Health Nutrition and Population Sector Program (HNPSP)

Environmental Assessment

Executive Summary

There are a number of environmental issues/impacts associated with the HNPSP, which have been identified. The health care waste management (HCWM) being the most significant issue, while there are other issues that also need attention due to the important impacts they may have depending on the prevailing circumstances. These issues are clean water supply and sanitation, construction related environmental issues and use of hazardous insecticides/pesticides associated with the health sector.

This report is mainly concerned with the review and mitigation of the impact of the current lack of proper HCWM in Bangladesh. The use of hazardous insecticides in the HCFs is to be managed using procedures for handling and use of such insecticides, training of workers etc. developed for the vector borne disease control program. Construction waste management problem is to be tackled by proper o observance of the national construction codes of practices to minimize environmental impacts. The problem of lack of safe water supply in the HCFs especially in view of wide spread Arsenic contamination of groundwater in Bangladesh, is to be addressed through the provision of improved water supply by linking with the ongoing schemes of GoB to this end. The issue of improper sanitation is similar to that of HCWM management as both pose the risk of spreading infection. This issue is to be considered and addressed during planning of HCWM activities at the HCF level.

This report attempts at a fairly comprehensive look at the environmental aspects of HCWM in Bangladesh. The present status of the HCWM including legislative and regulatory aspects have been reviewed and gaps in the system have been identified. These factors are broadly classified as inadequate legal provisions, inadequate institutional accountability, low awareness and capacity at facility level, resource constraints and lack of clarity on acceptable technical solutions. Strategy and its implementation including institutional and policy framework to tackle these gaps have been proposed. A phased investment and operation plan for five years during the period FY05-06 to FY09-10 at an estimated approximate cost of BDT 257 million (about US$4.5 million) has been proposed. The program is to be executed by the line director in the DGHS office under MOHFW.