All children have a right to a healthy environment. Sustainable Development Goal Target 3.9 is to “substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination” by 2030. The World Health Organization (WHO) estimates that 26 per cent of deaths in children under 5 years can be prevented by addressing environmental risks, including hazardous waste from unsound management of health-care waste.

To meet the goals of the WHO framework for climate-resilient, environmentally sustainable health-care facilities, UNICEF has devised a package of support, including that for the safe and environmentally sustainable disposal of health-care waste. Currently, more than two thirds of health facilities in low- and middle-income countries do not practice safe and environmentally sustainable health-care waste management practices due to lack of resources and non-prioritization of resource allocation.

This technical brief provides guidance for country-level health-care managers and UNICEF workers, and partners, government ministries/departments and civil society members involved in planning, assessing, implementing, monitoring and evaluating health-care waste programmes at country level in the resource-constrained settings of low- and middle-income economies. It aims to define the planning tools and operational measures to be implemented through the hands-on involvement of in-country personnel, using cost-effective solutions to mitigate the risk of infection – for health workers, patients and local communities – from poor waste management practices.This technical brief is divided into three blocks.

Block A discusses actions at national level, and covers programme design, planning, assessment and supportive tools; quality assurance and costing.

Block B looks at standard operating procedures for primary health-care facility personnel, covering capacity-building, motivation and quality control.

Block C deals with implementation at facility level, including choice of treatment system, preparing for waste disposal equipment; waste disposal devices and equipment options; protective gear and safe practices; and operation and maintenance.