Development of a Community-Based Infectious Waste Management Model Through a Participatory Process Involving Multi-sectoral Stakeholders in Nonthaburi Province, Thailand

Abstract

This participatory action research aimed to: (1) investigate the situation, problems, knowledge, attitudes, practices, and contextual factors related to community infectious waste management in Nonthaburi Province; (2) develop a community infectious waste management model; and (3) evaluate the effectiveness of the developed model. The study was conducted over a 9-month period and comprised four phases. Phase 1 involved situation analysis through focus group discussions with key stakeholders and a survey of knowledge, attitudes, and practices regarding infectious waste management among community residents aged 18 years and older. Phase 2 focused on developing the model using a participatory approach involving community stakeholders. Phase 3 consisted of a two-cycle implementation, including a pilot test with 10 households to evaluate and refine the model, followed by field implementation in 103 target households. Phase 4 involved reflection and evaluation through focus group discussions with stakeholders to validate and refine the model. Research instruments included focus group discussion guides, questionnaires on knowledge, attitudes, and practices, a practice assessment checklist, a system performance indicator record form, and a reflection interview guide. Data were analyzed using descriptive statistics, paired t-test, and content analysis.

The results revealed that community residents demonstrated good levels of knowledge, attitudes, and practices regarding infectious waste management; however, several limitations in the community infectious waste management system remained. The developed model comprised four components: (1) household source management, (2) community collection and transportation, (3) standardized transfer and disposal, and (4) a stakeholder support mechanism. Following implementation, the mean practice score for infectious waste management significantly increased from 2.90 ± 0.42 to 3.87 ± 0.41, while the mean practice accuracy score increased from 4.98 ± 1.50 to 8.85 ± 0.98 (t = 50.180 and t = 22.648, respectively; p < .001). Furthermore, stakeholders accepted the developed model and identified systematic multisectoral integration and collaboration as the key factors contributing to its successful implementation.