PRISMS project: a new biomedical waste incinerator in Ouagadougou
While 85% of healthcare waste is non-hazardous, other types of waste can be infectious. This is the case with biomedical waste (BMW), a category which includes human anatomical waste (tissues, organs…), sharps which have been in contact with human fluids or tissues such as blood (syringes, blades…), or live virus vaccines. Due to the risks it poses to health, BMW must therefore be treated separately from other hospital waste: this will be the role of the new common incineration plant, which will treat BMW from public and private health facilities in the city of Ouagadougou and its surrounding area.
To complete the system, two secure BMW collection vehicles have been provided and four regional incinerators have been installed in the cities of Fada (East), Tenkodogo (Central East), Kaya (Central North) and Ouahigouya (North).
The finalisation of the construction of this new incinerator was the last main activity of the PRISMS project, which is reaching completion after 34 months of implementation. With a budget of EUR 3.7m, PRISMS has assisted the Ministry of Health of Burkina Faso with the implementation of measures and tools to improve hospital hygiene and the safety of care.
Hospital hygiene, key to fighting hospital-acquired infections
A lack of hygiene in healthcare settings leads to a risk of hospital-acquired infections for patients and is an occupational hazard for caregivers. In Burkina Faso, the practices observed and the lack of medical materials and equipment required to maintain a secure healthcare setting suggest there is a high frequency of these risks. This observation has been made in all the health facilities, with frequent stock-outs of hydroalcoholic gel and hygiene products.
To address this, Expertise France, the French international technical cooperation agency responsible for the implementation of the PRISMS project, has worked closely with the Ministry of Health and actors with expertise in the field of hospital hygiene: the World Health Organization (WHO), the Study Group on Healthcare Workers' Exposure to Infectious Risks (GERES) and the University Hospitals (CHU) of Montpellier and Bordeaux. A total of 21 facilities in the 13 regions of Burkina Faso have been involved in the project.
New standards for increased healthcare safety
One of the priorities of PRISMS has been to strengthen the institutional framework for the prevention of infectious risks and the safety of care. It initially involved strengthening the normative framework in this area (regulations, procedures…), which was still poorly defined when the project started in 2017. The experts mobilised have produced fourteen documents and tools designed to promote the adoption of safer healthcare practices – for example, handbooks on the monitoring and investigation of healthcare-associated infections, the safety of patients in surgery, maternity and neonatal care, and prescribing antibiotics correctly. These handbooks were subsequently widely disseminated in the Ministry of Health and its regional services, as well as in health facilities and among private actors.
Furthermore, to communicate the new standards at regional level, six committees for the prevention of healthcare-associated infections have been set up with support from the University Hospitals (CHU) of Bordeaux and Montpellier in France. These committees, which are based in hospital facilities, are responsible for organising activities for the prevention and monitoring of healthcare-associated infections in hospital facilities. They have been equipped to conduct studies on the circulating levels of germs likely to cause healthcare-associated infections (HAI) and to measure these levels. As it was not possible to conduct these studies due to the project deadlines, they provide a way to ensure the sustainability of the achievements.
Raising awareness, training and equipping on a large scale
At the same time, PRISMS has implemented activities to promote the effective application of these new standards by health workers. All the public staff on the 21 hospital sites concerned by the project have been made aware of the general good practices for the safety of care (hand hygiene, risky behaviour…). This has been combined with targeted training: over 4,000 people have benefited from sessions tailored to their profile (prevention and control of infections, waste management, hospital linen management, surgical safety, maternity…).
In addition, the PRISMS project has provided equipment (personal protection kits, hygiene products, sterilisers…) and has supervised the construction or refurbishment of certain hospital facilities directly related to hospital hygiene (sterilisation units, laundry services…).
Groundwork laid for the future
Finally, to help strengthen good practices over the long term and on a large scale, PRISMS has assisted with the development of training modules on hospital hygiene and has trained a team of 45 trainers, which is now able to train health workers. Technical and financial support has also been provided to establish a new university diploma in hospital hygiene, which started in May 2017. Two sessions have been organised so far with 55 participants, including 19 with scholarships financed by the PRISMS project.
The activities carried out by the PRISMS project have laid the groundwork for the State of Burkina Faso to ensure the safety of hospitalised patients and thereby build the confidence of users in the national health system.
The support provided to Burkina Faso is part of the broader framework of the action of the European Union and France to strengthen health systems in West Africa. For example, Expertise France has implemented projects in Guinea in a post-Ebola context with the PREPARE and TWIN2H projects, which are now being continued under the PASA2 project to improve governance in the health sector.
