Final evaluation: Reducing UPOPs and Mercury releases from the Health Sector in Ghana

Report Cover Image
Evaluation Plan:
2018-2022, Ghana
Evaluation Type:
Final Project
Planned End Date:
11/2020
Status:
Planned
Management Response:
Yes
Evaluation Budget(US $):
30,000
Document Type Language Size Status Downloads
Title Final evaluation: Reducing UPOPs and Mercury releases from the Health Sector in Ghana
Atlas Project Number: 00089426
Evaluation Plan: 2018-2022, Ghana
Evaluation Type: Final Project
Status: Planned
Planned End Date: 11/2020
Management Response: Yes
UNDP Signature Solution:
  • 1. Sustainable
Corporate Outcome and Output (UNDP Strategic Plan 2018-2021)
  • 1. Output 1.4.1 Solutions scaled up for sustainable management of natural resources, including sustainable commodities and green and inclusive value chains
SDG Goal
  • Goal 12. Ensure sustainable consumption and production patterns
  • Goal 17. Strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development
SDG Target
  • 12.4 By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle, in accordance with agreed international frameworks, and significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment
  • 17.16 Enhance the Global Partnership for Sustainable Development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology and financial resources, to support the achievement of the Sustainable Development Goals in all countries, in particular developing countries
Evaluation Budget(US $): 30,000
Source of Funding: Non Core: Global Environment Fund Trustee
Joint Programme: No
Joint Evaluation: Yes
  • Joint with Madagasca, Zambia and Tanzanie
GEF Evaluation: No
Key Stakeholders: Ghana Health Services, Ministry of Health, MMDAs, WHO
Countries: GHANA
Comments:

Final Project evaluation

Lessons
Findings
Recommendations
1

The project must ensure that the non-incineration and mercury-free technologies introduced under Phase 1 of the project become or remain (as applicable) sustainable in the long-term through periodic follow-up visits.

2

The Project Document expects the introduction of non-incineration and mercury-free technologies at more HCFs during the second phase of the project. It is recommended to consider the installation of more autoclaves very carefully, as the project’s completion date is in April 2020. This leaves little time of the time consuming and complex issue of establishing structures to house the new autoclaves. So, if the PIU decides to purchase one or more autoclaves, very great care must be taken in selecting the receiving HCFs, so that it is certain that all necessary resources are available to rapidly establish a building for the new autoclaves.

3

When planning the second phase of the project, it is important that measures are taken to ensure that the treatment capacities of the installed (and any future) autoclaves are fully utilised. These autoclaves can complete six treatment cycles in an eight-hour working day. This means that several treatment facilities should not be placed within one city, unless there is sufficient waste to keep all the autoclaves busy. Some of the already installed autoclaves can be expected to operate at well below capacity, i.e. their waste treatment capacity is far greater than the quantity of waste generated by their host facility. To utilise this excess capacity, the PIU should work toward ensuring that all surrounding HCFs send their infectious waste to the hospitals equipped with treatment systems. Here the project can help these new model facilities with training, equipment, workshops and other actions to bring about a collaboration between the HCFs within each project region.

 

1. Recommendation:

The project must ensure that the non-incineration and mercury-free technologies introduced under Phase 1 of the project become or remain (as applicable) sustainable in the long-term through periodic follow-up visits.

Management Response: [Added: 2019/05/07]

This recommendation is very relevant in order to ensure the long-term sustainability of the project. Already, the 2019 Annual Work Plan included quarterly visits to the pilot facilities

Key Actions:

Key Action Responsible DueDate Status Comments Documents
The PIU will conduct quarterly follow-up visits to the health facilities to assess the status of the non-mercury devices. Focus shall be placed on the current numbers, vis-a-vis the numbers that were provided, their effectiveness in health service delivery, ease of usage and maintenance issues. In this respect, the PIU shall also analyze the records generated through the operation of the non-incineration technologies to assess the frequency of operation, the level of waste treated and frequency of maintenance when there are technical challenges. The PIU shall also pay attention to the communication systems between the operators, management and staff of the hospital to ensure that there is enough communication, collaboration and management support for the continuous operation and maintenance of the non-incineration equipment.
[Added: 2019/05/07]
Project Implementation Unit (PIU) 2020/03 Overdue-Initiated
2. Recommendation:

The Project Document expects the introduction of non-incineration and mercury-free technologies at more HCFs during the second phase of the project. It is recommended to consider the installation of more autoclaves very carefully, as the project’s completion date is in April 2020. This leaves little time of the time consuming and complex issue of establishing structures to house the new autoclaves. So, if the PIU decides to purchase one or more autoclaves, very great care must be taken in selecting the receiving HCFs, so that it is certain that all necessary resources are available to rapidly establish a building for the new autoclaves.

Management Response: [Added: 2019/05/07]

This recommendation is accepted. Having taken the decision to purchase one more autoclave for a new health facility in Ghana, the PIU in consultation with the Ministry of Health and UNDP has selected a health facility that is committed to best practices in HCWM and have adequate resources to build a structure in time for the delivery of the autoclave around June 2019

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Maintain strong engagement with the selected health care facility to ensure that the structure is completed before the arrival of the autoclave.
[Added: 2019/05/07]
Project implementation unit 2019/06 Overdue-Initiated
Ensure due diligence in the selection of the new health care facility receiving support from the project
[Added: 2019/05/07]
Project Implementation Unit 2019/04 Completed This recommendations has been fully implemented
3. Recommendation:

When planning the second phase of the project, it is important that measures are taken to ensure that the treatment capacities of the installed (and any future) autoclaves are fully utilised. These autoclaves can complete six treatment cycles in an eight-hour working day. This means that several treatment facilities should not be placed within one city, unless there is sufficient waste to keep all the autoclaves busy. Some of the already installed autoclaves can be expected to operate at well below capacity, i.e. their waste treatment capacity is far greater than the quantity of waste generated by their host facility. To utilise this excess capacity, the PIU should work toward ensuring that all surrounding HCFs send their infectious waste to the hospitals equipped with treatment systems. Here the project can help these new model facilities with training, equipment, workshops and other actions to bring about a collaboration between the HCFs within each project region.

 

Management Response: [Added: 2019/05/07]

This recommendation is accepted. Considering the amount of waste that can be processed by the autoclaves installed in the pilot HCFs in Ghana, it was discussed and agreed at the national Steering Committee meeting that the project should promote a cluster treatment system.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Provide support to the project’s facilities to develop a cluster management plan to enhance the operation of the non-incineration technologies as a cluster treatment facility. The plan among others, includes a management structure for the operation of the facility, charges for additional facilities in the cluster system and arrangements for the transportation of infectious waste to the treatment site
[Added: 2019/05/07]
Project implementation unit 2019/06 Completed
Procure tricycles for HCFs to support the transportation of waste from the additional facilities
[Added: 2019/05/07]
Project Implementation unit 2019/09 Overdue-Not Initiated
Explore the opportunity of having an agreement with Zoompak for them to expand their services to health facilities in the project’s regions using the autoclaves in the project’s facilities. Due to the company’s advanced logistics and market experience this arrangement could provide a more efficient transportation system and consistent income to enhance the continuous operation and management of the autoclaves
[Added: 2019/05/07]
Project Implementation Unit 2020/03 Overdue-Not Initiated

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