Small Healthcare Facilities

Chapter 17: Small Healthcare Facilities

Other Internet and Print Resources

NOTE: Listing of a resource does not constitute USAID endorsement or certificationReferences and Resources

Resources and References

  • Other Small-Scale Guidelines Chapters
    A number of the issues summarized in this guidance are treated in more detail in other chapters of The Environmental Guidelines for Small-Scale Activities in Africa (2nd Edition). Refer to these chapters for more detailed information on specific issues:

    • Chapter 3 – Small-Scale Construction
    • Chapter 8 – Healthcare Waste: Generation, Handling, Treatment, and Disposal
    • Chapter 13 – Safer Pesticide Use
    • Chapter 15 – Solid Waste
    • Chapter 16 – Water & Sanitation
  • S. Batterman. Assessment of Small-Scale Incinerators for Health Care Waste. WHO. Geneva, Switzerland. 2004.

    This report provides an analysis of low cost small-scale incinerators used to dispose of health care waste in developing countries, specifically sharps waste (used and possibly infected syringes and needles). The report includes a situation analysis, a “best practices” guide to small-scale incineration, a screening level health risk assessment for ingestion and inhalation exposure to dioxin-like compounds, and other information related to the operation and evaluation of the incineration option for health care waste.

  • Consumer Product Safety commission, US EPA, and American Lung Association, Asbestos in the Home
  • Belinda Greenwood-Smith (MBBS). Basic Health Care Center in Ghurian, Afghanistan.

    This is the report of measures taken to ensure proper inclusion of environmental health issues while rehabilitating a clinic in rural Afghanistan.

  • T. Grayling. Guidelines for Safe Disposal of Unwanted Pharmaceuticals In and After Emergencies. WHO. Geneva, Switzerland. 1999.

    These guidelines provide advice on the implementation of safe disposal of unusable pharmaceuticals in emergencies and in countries in transition where official assistance and advice may not be available. A number of methods for safe disposal of pharmaceuticals are described. These are methods which involve minimal risks to public health and the environment, and include those suitable for countries with limited resources and equipment. The adoption of the guidelines by ministries of health, environment and other relevant ministries, and their practical application, will contribute to the safe and economical elimination of stockpiles of unusable pharmaceuticals.

  • B. Hirsch, C. Gallegos, W. Knausenberger, and A. Arata. Programmatic Environmental Assessment for Insecticide-Treated Materials in USAID Activities in Sub-Saharan Africa. U.S. Agency for International Development, Bureau for Africa, Office of Sustainable Development, Agriculture, Natural Resources and Rural Enterprise Division. 2002.
  • Health Care Without Harm. Environmentally Responsible Management of Health Care Waste With a Focus on Immunization Waste. Washington, DC. 2002.

    A coalition of international NGOs, scientists, and medical professionals, Health Care Without Harm (HCWH) advocates for safe handling, treatment and disposal of medical waste. HWCH works to discourage antiquated approaches to waste management that produce harmful environmental and public health impacts, and replace them with innovative thinking and approaches that makes the best use of technology and management skills to solve this problem.

  • Health Care Without Harm. MedWaste Treatment: Minimizing Harm, Maximizing Health. Results of the International Competition for Technologies For the Treatment of Medical Waste in Rural Areas. Washington, DC. 2003.

    Results from the international competition in April 2002 to engage students, faculty, health professionals, researchers, inventors and others in the search for cleaner, safer, lower-cost, appropriate technologies to treat medical waste in rural areas.

  • Jimenez, A. and K. Olson. Renewable Energy for Rural Health Clinics. National renewable Energy Laboratory. Golden, Colorado. 1998.

    The National Renewable Energy Laboratory’s (NREL) Village Power Program has commissioned this guidebook to help communicate the appropriate role of renewables in providing rural health care services. It combines technical analysis and practical design, deployment, and training experience with renewables as a serious option for electrifying rural health clinics. It is useful to renewable energy practitioners in defining the parameters for designing and deploying their products for health clinic needs.

  • Kevens, RM, J Edwards, C Richards, T Horan, R Gaynes, D Pollock, and D Cardo. “Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002.” Public Health Reports. March–April 2007 Volume 122 pp 160–166. Available at
  • Pruss, A, E. Giroult, and P. Rushbrook (Eds). Safe Management of Wastes from Health-Care Activities. ISBN 92 4 154525 9. WHO, Geneva. 1999.

    This handbook is a comprehensive, user-friendly guide for practical management of health-care waste in local facilities. It provides guidelines for the responsible national and local administrators, and offers globally relevant advice on the management of health-care waste.

  • Sehulster LM, Chinn RYW, Arduino MJ, Carpenter J, Donlan R, Ashford D, Besser R.
  • Fields B, McNeil MM, Whitney C, Wong S, Juranek D, Cleveland J. Guidelines for environmental infection control in health-care facilities. Recommendations from CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Chicago IL; American Society for Healthcare Engineering/American Hospital Association; 2004.

    This is an environmental infection-control guideline that reviews and reaffirms strategies for the prevention of environmentally-mediated infections, particularly among health-care workers and immuno-compromised patients. The recommendations are evidence-based whenever possible. The contributors to this guideline reviewed predominantly English-language articles identified from MEDLINE literature searches, bibliographies from published articles, and infection-control textbooks.

  • The Sphere Project. Humanitarian Charter and Minimum Standards in Disaster Response: Minimum Standards in Water Supply, Sanitation, and Hygiene Promotion. Geneva, Switzerland. 2004.,English/

    This chapter is divided into six main sections: Hygiene Promotion, Water Supply, Excreta Disposal, Vector Control, Solid Waste Management and Drainage. Each contains the following:

    • the minimum standards: these are qualitative in nature and specify the minimum levels to be attained in the provision of water and sanitation responses;
    • key indicators: these are ‘signals’ that show whether the standard has been attained. They provide a way of measuring and communicating the impact, or result, of programs as well as the process, or methods, used. The indicators may be qualitative or quantitative;
    • guidance notes: these include specific points to consider when applying the standard and indicators in different situations, guidance on tackling practical difficulties, and advice on priority issues. They may also include critical issues relating to the standard or indicators, and describe dilemmas, controversies or gaps in current knowledge.
  • WHO. Laboratory Biosafety Guidelines (3rd edition). ISBN 92 4 154650 6. Geneva, Switzerland. 2004

    For more than 20 years, since it was first published in 1983, the Laboratory Biosafety Manual has provided practical guidance on biosafety techniques for use in laboratories at all levels. Laboratory biosecurity concepts are introduced, and the latest regulations for the transport of infectious substances are reflected. Material on safety in health-care laboratories, previously published elsewhere by WHO, has also been incorporated for the 3rd edition.

  • WHO. Management of Solid Health-Care Waste at Primary Health-Care Centres: A Decision-Making Guide. ISBN 92 4 159274 5. Geneva, Switzerland. 2005.

    This document is to provide guidance for selecting the most appropriate options for safely managing solid waste generated at Primary Health-Care centers (PHCs) in developing countries. The main tool of this guide consists of six decision-trees aimed at assisting the user in identifying appropriate waste management methods. The guide takes into consideration the most relevant local conditions, the safety of workers and of the general public as well as of environmental criteria.

  • Worker’s Health Centre, Asbestos Removal Fact Sheet,