ANNEX III INFECTION CONTROL AND WASTE MANAGEMENT PLAN (ICWMP) FOR KENYA COVID-19 EMERGENCY RESPONSE PROJECT (P173820) UNDER THE COVID-19 STRATEGIC PREPAREDNESS AND RESPONSE PROGRAM AUGUST, 2020 TABLE OF CONTENTS ABBREVIATION / ACRONYMS............................................................................................ iv 1.0 Introduction........................................................................................................................... 1 1.1 Project Context and Components..............................................................................................2 1.2 Targeted Healthcare Facility per project Component............................................................... 2 1.2.1 Component 1. Medical Supplies and Equipment [US$8,472,500 equivalent]......................2 1.2.2 Under Component 3: Quarantine, Isolation and Treatment Centers [US$12,676,400 equivalent].........................................................................................................................................3 1.2.3 Component 4. Medical Waste Management [US$3,387,600 equivalent].............................3 1.2.4 Component 6: Availability of Safe Blood & Blood Products [US$10,000,000 equivalent] 3 1.3 Design Requirement..................................................................................................................4 1.3.1 Laboratory Facilities............................................................................................................. 4 1.3.2 Quarantine / Isolation Rooms at Health Care Facilities........................................................5 1.3.3 Design and size and location of an incinerator .....................................................................7 1.4 Autoclaving and Shredding........................................................ Error! Bookmark not defined. 1.5 Biosafety Levels........................................................................................................................9 1.6 Access to Water and Power Supply........................................................................................ 10 2.0 Infection Control and Waste Management..........................................................................11 2.1 Overview of Infection Control and Waste Management in the HCFs.................................... 11 2.2 Classification of Health Care Waste....................................................................................... 12 2.3 Healthcare Waste Management System in the HCF............................................................... 13 2.3.1 Health Care Waste Generation............................................................................................14 2.3.2 Health Care Waste Handling...............................................................................................15 2.3.3 Waste Transportation and Storage...................................................................................... 16 2.3.4 Waste Treatment and Disposal............................................................................................16 2.3.5 Occupational Health & Safety.............................................................................................17 2.3.6 Capacity Building................................................................................................................18 2.3.7 Finance and Resources........................................................................................................18 2.4 Infection Control for highly infectious medical wastes ....................................................... 18 2.4.1 Management of the Healthcare Personnel...........................................................................19 2.4.2 Infection Control and Hand hygiene................................................................................... 20 2.4.3 Medical supplies and Equipment........................................................................................ 21 2.5 Waste Management Guiding Principles..................................................................................24 2.5.1 Waste Minimization............................................................................................................ 27 2.5.2 Waste Segregation and Colour Coding............................................................................... 27 2.5.3 Packaging and Labelling of Healthcare Waste....................................................................29 2.5.4 Waste Collection and Handling...........................................................................................30 2.5.5 Waste Storage......................................................................................................................31 2.5.6 Transportation..................................................................................................................... 32 2.5.7 Waste Treatment and Disposal Methods.............................................................................33 2.5.8 Liquid Waste Generated Treatment and Disposal...............................................................38 2.5.9 Managing Blood / Body fluid Exposure............................................................................. 43 2.6 Handling of Dead Bodies........................................................................................................ 44 3.0 Emergency Preparedness and Response (EPR)...................................................................45 3.1 EPR for Laboratories...............................................................................................................45 3.2 EPR for Hospitals, Isolation & Quarantine Areas PoE and KNBTS......................................46 3.3 Emergency Response for Waste Treatment Facility............................................................... 47 4.0 Institutional Arrangement and Capacity Building...............................................................48 4.1 Healthcare Facility HCWM / IPC / OHS Committee............................................................. 48 4.2 Laboratory Biosafety and Biosecurity Committee..................................................................49 4.3 Roles for Infection Control and Waste Management..............................................................49 4.3.1 Project Management Team..................................................................................................49 4.4 Staffing and Capacity Building .............................................................................................53 4.4.1 HCF HCWM /IPC Committee............................................................................................ 53 4.4.2 Head of Healthcare facilities...............................................................................................55 4.4.3 Departmental Managers,..................................................................................................... 55 4.4.4 County Waste Management Officer (CWMO)................................................................... 55 4.4.5 Infection Control Office......................................................................................................56 4.4.6 Chief Pharmacist/Radiation Officer....................................................................................56 4.4.7 Procurement Officer Responsibilities................................................................................. 57 4.4.8 Hospital Engineer................................................................................................................57 4.4.9 Waste Handlers................................................................................................................... 57 4.4.10 Incinerator Operator........................................................................................................ 58 4.4.11 Laboratory Manager........................................................................................................58 4.4.12 Medical Waste Autoclave / Microwave Operators......................................................... 59 4.4.13 Healthcare Facility cleaners............................................................................................ 59 4.4.14 Other COVID-19 Healthcare Service Providers............................................................. 59 4.4.15 Health Care Waste Disposal Facilities staff....................................................................59 4.5 External Supervision and Support Implementation................................................................ 60 4.5.1 The Role of National Environmental Management Authority............................................60 4.5.2 Project Implementation Support by World Bank................................................................60 5.0 Infection Control and Waste Management Plan (ICWMP)................................................ 61 5.1 Plan for mitigation of risks associated.................................................................................... 61 5.2 Monitoring Plan for the ICWMP Implementation.................................................................. 61 5.2.1 Frequency for monitoring....................................................................................................62 5.2.2 Reporting System................................................................................................................ 62 6.0 Capacity Building and Training.........................................................................................