The team assessed the current status of MWM and vocational training provision in Sylhet from the perspective of national norms and standards. Operational choices are provided for SCC to facilitate the design and delivery of job-oriented vocational training.
Introduction
- Introduction
- Methodology of the Study
- Primary and Secondary Data
- Profile of the City
- Ward-wise Population in SCC
- Land-use Pattern
- Chapter Outline
- Conclusion
The LAR provides detailed information on the priority public goods and services, including situational analysis and mapping of the city's economy in relation to factors, systems and structures related to providing and accessing these public goods. Informant interviews (KII) to explore the emphasized importance of the field data regarding both MWM and VTCs in SCC.
Medical Waste Management
Introduction
Medical Waste Management
It is evident that there is a causal relationship between MWM, health, treatment costs, population productivity and equitable economic growth in the city (Hassan et. al, 2008). Adoption of MWM policy and proper collection, transportation and disposal mechanisms of HCEs and SCC will jointly contribute to improving the quality of life and economic status of city residents.
Norms of Medical Waste Management
There are no specific norms in the Medical Waste Management Act 2008 regarding waste storage within HCEs. According to the Medical Waste Management Act 2008, untreated medical waste should only be transported in defined vehicles.
Existing Practice of Medical Waste Management
- Indoor Management
- Outdoor Management
Of which 70 percent of the waste is non-hazardous and 30 percent is hazardous. Under the supervision of the broker, five people (both men and women) work daily to separate the waste.
Stakeholder Mapping
The 2017 BIGD survey found that HCEs and SCC face a number of challenges in managing medical waste. In reality, SCC does not follow all standards and guidelines due to lack of staff, infrastructure, lack of awareness and weak enforcement (Appendix Table 2.6).
Gaps between Norms and Existing Practice of MWM
- Norms of Medical Waste Management
In the 2017 BIGD survey, six types of waste were identified as generated in HCEs, including general, hazardous, sharp, liquid, radioactive and recyclable waste. The willingness of the cleaners and health assistants to sort the waste is absent during the waste collection period. Service types Stages Standards and norms Identification of existing practice gaps Both HCEs authorities and SCC do not pay.
Having no storage facilities means they empty all bins directly into the garbage truck that comes to collect MW every day. SCC authority is willing to collect waste separately but has no facilities or infrastructure in place;. SCC also does not have the necessary facilities in the landfills to treat the waste separately and appropriately.
Impact Assessment of Medical Waste Management
As mentioned in the previous chapter, Sylhet has a rapidly growing population of around 3.9 million in 2016 (growth of 2.87 percent per year from 2016). In HCEs, healthcare assistants or nurses are generally responsible for the collection, handling and disposal of medical waste. The results above indicate that 29 percent of the total hospital waste is hazardous, which implies that separating the hazardous waste from the non-hazardous waste will reduce the total waste generated by the same percentage of 29 percent.
The 2017 survey found that the total amount of medical waste for Sylhet is 9,127 kg per day. Specifically for Sylhet, Waste Concern (2009) states that the amount of waste generated could potentially release 0.02 million tonnes of CO2 per year; and thus proper separation of medical waste can also reduce carbon emissions. Proper MWM also helps reduce the release of persistent organic pollutants (POPs), mercury and other hazardous wastes.
Conclusion
According to the BIGD State of Cities Report (BIGD, 2015), good waste management can also reduce greenhouse gas emissions by 0.5 tonnes. Other concerns for MWM include infection control, patient safety, occupational health (in the hospital), and general community and environmental health.
Vocational Training Centre
Introduction
Vocational and Skill Training in Bangladesh
To achieve the objectives, the Government of Bangladesh has adopted the 'National Technical Vocational Qualification Framework (NTVQF)' following the TVET approach. DTE is responsible for setting the overall policy framework for the entire vocational education and training system. Therefore, it introduced the TVET approach to improve national employability and reduce poverty by improving the quality of vocational education and training (Government of Slovenia and ILO, 2015).
The BTEB is responsible for the implementation of the TVET system in Bangladesh and is mandated to provide a standard framework of qualifications in all registered VTCs (GoB and ILO, 2015). The Municipal Corporations Ordinance 2009 states that municipal corporations are neither prohibited nor directed to provide educational services to their citizens (except the Chittagong Municipal Corporation, which is empowered to provide compulsory education under an Act passed by the Parliament of Bengal in 1929). However, the recent Bangladesh National Skill Development Policy 2011 mandates city corporations to provide skill development training.
Defining Skill Development in Bangladesh
- TVET System and Bangladesh Standards
- National Technical and Vocational Qualification Framework (NTVQF)
- Industry Sector Qualifications and Competency Standards Framework
- National Quality Assurance System
Empowerment of youth and women by transforming them into an effective workforce for the comprehensive development of the nation. To turn the youth into an efficient workforce that will contribute to the economic, administrative and social sectors of the country. The modern TVET system in Bangladesh consists of the following three main components as presented in Table 3.2.
This ensures that the graduates of the TVET system have the required skills and knowledge to meet the needs of the industry. After the first component, the second major component of the TVET system is Competency Based Training and Assessment (CBT&A). Under the umbrella of the NSDC, 15 Industrial Skill Councils (ISC) were established, with each ISC focusing on a particular occupational sector, such as information technology (IT), furniture, construction or transportation.
Vocational Training Centres: Existing Scenario of Sylhet
The number of centers may increase depending on the administrative area considered; for example, in greater Sylhet, the number of vocational training centers is even higher. As mentioned earlier, there are a significant number of vocational training centers managed by various authorities in Sylhet. The quality assessment in public authorized training centers is carried out by high-level authorities at the local level (respective ministries [ministers], BMET and regional-level government offices).
The KII and field survey conducted in 2017 revealed that there is a self-developed internal quality management system in almost all training centers in Sylhet, regardless of whether they are public, private or NGOs. The NSDC is the apex skills development body that oversees the TVET-oriented skills training activities in public and private training centers in Bangladesh (GoB and ILO, 2011). However, at the implementation level, there are public, private and NGO-driven training centers in Bangladesh that have accredited the TVET approach in the training curriculum.
Existing Gaps of Vocational Training Centres in Sylhet
- Possible Role of SCC in VTCs to Minimize the Existing Gaps
There are both public and private educational organizations in SCC that comply with NTVQF in light of the TVET system in Bangladesh. However, of the other general category of training providers (food and beverage service, cooking, housekeeping, hotel management, tailoring and dressmaking), very few comply with the NTVQF. Due to the large number of computer and technical training centers, more technical skills are developed compared to the other general type (food and beverage service, cooking, housekeeping, tailoring and dressmaking) and community-oriented rural. livestock, agriculture, weaving, fishing) skill development.
Separate prayer rooms are often not available and most importantly, day care facilities are not found in any of the publicly or privately owned training centers. First, SCC should urgently conduct a training needs assessment in Sylhet to analyze: (i) the social, economic and academic profile of prospective trainees; (ii) skill requirements for work and business opportunities in Sylhet; and, (iii) analysis of the training courses offered by the QAPs. Third, KSHC can subsidize the development of training curricula and/or the provision of new training courses by VETs if these institutions are unable to cover the costs from the tuition fee.
Impact Assessment of Vocational Training Centres
Since a significant 23 percent of students tend to drop out at the primary school level, it is imperative to reach out to these people through vocational training programs. On average, 85 percent of the total employed people are involved in informal activities. It can be seen that the overall pass rate has improved from 44 percent to 56 percent.
Considering the number of eligible people who can claim vocational training, the number of vocational training centers falls short in comparison. Moreover, the 2011 census recorded only one training and vocational institution in Sylhet, and it houses 33 teachers and 1,250 students, of which only 14 percent are women (BBS, 2011). Vocational training can help to significantly reduce the number of criminal cases in the coming years by helping people to enter the labor market.
Conclusion
Financial Operating Plan
- Introduction
- Medical Waste Management
- Assessment of Demand and Gaps
- Choice of Technology and Cost
- Basis for Costs Estimation
- Vocational Training Centre
- Assessment of Demand and Gaps
- Identification and Cost Estimation of Items
- Basis for Cost
- Means of Finance
- Sensitivities
- Conclusion
For details technical note and technical cost estimate please see attachment table 4.1a and attachment table 4.1b respectively. The sustainable management of medical waste in Sylhet requires appropriate use of available technologies, such as incinerator, autoclave, waste water treatment plant, chemical disinfection, work shed and covered truck for waste transport (Appendix table 4.2). the capital investment requirement for MWM is much lower. The cost is estimated to increase in subsequent years, rising to about $104,179 in the fifth year.
The sensitivity analysis showed that fuel and technological replacement prices are sensitive to changes over the next five years. Similarly, in the VTC, the maintenance of training equipment (such as computer, air conditioning and printer) is also sensitive to technological changes and unexpected failures. The financial planning aims to address the service shortcomings identified in the previous sections and is based on the choice of the most appropriate technological options.
Conclusion
Recommendation for MWM
The number of vans needs to be increased, as only two vans operating at MWM cannot cover the daily amount of waste. Proper disposal of hazardous and infectious waste in landfills should be ensured as prescribed in the guideline. Formalizing the informal recycling process and recognizing informal workers and their market would help enforce the MWM policy.
There are six financing options to improve MWM and SCC's budget surplus is sufficient to cover the estimated investment.
Recommendations for VTC
Eighth International Waste Management Congress and Exhibition, Waste Management Institute of Southern Africa - Botswana Section. Available at: http://watertreatmentindia.blogspot.com/2009/10/deep-burial-of-bio-medical-waste.html (accessed on 26 September Medical Waste Treatment and Disposal Methods Used by Hospitals in Oregon, Washington and Idaho Online] Available at: https://www.epa.gov/hwpermitting/hazardous-waste-management-facilities-and-units#incinerators (accessed 26 September 2018).
Health Care Waste Management Status Report in Countries of the Southeast Asian Region. With specific reference to SCC, the participating groups identified five sectors as priorities: medical waste management (MWM), center establishment (vocational, IT, women), water supply and governance/institutional accountability (Table 1.1a in the Annex). For medical waste that will be landfilled, autoclaves can be used as processing units for thermal treatment to destroy microorganisms before disposal in a traditional landfill or further processing (Malsparo, 2018).
Chemical disinfection, primarily using chlorine compounds, kills microorganisms in medical waste and can sometimes oxidize hazardous chemical constituents. Ethylene oxide treatment is used to disinfect materials and is sometimes used to treat medical waste.
