptly to the waste management officer or an assigned representative [ 5 ].

Africa is facing a growing waste management crisis. While the volumes of waste generated in Africa are relatively small compared to developed regions, the mismanagement of waste in Africa already impacts human and environmental health. Infectious waste management has always remained a neglected public health problem in developing countries, resulting in a high burden of environmental pollution affecting the general masses. In Ethiopia, there is no updated separate regulation specific to healthcare waste management in the country to enforce the proper management of solid HCW [ 6 ].

In Ethiopia, like other developing countries, healthcare waste segregation practice was not given attention and did not meet the minimum HCWM standards, and it is still not jumped from paper. Previous study reveals that healthcare waste generation rates are significantly higher than the World Health Organization threshold, which ranges from 29.5–53.12% [ 7 , 8 ]. In Meneilk II Hospital, the proportion of infectious waste was 53.73%, and in the southern and northern parts of Ethiopia, it was 34.3 and 53%, respectively. Generally, this figure shows a value 3 to 4 times greater than the threshold value recommended by the World Health Organization [ 7 ].

Except for sharp wastes, segregation practice was poor, and all solid wastes were collected without respecting the colour-coded waste disposal system [ 9 ]. The median waste generation rate was found to vary from 0.361- 0.669 kg/patient/day, comprising 58.69% non-hazardous and 41.31% hazardous wastes. The amount of waste generated increased as the number of patients flow increased. Public hospitals generated a high proportion of total healthcare waste (59.22%) in comparison with private hospitals (40.48) [ 10 ]. The primary SHCW treatment and disposal mechanism was incineration, open burning, burring into unprotected pits and open dumping on municipal dumping sites as well as in the hospital backyard. Carelessness, negligence of the health workers, patients and cleaners, and poor commitment of the facility leaders were among the major causes of poor HCWM practice in Ethiopia [ 9 ]. This study aimed to investigate solid healthcare waste management practices and develop guidelines to improve solid healthcare waste management practices in Ethiopia.

The setting for this study was all health facilities found in Hossaena town, which is situated 232 kms from the capital city of Ethiopia, Addis Ababa, and 165 kms from the regional municipality of Hawasa. The health facilities found in the town were one university hospital, one private surgical centre, three government health centres, 17 medium clinics, and 19 small clinics were available in the city and; health facility workers who have direct contact with generating and disposal of HCW and those who are responsible as a manager of health facilities found in Hossaena town are the study settings. All health facilities except drug stores and health facility workers who have direct contact with healthcare waste generation participated in this study.

A mixed-method study design was used. For the quantitative part of this study, all healthcare workers who have direct contact with healthcare waste management practice participated in this study, and one focus group discussion from each health facility was used. Both of the study participants were taken from the same population. All health facility workers who have a role in healthcare waste management practice were included in the quantitative part of this study. The qualitative data collection phase used open-ended interviews, focus group discussions, and visual material analysis like posters and written materials. All FGDs were conducted by the principal investigator, one moderator, and one note-taker, and it took 50 to 75 min. 4–6 participants participated in each FGD.

According to Elizabeth (2018: 5), cited by Creswell and Plano (2007: 147), the mixed method is one of the research designs with philosophical assumptions as well as methods of inquiry. As a method, it focuses on collecting, analyzing, and mixing both quantitative and qualitative data in a single study. As a methodology, it involves philosophical assumptions guiding the direction of the collection and analysis and combining qualitative and quantitative approaches in many phases of the research project. The central premise is that using qualitative and quantitative approaches together provides a better understanding of the research problems than either approach alone.

The critical assumption of the concurrent mixed methods approach in this study is that quantitative and qualitative data provide different types of information, often detailed views of participants’ solid waste management practice qualitatively and scores on instruments quantitatively, and together, they yield results that should be the same. In this approach, the researcher collected quantitative and qualitative data almost simultaneously and analyzed them separately to cross-validate or compare whether the findings were similar or different between the qualitative and quantitative information. Concurrent approaches to the data collection process are less time-consuming than other types of mixed methods studies because both data collection processes are conducted on time and at the same visit to the field [ 11 ].

Data collection

The data collection involves collecting both quantitative and qualitative data simultaneously. The quantitative phase of this study assessed three components. Health care waste segregation practice, the availability of waste segregation equipment for HCW segregation, temporary storage facilities, transportation for final disposal, and disposal facilities data were collected using a structured questionnaire and observation of HCW generation. Recycling or re-using practice, waste treatment, the availability of the HCWM committee, and training data were collected.

Qualitative data collection

The qualitative phase of the data collection for this study was employed by using focus group discussions and semi-structured interviews about SHCWMP. Two focus group discussions (FGD) from each health facility were conducted in the government health facilities, one at the administrative level and one at the technical worker level, and one FGD was conducted for all private health facilities because of the number of available health facility workers. Each focus group has 4–6 individuals.

In this study, the qualitative and the quantitative data provide different information, and it is suitable for this study to compare and contrast the findings of the two results to obtain the best understanding of this research problem.

Quantitative data collection

The quantitative data were entered into Epi data version 3.1 to minimize the data entry mistakes and exported to the statistical package for social science SPSS window version 27.0 for analysis. A numeric value was assigned to each response in a database, cleaning the data, recoding, establishing a codebook, and visually inspecting the trends to check whether the data were typically distributed.

Data analysis

Data were analyzed quantitatively by using relevant statistical tools, such as SPSS. Descriptive statistics and the Pearson correlation test were used for the bivariate associations and analysis of variance (ANOVA) to compare the HCW generation rate between private and government health facilities and between clinics, health centres and hospitals in the town. Normality tests were performed to determine whether the sample data were drawn from a normally distributed population.

The Shapiro–Wilk normality tests were used to calculate a test statistic based on the sample data and compare it to critical values. The Shapiro–Wilk test is a statistical test used to assess whether a given sample comes from a normally distributed population. The P value greater than the significance level of 0.05 fails to reject the null hypothesis. It concludes that there is not enough evidence to suggest that the data does not follow the normal distribution. Visual inspection of a histogram, Q-Q plot, and P-P plot (probability-probability plot) was assessed.

Bivariate (correlation) analysis assessed the relationships between independent and dependent variables. Then, multiple linear regression analysis was used to establish the simple correlation matrices between different variables for investigating the strength relationships of the study variables in the analysis. In most variables, percentages and means were used to report the findings with a 95% confidence interval. Open-ended responses and focused group findings were undertaken by quantifying and coding the data to provide a thematic narrative explanation.

Appropriate and scientific care was taken to maintain the data quality before, during, and after data collection by preparing the proper data collection tools, pretesting the data collection tools, providing training for data collectors, and proper data entry practice. Data were cleaned on a daily basis during data collection practice, during data entry, and before analysis of its completeness and consistency.

Data analysis in a concurrent design consists of three phases. First, analyze the quantitative database in terms of statistical results. Second, analyze the qualitative database by coding the data and collapsing the codes into broad themes. Third comes the mixed-method data analysis. This is the analysis that consists of integrating the two databases. This integration consists of merging the results from both the qualitative and the quantitative findings.

Descriptive analysis was conducted to describe and summarise the data obtained from the samples used for this study. Reliability statistics for constructs, means and modes of each item, frequencies and percentage distributions, chi-square test of association, and correlations (Spearman rho) were used to portray the respondents’ responses.

All patient care-providing health facilities were included in this study, and the generation rate of healthcare waste and composition assessed the practice of segregation, collection, transportation, and disposal system was observed quantitatively using adopted and adapted structured questionnaires. To ensure representativeness, various levels of health facilities like hospitals, health centres, medium clinics, small clinics and surgical centres were considered from the town. All levels of health facilities are diagnosing, providing first aid services and treating patients accordingly.

The hospital and surgical centre found in the town provide advanced surgical service, inpatient service and food for the patients that other health facilities do not. The HCW generation rate was proportional to the number of patients who visited the health facilities and the type of service provided. The highest number of patients who visited the health facilities was in NEMMCSH; the service provided was diverse, and the waste generation rate was higher than that of other health facilities. About 272, 18, 15, 17, and 20 average patients visited the health facilities daily in NEMMCSH: government health centres, medium clinics, small clinics, and surgical centres. Paper and cardboard (141.65 kg), leftover food (81.71 kg), and contaminated gloves (42.96 kg) are the leading HCWs generated per day.

A total of 556 individual respondents from sampled health facilities were interviewed to complete the questionnaire. The total number of filled questionnaires was 540 (97.1) from individuals representing these 41 health facilities.

The principal investigator observed the availability of handwashing facilities near SHCW generation sites. 17(3.1%) of health facility workers had hand washing facilities near the health care waste generation and disposal site. Furthermore,10 (3.87%), 2 (2.1%), 2 (2.53%), 2 (2.1%), 1 (6.6%) of health facility workers had the facility of hand washing near the health care waste generation site in Nigist Eleni Mohamed Memorial Comprehensive Specialized Hospital (NEMMCSH), government health centres, medium clinics, small clinics, and surgical centre respectively. This finding was nearly the same as the study findings conducted in Myanmar; the availability of hand washing facilities near the solid health care waste generation was absent in all service areas [ 12 ]. The observational result was convergent with the response of facility workers’ response regarding the availabilities of hand washing facilities near to the solid health care waste generation sites.

The observational result was concurrent with the response of facility workers regarding the availability of hand-washing facilities near the solid health care waste generation sites.

The availability of personal protective equipment (PPE) was checked in this study. Three hundred ninety-two (72.6%) of the respondents agree on the facility’s availability of one or more personal protective equipment (PPE). The availability of PPEs in different levels of health facilities shows 392 (72.6%), 212 (82.2%), 56 (58.9%), 52 (65.8%), 60 (65.2%), 12 (75%) health facility workers in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres respectively agree to the presence of personal protective equipment in their department. The analysis further shows that the availability of masks for healthcare workers was above the mean in NEMMCSH and surgical centres.

Focus group participants indicated that health facilities did not volunteer to supply Personal protective equipment (PPEs) for the cleaning staff.

“We cannot purchase PPE by ourselves because of the salary paid for the cleaning staff.”

Cost inflation and the high cost of purchasing PPEs like gloves and boots are complained about by all (41) health facility owners.

“the reason for the absence of some of the PPEs like boots, goggles, and shortage of disposable gloves are owing to cost inflation from time to time and sometimes absent from the market is the reason why we do not supply PPE to our workers.”

Using essential personal protective equipment (PPEs) based on the risk (if the risk is a splash of blood or body fluid, use a mask and goggles; if the risk is on foot, use appropriate shoes) is recommended by the World Health Organization [ 13 ]. The mean availability of gloves in health facilities was 343 (63.5% (95% CI: 59.3–67.4). Private health institutions are better at providing gloves for their workers, 67.1%, 72.8%, and 62.5% in medium clinics, small clinics, and surgical centres, respectively, which is above the mean.

Research participants agree that.

‘‘ there is a shortage of gloves to give service in Nigist Eleni Mohamed Memorial Comprehensive Specialized Hospital (NEMMCSH) and government health centres .’’

Masks are the most available personal protective equipment for health facility workers compared to others. 65.4%, 55.6%, and 38% of the staff are available with gloves, plastic aprons and boots, respectively.

The mean availability of masks, heavy-duty gloves, boots, and aprons was 71.1%, 65.4%, 38%, and 44.4% in the study health facilities. Health facility workers were asked about the availability of different personal protective equipment, and 38% of the respondents agreed with the presence of boots in the facility. Still, the qualitative observational findings of this study show that all health facility workers have no shoes or footwear during solid health care waste management practice.

SHCW segregation practice was checked by observing the availability of SHCW collection bins in each patient care room. Only 4 (1.7%) of the room’s SHCW bins are collected segregated (non-infectious wastes segregated in black bins and infectious wastes segregated in yellow bins) based on the World Health Organization standard. Colour-coded waste bins, black for non-infectious and yellow for infectious wastes, were available in 23 (9.6%) rooms. 90% of the sharp containers were reusable, and 100% of the waste storage bins were plastic buckets that were easily cleanable. Only 6.7% of the waste bins were pedal operated and adequately covered, and the rest were fully opened, or a tiny hole was prepared on the container’s cover. All of the healthcare waste disposal bins in each health facility and at all service areas were away from the arm’s reach distance of the waste generation places, and this is contrary to World Health Organization SHCWM guidelines [ 13 ]. The observation result reveals that the reason for the above result was that medication trolleys were not used during medication or while healthcare providers provided any health services to patients.

Most medical wastes are incinerated. Burning solid and regulated medical waste generated by health care creates many problems. Medical waste incinerators emit toxic air pollutants and ash residues that are the primary source of environmental dioxins. Public concerns about incinerator emissions and the creation of federal regulations for medical waste incinerators are causing many healthcare facilities to rethink their choices in medical waste treatment. Health Care Without Harm [ 14 ], states that non-incineration treatment technologies are a growing and developing field. The U.S. National Academy of Science 2000 argued that the emission of pollutants during incineration is a potential risk to human health, and living or working near an incineration facility can have social, economic, and psychological effects [ 15 ].

The incineration of solid healthcare waste technology has been accepted and adopted as an effective method in Ethiopia. Incineration of healthcare waste can produce secondary waste and pollutants if the treatment facilities are not appropriately constructed, designed, and operated. It can be one of the significant sources of toxic substances, such as polychlorinated dibenzo-dioxins/dibenzofurans (PCDD/ PCDF), polyvinyl chloride (PVC), hexachlorobenzenes and polychlorinated biphenyls, and dioxins and furans that are known as hazardous pollutants. These pollutants may have undesirable environmental impacts on human and animal health, such as liver failure and cancer [ 15 , 16 ].

All government health facilities (4 in number) used incineration to dispose of solid waste. 88.4% and 100% of the wastes are incinerated in WUNEMMCSH and government health centres. This finding contradicts the study findings in the United States of America and Malaysia, in which 49–60% and 59–60 were incinerated, respectively, and the rest were treated using other technologies [ 15 , 16 ].

World Health Organization (2014:45) highlighted those critical elements of the appropriate operation of incinerators include effective waste reduction and waste segregation, placing incinerators away from populated areas, satisfactory engineered design, construction following appropriate dimensional plans, proper operation, periodic maintenance, and staff training and management are mandatory.

Solid waste collection times should be fixed and appropriate to the quantity of waste produced in each area of the health care facility. General waste should not be collected simultaneously or in the same trolley as infectious or hazardous wastes. The collection should be done daily for most wastes, with collection timed to match the pattern of waste generation during the day [ 13 ].

SHCW segregation practices were observed for 240 rooms in 41 health facilities that provide health services in the town. In government health centres, medium clinics, small clinics, and surgical centres, SHCW segregation practice was not based on the World Health Organization standard. All types of solid waste were collected in a single container near the generation area, and there were no colour-coded SHCW storage dust bins. Still, in NEMMCSH, in most of the service areas, colour-coded waste bins are available, and the segregation practice was not based on the standard. Only 3 (10%) of the dust bins collected the appropriate wastes according to the World Health Organization standard, and the rest were mixed with infectious and non-infectious SHCW.

Table 1 below shows health facility managers were asked about healthcare waste segregation practices, and 9 (22%) of the facility leaders responded that there is an appropriate solid healthcare waste segregation practice in their health facilities. Still, during observation, only 4 (1.7%) of the rooms in two (4.87%) of the facilities, SHCW bins collected the segregated wastes (non-infectious wastes segregated at the black bin and infectious wastes segregated at yellow bin) based on the world health organization standard. The findings of this study show there is a poor segregation practice, and all kinds of solid wastes are collected together.

In 40 (97.56%) health facilities, infectious wastes were collected daily from the waste generation areas to the final disposal points. During observation in one of the study health facilities, infectious wastes were not collected daily and left for days. Utility gloves, boots, and aprons are not available for cleaning staff to collect and transport solid healthcare wastes in all study health facilities. 29.26% of the facilities’ cleaning staff have a face mask, and 36.5% of the facilities remove waste bins from the service area when 3/4 full, and the rest were not removed or replaced with new ones. There is a separate container only in 2 health facilities for infectious and non-infectious waste segregation practice, and the rest were segregated and collected using single and non-colour coded containers.

At all of the facilities in the study area, SHCW was transported from the service areas to the disposal site were transported manually by carrying the collection container and there is no trolley for transportation. This finding was contrary to the study findings conducted in India, which show segregated waste from the generation site was being transported through the chute to the carts placed at various points on the hospital premises by skilled sanitary workers [ 17 ].

Only 2 out of 41 health facilities have temporary solid waste storage points at the facility. One of the temporary storage places was clean, and the other needed to be properly cleaned and unsightly. Two (100%) of the temporary storage areas are not fenced and have no restriction to an authorized person. Temporary storage areas are available only in two health facilities that are away from the service provision areas.

Observational findings revealed that pre-treatment of SHCW before disposal was not practised at all study health facilities. 95% of the facilities have no water supply for hand washing during and after solid healthcare waste generation, collection, and disposal.

The United States Agency estimated sharp injuries from medical wastes to health professionals and sanitary service personnel for toxic substances and disease registry. Most of the injuries are caused during the recapping of hypodermic needles before disposal into sharps containers [ 13 ]. Nearly half of the respondents, 245 (51.5%), are recapping needles after providing an injection to the patient. Recapping was more practised in NEMMCSH and surgical centres, which is 57.5% and 57.5%, respectively. In government health centres, medium clinics, and surgical centres, the recapping of used needles was practised below the mean, which is 47.9%, 48, and 43.8%, respectively. This finding was reasonable compared to the study findings of Doylo et al. [ 18 ] in western Ethiopia, where 91% of the health workers are recapping needles after injection [ 18 ]. The research finding shows that there is no significant association P-value of 0.82 between the training and recapping of needles after injection.

Focus group participants ’ response for appropriate SHCWMP regarding patients ’ and visitors ’ lack of knowledge on SHCW segregation practice

“The personal responsibilities of patients and visitors on solid HCW disposal should be explained to help appropriate safe waste management practice and maintain good hygiene .” “Providing waste management training and creating awareness are the two aspects of improving SHCW segregation practice.” “Training upgrades and creates awareness on hygiene for all workers.”

Sharp waste collection practices were observed in 240 rooms in the study health facilities, and 9.2% of the rooms used disposable sharp containers.

Sixty per cent (60%), 13.3%, 8.24%, and 15.71% of the sharps containers in NEMMCSH, government health centres, medium clinics, and small clinics, respectively, were using disposable sharps containers; sharps were disposed together with the sharps container, and surgical centre was using reusable sharp collection container. All disposable sharps containers in medium and small clinics used non-puncture-resistant or simple packaging carton boxes. 60% and 13.3% of the disposable sharps containers in NEMMCSH and the government health centre use purposefully manufactured disposable safety boxes.

Needle sticks injury reporting and occurrence

A total of 70 injuries were reported to the health facility manager in the last one year, and 44 of the injuries were reported by health professionals. The rest of the injuries were reported by supportive staff. These injuries were reported from 35 health facilities, and the remaining six health facilities did not report any cases of injury related to work; see Tables 2 and 3 below.

Accidents or incidents, including near misses, spillages, damaged containers, inappropriate segregation, and any incidents involving sharps, should be reported to the waste-management officer. Accidental contamination must be notified using a standard-format document. The cause of the accident or incident should be investigated by the waste-management officer (in case of waste) or another responsible officer, who should also take action to prevent a recurrence [ 13 ]. Two hundred seventy-one (50.2% (CI: 45.7–54.6) of the respondents agree that satisfactory procedures are available in case of an accident, while the remaining 269 (49.8%( CI: 45.4–54.3) of respondents do not agree on the availability of satisfactory procedures in case of an accident, see Table  4 below. The availability of satisfactory procedures in case of an accident is above the mean in medium clinics, which is 60.8%. 132(24.4%) of the staff are pricked by needle stick injury while providing health services. Nearly half of the respondents, 269 (49.8%), who have been exposed to needle stick injury do not get satisfactory procedures after being pricked by a needle, and those who have not been stung by a needle stick injury for the last year. 204 (37.8%) disagree with the presence of satisfactory procedures in the case of a needle stick injury. In NEMMCSH, 30.2% of the research participants were pricked by needle stick injury within one year of period, and 48.8% of those who were stung by needle stick injuries did not agree upon the presence of satisfactory procedures in case of needle stick injuries in the study hospital. 17.9% and 49.5%, 24.1% and 60.8%, 7.6% and 50% of the respondents are pricked by needle sticks, and they disagree on the availability of satisfactory procedures in case of accidents, respectively, in government health centres, medium clinics, small clinics, and surgical centre respectively.

One hundred seventy-seven (32.7% (CI:29.1–37) respondents were exposed to needle stick injury while working in the current health facilities. One hundred three (58.1%) and 26 (32.9%) needle stick injuries were reported from WUNEMMCSH and medium clinics, which is above the mean. One hundred thirty-two(24.7% (95%CI:20.7–28.1) of the respondents are exposed to needle stick injury within one year of the period. Seventy-eight(30.2%), 17 (17.9%), 19 (24.1%), 15 (16.3%), 3 (18.8%) of the staff are injured by needle sticks from NEMMCSH, government health centres, medium clinics, small clinics, and surgical centre staffs respectively within one year of service.

The mean availabilities of satisfactory procedures in case of accidents were 321 (59.4% (CI:55.4–63.7). Out of this, 13.7% of the staff is injured by needle sticks within one year before the survey. Except in NEMMCSH, the mean availabilities of satisfactory procedures were above the mean, which is 50%, 60%, 77.2%, 66.3%, and 81.3% in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres respectively.

Table 5 below shows that Hepatitis B, COVID-19, and tetanus toxoid vaccinations are the responses of the research participants to an open-ended question on which vaccine they took. The finding shows that 220 (40.8%) of the respondents were vaccinated to prevent themselves from health facility-acquired infection. One hundred fifty-six (70.9%) of the respondents are vaccinated to avoid themselves from Hep B infection. Fifty-nine (26%0.8) of the respondents were vaccinated to protect themselves from two diseases that are Hep B and COVID-19.

Appropriate health care waste management practice was assessed by using 12 questions: availability of colour-coded waste bins, foot-operated dust bins, elbow or foot-operated hand washing basin, personal protective equipment, training, role and responsibility of the worker, the presence of satisfactory procedures in case of an accident, incinerator, vaccination, guideline, onsite treatment, and the availability of poster. The mean of appropriate healthcare waste management practice was 55.58%. The mean of solid health care waste management practice based on the level of health facilities was summed and divided into 12 variables to get each health facility’s level of waste management practice. 64.9%, 45.58%, 49%, 46.9%, and 51.8% are the mean appropriate health care waste management practices in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres, respectively. In NEMMCSH, the practice of solid healthcare waste management shows above the mean, and the rest was below the mean of solid healthcare waste management practice.

Healthcare waste treatment and disposal practice

Solid waste treatment before disposal was not practised at all study health facilities. There is an incineration practice at all of the study health facilities, and the World Health Organization 2014 recommended three types of incineration practice for solid health care waste management: dual-chamber starved-air incinerators, multiple chamber incinerators, and rotary kilns incinerators. Single-chamber, drum, and brick incinerators do not meet the best available technique requirements of the Stockholm Convention guidelines [ 13 ]. The findings of this study show that none of the incinerators found in the study health facilities meet the minimum standards of solid healthcare waste incineration practice, and they need an air inlet to facilitate combustion. Eleven (26.82%) of the health facilities have an ash pit to dispose of burned SHCW; the majority, 30 (73.17%), dispose of the incinerated ash and burned needles in the municipal waste disposal site. In one out of 11 health facilities with an ash pit, one of the incinerators was built on the ash pit, and the incinerated ashes were disposed of in the ash pit directly. Pre-treatment of SHCW before disposal was not practised at all health facilities; see Table  6 below.

All government health facilities use incineration to dispose of solid waste. 88.4% and 100% of the solid wastes are incinerated in WUNEMMCS Hospital and government health centres, respectively. This finding was not similar to the other studies because other technologies like autoclave microwave and incineration were used for 59–60% of the waste [ 15 ]. Forty-one (100%) of the study facilities were using incinerators, and only 5 (12.19%) of the incinerators were constructed by using brick and more or less promising than others for incinerating the generated solid wastes without considering the emitting gases into the atmosphere and the residue chemicals and minerals in the ashes.

Research participants’ understanding of the environmental friendliness of health care waste management practice was assessed, and the result shows that more than half, 312(57%) of the research participants do not agree on the environmental friendliness of the waste disposal practices in the health facilities. The most disagreement regarding environmental friendliness was observed in NEMMCSH; 100 (38.8%) of the participants only agreed the practice was environmentally friendly of the service. Forty-four (46.3%), 37 (46.8%), 40 (43.5%), and 7 (43.8%) of the participants agree on the environmental friendliness of healthcare waste management practice in government health centres, medium clinics, small clinics, and surgical centres, respectively.

One hundred twenty-five (48.4%) and 39(42.4%) staff are trained in solid health care waste management practice in NEMMCSH and small clinic staff, respectively; this result shows above the mean. Twenty-seven (28.4%), 30 (38%), and 4 (25%) of the staff are trained in health care waste management practice in Government health centres, medium clinics, and surgical centres, respectively. The training has been significantly associated with needle stick injury, and the more trained staff are, the less exposed to needle stick injury. One hundred ninety-six (36.4%) of the participants answered yes to the question about the availability of trainers in the institution. 43.8% of the NEMMCSH staff agreed on the availability of trainers on solid health care waste management, which is above the mean, and 26.3%, 31.6%, 31.5%, and 25% for the government health centres, medium clinics, small clinics, and surgical centre respectively, which is below the mean.

Trained health professionals are more compliant with SHCWM standards, and the self-reported study findings of this study show that 41.7% (95%CI:37.7–46) of the research participants are trained in health care waste management practice. This finding was higher compared to the study findings of Sahiledengle in 2019 in the southeast of Ethiopia, shows 13.0% of healthcare workers received training related to HCWM in the past one year preceding the study period and significantly lower when compared to the study findings in Egypt which is 71% of the study participants were trained on SHCWM [ 8 , 19 , 20 ].

Three out of four government health facility leaders, 17 (45.94%) of private health facility leaders/owners of the clinic and 141 FGD participants complain about the absence of some PPEs like boots and aprons to protect themselves from infectious agents.

‘ ‘Masks, disposable gloves, and changing gowns are a critical shortage at all health facilities.’’

Cleaners in private health facilities are more exposed to infectious agents because of the absence of personal protective equipment. Except for the cleaning staff working in the private surgical centre, all cleaning staff 40 (97.56) of the health facilities complain about the absence of changing gowns and the fact that there are no boots in the facilities.

Cost inflation and the high cost of purchasing PPEs like gloves and boots are complained by all of (41) the health facility owners and the reason for the absence of some of the PPEs like boots, goggles, and shortage of disposable gloves. Sometimes, absence from the market is the reason why we do not supply PPE to our workers.

Thirty-four (82.92%) of the facility leaders are forwarded, and there is a high expense and even unavailability of some of the PPEs, which are the reasons for not providing PPEs for the workers.

‘‘Medical equipment and consumables importers and whole sellers are selective for importing health supplies, and because of a small number of importers in the country and specifically, in the locality, we can’t get materials used for health care waste management practice even disposable gloves. ’’

One of the facility leaders from a private clinic forwarded that before the advent of COVID-19 -19) personal protective equipment was more or less chip-and-get without difficulty. Still, after the advent of the first Japanese COVID-19 patient in Ethiopia, people outside the health facilities collect PPEs like gloves and masks and storing privately in their homes.

‘‘PPEs were getting expensive and unavailable in the market. Incinerator construction materials cost inflation, and the ownership of the facility building are other problems for private health facilities to construct standard incinerators.’’

For all of the focus group discussion participants except in NEMMCSH and two private health facilities, covered and foot-operated dust bins were absent or in a critical shortage compared to the needed ones.

‘‘ Waste bins are open and not colour-coded. The practice attracts flies and other insects. Empty waste bins are replaced without cleaning and disinfecting by using chlorine solution.’’ “HCW containers are not colour-coded, but we are trying to label infectious and non-infectious in Amharic languages.”

Another issue raised during focus group discussions is incineration is not the final disposal method. It needs additional disposal sites, lacks technology, is costly to construct a brick incinerator, lacks knowledge for health facility workers, shortage of man powers /cleaners, absence of environmental health professionals in health centres and all private clinics, and continues exposure to the staff for needle stick injury, foully smell, human scavengers, unsightly, fire hazard, and lack of water supply in the town are the major teams that FGD participants raise and forwarded the above issue as a problem to improve SHCWMP.

Focus group participants, during the discussion, raised issues that could be more comfortable managing SHCWs properly in their institution. Two of the 37 private health facilities are working in their own compound, and the remaining 35 are rented; because of this, they have difficulty constructing incinerators and ash removal pits and are not confident about investing in SHCWM systems. Staff negligence and involuntary abiding by the rules of the facilities were raised by four of the government health facilities, and it was difficult to punish those who violated the healthcare waste management rules because the health facility leaders were not giving appropriate attention to the problem.

Focus group participants forwarded recommendations on which interventions can improve the management of SHCW, and recommendations are summarised as follows:

“PPE should be available in quality and quantity for all health facility workers who have direct contact with SHCW.” “Scientific-based waste management technologies should be availed for health facilities.” “Continuous induction HCW management training should be provided to the workers. Law enforcement should be strengthened.” “Communal HCW management sites should be availed, especially for private health facilities.” “HCWM committee should be strengthened.” “Non-infectious wastes should be collected communally and transported to the municipal SHCW disposal places.” “Leaders should be knowledgeable on the SHCWM system and supervise the practice continuously.” “Patient and client should be oriented daily about HCW segregation practice.” “Regulatory bodies should supervise the health facilities before commencing and periodically between services .”

The above are the themes that FGD participants discussed and forwarded for the future improvements of SHAWMP in the study areas.

Lack of water supply in the town

Other issues raised during FGDs were health facilities’ lack of water supply. World Health Organization (2014: 89) highlights that water supply for the appropriate waste management system should be mandatory at any time in all health service delivery points.

Thirty-nine (95.12%) of the health facilities complain about the absence of water supply to improve HCW management practices and infection prevention and control practices in the facilities.

“We get water once per week, and most of the time, the water is available at night, and if we are not fetching as scheduled, we can’t get water the whole week”.

In this research, only those who have direct contact have participated in this study, and 434 (80.4%) of the respondents agree they have roles and responsibilities for appropriate solid health care waste management practice. The rest, 19.6%, do not agree with their commitment to manage health care wastes properly, even though they are responsible. Health facility workers in NEMMCSH and medium clinics know their responsibilities better than others, and their results show above the mean. 84.5%, 74.5%, 81%, 73.9% and 75% in NEMMCSH, Government health centres, medium clinics, small clinics, and surgical centres, respectively.

Establishing a policy and a legal framework, training personnel, and raising public awareness are essential elements of successful healthcare waste management. A policy can be viewed as a blueprint that drives decision-making at a political level and should mobilize government effort and resources to create the conditions to make changes in healthcare facilities. Three hundred and seventy-four (69.3%) of the respondents agree with the presence of any solid healthcare waste management policy in Ethiopia. The more knowledge above the mean (72.9%) on the presence of the policy is reported from NEMMCSH.

Self-reported level of knowledge on what to do in case of an accident revealed that 438 (81.1% CI: 77.6–84.3%) of the respondents knew what to do in case of an accident. Government health centre staff and medium clinic staff’s knowledge about what to do in case of an accident was above the mean (88.4% and 82.3%), respectively, and the rest were below the mean. The action performed after an occupational accident revealed that 56 (35.7%) of the respondents did nothing after any exposure to an accident. Out of 56 respondents who have done nothing after exposure, 47 (83.92%) of the respondents answered yes to their knowledge about what to do in case of an accident. Out of 157 respondents who have been exposed to occupational accidents, only 59 (37.6%) of the respondents performed the appropriate measures, 18 (11.5%), 9 (5.7%), 26 (16.6%), 6 (3.8%) of the respondents are taking prophylaxis, linked to the incident officer, consult the available doctors near to the department, and test the status of the patient (source of infection) respectively and the rest were not performing the scientific measures, that is only practising one of the following practices washing the affected part, squeezing the affected part to remove blood, cleaning the affected part with alcohol.

Health facility workers’ understanding of solid health care waste management practices was assessed by asking whether the current SHCWM practice needs improvement. Four hundred forty-nine (83.1%) health facility workers are unsatisfied with the current solid waste management practice at the different health facility levels, and they recommend changing it to a scientific one. 82.6%, 87.4%, 89.9%, 75%, and 81.3% of the respondents are uncomfortable or need to improve solid health care waste management practices in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres, respectively.

Lack of safety box, lack of colour-coded waste bins, lack of training, and no problems are the responses to the question problems encountered in managing SHCWMP. Two Hundred and Fifty (46.92%) and 232 (42.96%) of the respondents recommend the availability of safety boxes and training, respectively.

Four or 9.8% of the facilities have infection prevention and control (IPC) teams in the study health facilities. This finding differed from the study in Pakistan, where thirty per cent (30%) of the study hospitals had HCWM or infection control teams [ 21 ]. This study’s findings were similar to those conducted in Pakistan by Khan et al. [ 21 ], which confirmed that the teams were almost absent at the secondary and primary healthcare levels [ 20 ].

The availability of health care waste management policy report reveals that 69.3% (95% CI: 65.4–73) of the staff are aware of the presence of solid health care waste management policy in the institution. Availability of health care waste management policy was 188 (72.9%), 66 (69.5%), 53 (677.1%), 57 (62%), 10 (62.5%) in NEMMCSH, Government health centres, medium clinics, small clinics, and surgical centre respectively. Healthcare waste management policy availability was above the mean in NEMMCSH and government health centres; see Table  6 below.

Open-ended responses on the SHCWM practice of health facility workers were collected using the prepared interview guide, and the responses were analyzed using thematic analysis. All the answered questions were tallied on the paper and exported to Excel software for thematic analysis.

The study participants recommend.

“appropriate segregation practice at the point of generation” "health facility must avail all the necessary supplies that used for SHCWMP, punishment for those violating the rule of SHCWMP",

“waste management technologies should be included in solid waste management guidelines, and enforcement should be strengthened.”

The availability of written national or adopted/adapted SHCWM policies was observed at all study health facilities. Twenty eight (11.66%) of the rooms have either a poster or a written document of the national policy document. However, all staff working in the observed rooms have yet to see the inside content of the policy. The presence of the policy alone cannot bring change to SHCWMP. This finding shows that the presence of policy in the institution was reasonable compared to the study findings in Menelik II hospital in Addis Ababa, showing that HCWM regulations and any applicable facility-based policy and strategy were not found [ 22 ]. The findings of this study were less compared to the study findings in Pakistan; 41% of the health facilities had the policy document or internal rules for the HCWM [ 21 ].

Focus group participants have forwarded recommendations on which interventions can improve the management of SHCW, and recommendations are summarised as follows.

‘‘Supplies should be available in quality and quantity for all health facility workers with direct contact with SHCW. Scientific-based waste management technologies should be available for health facilities. Continues and induction health care waste management training should be provided to the workers. Law enforcement should be strengthened. Community healthcare waste management sites should be available, especially for private health facilities. HCWM committee should be strengthened. Non-infectious wastes should be collected communally and transported to the municipal SHCW disposal places. Leaders should be knowledgeable about the SHCWM system and supervise the practice continuously. Patients and clients should be oriented daily about health care waste segregation practices. Regulatory bodies should supervise the health facilities before commencing and periodically in between the service are the themes those FGD participants discussed and forward for the future improvements of SHCWMP in the study areas.’’

The availability of PPEs in different levels of health facilities shows 392 (72.6%), 212 (82.2%), 56 (58.9%), 52 (65.8%), 60 (65.2%), 12 (75%) health facility workers in NEMMCSH, government health centres, medium clinics, small clinics, and surgical centres respectively agree to the presence of personal protective equipment in their department. The availability of PPEs in this study was nearly two-fold when compared to the study findings in Myanmar, where 37.6% of the staff have PPEs [ 12 ].

The mean availability of masks, heavy-duty gloves, boots, and aprons was 71.1%, 65.4%, 38%, and 44.4% in the study health facilities. This finding shows masks are less available in the study health facilities compared to other studies. The availability of utility gloves, boots, and plastic aprons is good in this study compared to the study conducted by Banstola, D in Pokhara Sub-Metropolitan City [ 23 ].

The findings of this study show there is a poor segregation practice, and all kinds of solid wastes were collected together. This finding was similar to the study findings conducted in Addis Ababa, Ethiopia, by Debere et al. [ 24 ] and contrary to the study findings conducted in Nepal and India, which shows 50% and 65–75% of the surveyed health facilities were practising proper waste segregation systems at the point of generation without mixing general wastes with hazardous wastes respectively [ 9 , 17 ].

Ninety percent of private health facilities collect and transport SHCW generated in every service area and transport it to the disposal place by the collection container (no separate container to collect and transport the waste to the final disposal site). This finding was similar to the study findings of Debre Markos’s town [ 25 ]. At all of the facilities in the study area, SHCW was transported from the service areas to the disposal site manually by carrying the collection container, and there was no trolley for transportation. This finding was contrary to the study findings conducted in India, which show segregated waste from the generation site was being transported through the chute to the carts placed at various points on the hospital premises by skilled sanitary workers [ 17 ].

Observational findings revealed that pre-treatment of SHCW before disposal was not practised at all study health facilities. This study was contrary to the findings of Pullishery et al. [ 26 ], conducted in Mangalore, India, which depicted pre-treatment of the waste in 46% of the hospitals [ 26 ]. 95% of the facilities have no water supply for handwashing during and after solid healthcare waste generation, collection, and disposal. This finding was contrary to the study findings in Pakistan hospitals, which show all health facilities have an adequate water supply near the health care waste management sites [ 27 ].

Questionnaire data collection tools show that 129 (23.8%) of the staff needle stick injuries have occurred on health facility workers within one year of the period before the data collection. This finding was slightly smaller than the study findings of Deress et al. [ 25 ] in Debre Markos town, North East Ethiopia, where 30.9% of the workers had been exposed to needle stick injury one year prior to the study [ 25 ]. Reported and registered needle stick injuries in health facilities are less reported, and only 70 (54.2%) of the injuries are reported to the health facilities. This finding shows an underestimation of the risk and the problem, which was supported by the study conducted in Menilik II hospitals in Addis Ababa [ 22 ]. 50%, 33.4%, 48%, 52%, and 62.5% of needle stick injuries were not reported in NEMMCSH, Government health centres, medium clinics, small clinics, and surgical centres, respectively, to the health facility manager.

Nearly 1/3 (177 or 32.7%) of the staff are exposed to needle stick injuries. Needle stick injuries in health facilities are less reported, and only 73 (41.24%) of the injuries are reported to the health facilities within 12 months of the data collection. This finding is slightly higher than the study finding of Deress et al. [ 25 ] in Debere Markos, Ethiopia, in which 23.3% of the study participants had encountered needle stick/sharps injuries preceding 12 months of the data collection period [ 25 ].

Seventy-three injuries were reported to the health facility manager in the last one year, 44 of the injuries were reported by health professionals, and the rest were reported by supportive staff. These injuries were reported from 35(85.3%) health facilities; the remaining six have no report. These study findings were better than the findings of Khan et al. [ 21 ], in which one-third of the facilities had a reporting system for an incident, and almost the same percentage of the facilities had post-exposure procedures in both public and private sectors [ 21 ].

Within one year of the study period, 129 (23.88%) needle stick injuries occurred. However, needle stick injuries in health facilities are less reported, and only 70 (39.5%) of the injuries are reported to the health facilities. These findings were reasonable compared to the study findings of the southwest region of Cameroon, in which 50.9% (110/216) of all participants had at least one occupational exposure [ 28 , 29 ]. This result report shows a very high exposure to needle stick injury compared to the study findings in Brazil, which shows 6.1% of the research participants were injured [ 27 ].

The finding shows that 220 (40.8%) of the respondents were vaccinated to prevent themselves from health facility-acquired infection. One Hundred Fifty-six (70.9%) of the respondents are vaccinated in order to avoid themselves from Hep B infection. Fifty-nine (26%0.8) of the respondents were vaccinated to protect themselves from two diseases that are Hep B and COVID-19. This finding was nearly the same as the study findings of Deress et al. [ 7 ],in Ethiopia, 30.7% were vaccinated, and very low compared to the study findings of Qadir et al. [ 30 ] in Pakistan and Saha & Bhattacharjya India which is 66.67% and 66.17% respectively [ 25 , 30 , 31 ].

The incineration of solid healthcare waste technology has been accepted and adopted as an effective method in Ethiopia. These pollutants may have undesirable environmental impacts on human and animal health, such as liver failure and cancer [ 15 , 16 ]. All government health facilities use incineration to dispose of solid waste. 88.4% and 100% of the wastes are incinerated in WUNEMMCSH and government health centres, respectively. This finding contradicts the study findings in the United States of America and Malaysia, which are 49–60% and 59–60 are incinerated, respectively, and the rest are treated using other technologies [ 15 , 16 ].

All study health facilities used a brick or barrel type of incinerator. The incinerators found in the study health facilities need to meet the minimum standards of solid health care waste incineration practice. These findings were similar to the study findings of Nepal and Pakistan [ 32 ]. The health care waste treatment system in health facilities was found to be very unsystematic and unscientific, which cannot guarantee that there is no risk to the environment and public health, as well as safety for personnel involved in health care waste treatment. Most incinerators are not properly operated and maintained, resulting in poor performance.

All government health facilities use incineration to dispose of solid waste. All the generated sharp wastes are incinerated using brick or barrel incinerators, as shown in Fig.  1 above. This finding was consistent with the findings of Veilla and Samwel [ 33 ], who depicted that sharp waste generation is the same as sharps waste incinerated [ 33 ]. All brick incinerators were constructed without appropriate air inlets to facilitate combustion except in NEMMCSH, which is built at a 4-m height. These findings were similar to the findings of Tadese and Kumie at Addis Ababa [ 34 ].

Barrel and brick incinerators used in private clinic

Strengths and limitations

This is a mixed-method study; both qualitative and quantitative study design, data collection and analysis techniques were used to understand the problem better. The setting for this study was one town, which is found in the southern part of the country. It only represents some of the country’s health facilities, and it is difficult to generalize the findings to other hospitals and health centres. Another limitation of this study was that private drug stores and private pharmacies were not incorporated.

Conclusions

In the study, health facilities’ foot-operated solid waste dust bins are not available for healthcare workers and patients to dispose of the generated wastes. Health facility managers in government and private health institutions should pay more attention to the availability of colour-coded dust bins. Most containers are opened, and insects and rodents can access them anytime. Some of them are even closed (not foot-operated), leading to contamination of hands when trying to open them.

Healthcare waste management training is mandatory for appropriate healthcare waste disposal. Healthcare-associated exposure should be appropriately managed, and infection prevention and control training should be provided to all staff working in the health facilities.

Availability of data and materials

The authors declare that data for this work are available upon request to the first author.

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Acknowledgements

The authors are grateful to the health facility leaders and ethical committees of the hospitals for their permission. The authors acknowledge the cooperation of the health facility workers who participated in this study.

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Dr. Yeshanew Ayele Tiruneh is a researcher of this study; the principal investigator does all the proposal preparation, methodology, data collection, result and discussion, and manuscript writing. Professor LM Modiba and Dr. SM Zuma are supervisors for this study. They participated in the topic selection and modification to the final manuscript preparation by commenting on and correcting the study. Finally, the three authors read and approved the final version of the manuscript and agreed to submit the manuscript for publication.

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Tiruneh, Y.A., Modiba, L.M. & Zuma, S.M. Solid health care waste management practice in Ethiopia, a convergent mixed method study. BMC Health Serv Res 24 , 985 (2024). https://doi.org/10.1186/s12913-024-11444-8

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86 Healthcare Reform Essay Topic Ideas & Examples

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