# Analysis of the Correlation Between the Governance and Quality of Biomedical Waste Management in Public Health Facilities in Togo, 2024

## TL;DR

This study examines how governance in Togo's public health facilities affects the quality of biomedical waste management, finding that better organization and training lead to safer practices.

## Contribution

The study identifies specific governance factors that significantly correlate with improved biomedical waste management in public health facilities.

## Key findings

- Health facilities with strong governance in training and organization are more likely to manage biomedical waste properly.
- Sorting, quantification, transportation, and disposal infrastructure are key criteria for effective biomedical waste management.
- Only 17.8% of surveyed facilities met acceptable standards for biomedical waste management.

## Abstract

Increasing the use of healthcare facilities has resulted in the growing production of biomedical waste, which poses health risks to users, health professionals, and the environment. The aim of this research is to study the correlation between governance in Togo’s public health facilities and the quality of biomedical waste management within these facilities. Methods: This was a cross-sectional, descriptive, and analytical study conducted from September to December 2024. It involved 264 public health facilities of all types in all health regions of Togo. Health facilities were selected using the simple random selection technique. Healthcare providers were selected using the reasoned choice technique. The statistical tests used were the chi-square test and logistic regression, which enabled proportions to be compared and confounding factors to be eliminated, respectively. Results: Multivariate analysis revealed a statistically significant association between the organization and training component of governance and the quality of biomedical waste management (BMWM) in health facilities (OR = 3.79; 95% CI [1.79–8.03]; p < 0.001). This relationship suggests that health facilities with functional infection prevention and control (ICP) or BMWM committees, trained staff at all levels (nursing, technical, and administrative), and dedicated waste management personnel are more likely to implement compliant waste management practices. Analyses of the data also revealed that, among the criteria for assessing the quality of biomedical waste management (BMWM), the most significant were sorting (OR = 1.482; 95% CI [1.286; 1.708]), quantification (OR = 2.026; 95% CI [1.491; 2.753]), transportation (OR = 1.403; 95% CI [1.187; 1.66]), and disposal infrastructure (OR = 1.604; 95% CI [1.298; 1.982]). The application of this grid shows that 17.8% of the health facilities surveyed had a score equal to or above 80% on all the criteria used to assess the quality of biomedical waste management, and they were therefore managing waste in an “acceptable” manner. The study highlights key findings in biomedical waste management practices, providing actionable insights for improving public health safety.