{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:53:58Z","timestamp":1790927638348,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Effective healthcare waste management (HCWM) is crucial for preventing infection and protecting the environment. Primary healthcare facilities (HCFs) in low\u2010resource settings often demonstrate inadequate practices. This study assessed HCWM practices and explored facilitators and barriers to safe HCWM practices in the public primary healthcare facilities of Kathmandu District, Nepal, focusing on segregation, internal collection, storage, treatment, and disposal practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional study using a concurrent triangulation mixed\u2010methods approach was conducted in public primary healthcare facilities under four local government units in Kathmandu District. For the quantitative component, 24 facilities were purposively selected. Data were collected through interviewer\u2010administered structured questionnaires with the HCWM focal person or facility in charge as well as through facility observations using the Minimum Service Standards (MSS) assessment tool. For the qualitative component, in\u2010depth interviews (IDIs) were conducted with focal persons or facility in\u2010charges from 11 facilities selected from the 24 using convenience sampling. HCWM practices were categorized based on MSS scores. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were analyzed thematically using Braun and Clarke's framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 70.8% of HCFs scored below 50% on MSS, indicating poor HCWM performance. While waste segregation at the source was high (95.8%), adherence to color\u2010coded bins and labeling was low (45.8% each). Sharp waste segregation was universal, but 37.5% reported unsafe safety box accumulation. Only 12.5% had autoclaves, and 83.3% disposed of infectious waste without prior treatment, and 70.8% disposed of infectious waste via municipal systems. Key barriers were limited space, inadequate training, weak supervision, and a lack of disposal mechanisms, whereas facilitators included staff awareness, designated handlers, MSS programs, and external support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings highlight gaps in HCWM practices in primary HCFs. The results suggest that interventions such as centralized or on\u2010site treatment of hazardous waste, along with regular staff training and supervision, may help improve HCWM practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72971","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:28:22Z","timestamp":1785907702000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare Waste Management Practices and Facilitators and Barriers in Primary Healthcare Facilities: A Mixed\u2010Methods Study in Kathmandu, Nepal"],"prefix":"10.1002","volume":"9","author":[{"given":"Kripa Thapa","family":"Magar","sequence":"first","affiliation":[{"name":"Department of Health Services Ministry of Health and Population Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7637-6969","authenticated-orcid":false,"given":"Ganesh","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Pokhara University Pokhara Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6872-254X","authenticated-orcid":false,"given":"Kamal","family":"Ranabhat","sequence":"additional","affiliation":[{"name":"Department of Health Services Ministry of Health and Population Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0341-595X","authenticated-orcid":false,"given":"Sujata","family":"Shakya","sequence":"additional","affiliation":[{"name":"Central Department of Public Health Institute of Medicine, Tribhuvan University Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Better Health Care Waste Management: An Integral Component of Health Investment","author":"Rushbrook P.","year":"2005"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3126\/jucms.v2i4.12070"},{"key":"e_1_2_14_4_1","volume-title":"National Health Care Waste Management Standards and Operating Procedures [Internet]","author":"Ministry of Health and Population","year":"2020"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3126\/jnhrc.v15i1.18006"},{"issue":"1","key":"e_1_2_14_6_1","first-page":"64","article-title":"Capacity Assessment and Implementation Analysis of Common Treatment Facility for the Management of Infectious Healthcare Waste in a Rapidly Urbanising City of Nepal","volume":"39","author":"Pathak D. R.","year":"2021","journal-title":"Waste Management (New York, N.Y.)"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11356-019-05785-9"},{"issue":"30","key":"e_1_2_14_8_1","first-page":"231","article-title":"Health Care Waste Management Practice in a Hospital","volume":"8","author":"Paudel R.","year":"2010","journal-title":"Kathmandu University Medical Journal"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.30574\/wjarr.2021.12.3.0722"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2009.02386.x"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16204044"},{"key":"e_1_2_14_12_1","volume-title":"Service Availability and Readiness Assessment (Sara): Reference Manual Version 2.2 [Internet]","author":"World Health Organization","year":"2015"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/11786302211073383"},{"key":"e_1_2_14_14_1","volume-title":"Use of Health Facilities and Levels of Selected Health Conditions in South Africa: Findings From the General Household Survey","author":"Lehohla P.","year":"2013"},{"issue":"2","key":"e_1_2_14_15_1","first-page":"16","article-title":"Assessment of Healthcare Waste Management Practices in Primary Health Care Facilities in a Lassa Fever Endemic Local Government Area of Edo State, Nigeria","volume":"4","author":"Tobin E. A.","year":"2013","journal-title":"African Journal of Medical and Health Sciences"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0128383"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.18203\/2394-6040.ijcmph20163280"},{"issue":"5","key":"e_1_2_14_18_1","first-page":"304","article-title":"Factors Affecting Medical Waste Management in Low\u2010Level Health Facilities in Tanzania","volume":"4","author":"Manyele S. V.","year":"2010","journal-title":"African Journal of Environmental Science and Technology"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-067752"},{"issue":"7","key":"e_1_2_14_20_1","first-page":"596","article-title":"Healthcare Waste Management for Hospitals in Resource\u2010Constrained Settings: What Determines Effective Implementation?","volume":"33","author":"McPherson J.","year":"2015","journal-title":"Waste Management and Research"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1757177414531632"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-6528-4"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.26502\/jesph.96120088"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.4103\/JLP.JLP_89_17"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72971","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.72971","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72971","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:08:45Z","timestamp":1790924925000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.72971"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/hsr2.72971"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.72971","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2025-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72971"}}