Small-scale healthcare projects (e.g., rural health posts, immunization posts, reproductive health posts, mobile health clinics, emergency healthcare programs, urban clinics, and small hospitals) provide important and often critical healthcare services to individuals and communities that would otherwise have little or no access to such services. The medical and health services they provide improve family planning, nurture human health, prevent disease, cure debilitating illnesses, and alleviate the suffering of the terminally ill. However, appropriate management of associated wastes from these services and facilities is limited, especially in small-scale facilities in developing countries.

Improper management of healthcare waste (HCW) poses risks to both the environment and human health. These risks include potential for disease transmission, physical injury, air pollution, soil pollution, water pollution, and impacts to fish and wildlife. Lack of resources, infrastructure, and training to properly manage HCW are common in developing countries. It is important for USAID and Implementing Partners (IPs) to take into consideration host country policies, laws, operational norms, and management constraints to integrate feasible waste management practices throughout the project lifecycle.

Toward this end, the Bureau for Global Health (GH) collaborated with the Bureaus for Africa and Latin America and the Caribbean (LAC) to update the Agency’s HCW Sector Environmental Guideline (SEG). The HCW SEG presents concise, plain-language information on common USAID development actions regarding:

• the typical, potential adverse impacts of activities involving HCW;
• how to prevent or otherwise mitigate these impacts, both in the form of general principles for sustainable HCW management and specific environmental guidance for project and activity design;
• how to minimize vulnerability of activities to climate change; and
• more detailed resources for further exploration of these issues.

All of the USAID SEGs, including the 2019 update to the HCW SEG, are available on the USAID Environmental Procedures Hub.