The health care waste management practices during COVID-19 pandemic at health clinics in Larut, Matang, and Selama (LMS) district, Perak

Since the outbreak of coronavirus infectious disease 2019 (COVID-19) in Malaysia in the year 2020, there has been a noticeable rise in health care waste (HCW) production from hospitals, clinics, and other health care facilities. This pandemic has significantly strained HCW management systems globally, posing human and environmental well-being risks. It underscores the urgent need to improve waste management protocols in health care settings. This study focuses on the evaluation of the association between socio-demographic factors and knowledge, attitudes, and practices (KAP) on HCW management. A mixed-method study has used a questionnaire to collect data on waste management among 265 health care personnel and a focus group discussion (FGD) was also conducted involving 10 participants from medical and non-medical personnel of health clinics and concession companies in Larut, Matang, and Selama (LMS) district, Perak. The findings of the questionnaire indicated that the respondents in the study achieved satisfactory scores for knowledge (1.58+0.31), attitudes (3.57+0.54), and practices (2.66+0.32). The results of Kruskal-Wallis found that some socio-demographic characteristics were significantly associated with KAP of HCW management, with a p-value <0.05. The characteristics such as gender, age, education level, designation, work experience, training, vaccination, guideline accessibility, committee, and gloves quantity sufficiency were the most statistically significant effects on KAP. Then, Pearson correlation revealed that all the KAPs have significant relationships with each other. Furthermore, the overall model of multiple linear regression was significantly useful for knowledge (34.0%), F (15, 249)=8.702, p<0.05, attitudes (35.0%), F (15, 249) =9.004, p<0.05, and practices (30.0%) F (15, 249) =7.415, p<0.05. Whereas, through an FGD, two major themes emerged. The first theme focuses on challenges in HCW management practices, highlighting several barriers that hinder effective HCW management. The second theme revolves around interventions that could improve HCW management practices, emphasizing educational and organizational strategies. It is advisable to propose and implement initiatives and strategies for the appropriate handling and disposal of HCW at health clinics to enhance and achieve more effective management, particularly during the pandemic. This study provides important insights into HCW management practices in government health clinics during the COVID-19 pandemic. The findings highlight that while health care workers generally demonstrated good knowledge, attitudes, and practices, gaps remained in compliance, training, and policy enforcement. The study emphasizes the influence of socio-demographic factors on waste management effectiveness and reveals key challenges such as inconsistent segregation and limited infrastructure. By identifying these issues, the research contributes to improving HCW management strategies through enhanced training, stronger regulations, and technological innovation, supporting safer and more sustainable health care environments.