ABSTRACT

Home-based care facilities provide basic healthcare services to people too sick or frail to access formal clinics and hospitals. These facilities produce ‘healthcare risk waste’ which must be managed responsibly, and it is the work of Environmental Health Practitioners working within municipalities to ensure that the waste produced by home-based care facilities is managed in line with legislation. This paper presents a case study of a twenty-seven-month expansive learning intervention in a South African municipality that sought to transform its healthcare risk waste management practices. Limited knowledge and inadequate knowledge-sharing practices were identified as the main hindrances to effective waste management. The practitioner-researcher facilitated a series of inter-agency, formative intervention workshops with municipal employees and Community Health Workers using the Developmental Work Research methodology. These workshops strengthened both groups of practitioners’ knowledge of the ‘who, how, what, why and when’ that underpins effective healthcare risk waste management, and enabled ‘boundary crossing’ for practitioners to work across their specialist areas towards co-defining and analysing problems and constructing new solutions.

摘要

家庭护理设施为那些病弱或体弱而无法进入正规诊所和医院的人们提供基本的医疗服务。这些设施产生的“医疗卫生风险废物”必须予以负责地管理，这是市政当局的环境卫生从业人员的工作，以确保对家庭护理设施产生的废物进行依法管理。本文提供了一个案例研究，该案例研究了南非一个市镇长达27个月的广泛学习干预措施，旨在改变其医疗保健风险废物管理做法。知识有限和知识共享做法不足被确定为有效废物管理的主要障碍。从业者研究人员促进了一系列机构间合作，使用发展工作研究方法与市政雇员和社区卫生工作者进行的干预性培训研讨会。这些研讨会加强了两组从业者对““谁，如何，什么，为什么，何时何地”为有效的医疗保健风险废物管理奠定了基础，并使从业人员可以跨越“专业领域”跨专业领域共同定义和分析问题并构建新的解决方案。