1. Demonstrating and Promoting Best Techniques and Practices for Reducing Health Care Waste to Avoid Environmental Releases of Dioxins and Mercury Project Activities

2. MODEL FACILITIES Activities:  Baseline assessment (at least one month)  Application of modified rapid assessment tool  Measurement of waste generation rate  Documentation of waste management practices  Estimation of mercury release rate  Documentation of mercury handling and disposal  Documentation of current costs for healthcare waste management  Dioxin estimation  Others studies (e.g., needle-stick injuries)

3. MODEL FACILITIES Activities:  Promulgation of hospital policies  General commitment to best environmental practices and best available technologies  Commitment to environmentally preferable purchasing (including mercury phase-out)  Required training on healthcare waste management  Occupational safety and health

4. MODEL FACILITIES Activities:  Development of a healthcare waste management plan  Organization  Defining roles and responsibilities  Identifying environmental champions  Stakeholder participation

5. MODEL FACILITIES Activities:  Development of a healthcare waste management plan  Review of baseline assessment data  Technical and economic evaluation of waste minimization options  Prioritization (e.g., early focus on sharps waste management and source reduction)  Development of a written HCWM plan including timeline  Allocation of human and financial resources  Strategy for implementation

6. MODEL FACILITIES Activities:  Development of a healthcare waste management plan  Waste classification  Segregation  Waste minimization  Containerization  Color coding  Labeling  Signage  Handling  On-site transport  Storage  Treatment  External transport  Final disposal  Contingency planning  System of monitoring and continuous improvement

7. MODEL FACILITIES Activities:  Implementation of the healthcare waste management plan  Criteria for evaluation  System of monitoring and evaluation  Record keeping  Cost tracking  Photo-documentation  Sustainability

8. MODEL FACILITIES Activities:  Training and capacity building  Raising awareness of risks, safe practices  Training of trainers  Periodic, multi-level training  Evaluation  Certification

9. TREATMENT TECHNOLOGY Activities:  Work with local government, waste transporter, landfill operator, etc.  Gathering site-specific data  Technology specifications  UN bidding process  Technology selection  Obtaining clearances and permits  Site preparation  Operator training  Installation and commissioning  Validation testing

10. TREATMENT TECHNOLOGY Activities:  Ensuring the technology is incorporated into the healthcare waste management system  Documentation of usage, maintenance, repairs, microbial inactivation, costs, etc.  Photo-documentation  Monitoring and evaluation  Spot checking

11. Mercury Waste Management and Mercury- Free Devices Activities:  Baseline assessment  Mercury policy  Development of a mercury plan with stakeholder participation  Procurement and construction  Training  Monitoring and evaluation  Educational and replication materials  National conference on mercury

12. National Training Activities:  Setting benchmarks for monitoring & evaluation  Defining overall goals, outcomes, approaches, indicators for success, methodology, etc.  Developing training content  Collaboration with certification entity  Finalization of training plans and implementation  Follow up, support and networking  Inclusion in existing professional curricula  Sustainability

13. National Policy Activities:  Review of existing policies  Development of recommendations  National policy review conference  Agreement of policy updates and implementation plans

14. National Dissemination Activities:  Announcement of project  Development of awareness-raising, educational and replication materials and toolkits  Targeted outreach to the health sector  Media outreach  National conference  Follow up  Sustainability