A Comparative Assessment of Nurses’ Perceptions and Practices on Hospital Waste Management in Nigeria and South Africa, and their Impact on Nosocomial Infection Risks: A Systematic Review

Abstract

Introduction: Healthcare waste management (HCWM) plays a critical role in infection prevention and control, particularly in low- and middle-income countries where systemic health infrastructure challenges persist. This systematic review set out to assess the perceptions and practices of nurses regarding HCWM in general hospitals across Nigeria and South Africa, and to explore the impact of these practices on the prevalence of nosocomial infections.

Methodology: A scoping review methodology was adopted, guided by the PRISMA framework. Five electronic databases including Google Scholar, PubMed, MEDLINE, Embase (Ovid), and CINAHL (EBSCO) were systematically searched using a defined Boolean strategy. The initial search yielded 785 records: 742 from Google Scholar, 42 from MEDLINE, 1 from PubMed, and none from Embase or CINAHL. After removing 12 duplicates, 773 studies were screened for relevance. Title and abstract screening led to the exclusion of 707 studies. 66 full-text studies soughed, 3 could not be retrieved. 63 articles were assed based on eligibility. Of the 63, 50 were excluded for not meeting inclusion criteria. Ultimately, 13 studies met all criteria and were included in the synthesis.

Results: The review revealed that nurses in both Nigeria and South Africa generally demonstrated strong awareness and positive attitudes toward healthcare waste management (HCWM). However, this awareness did not consistently translate into safe or standardized practices. Actual compliance was often hindered by inadequate training opportunities, insufficient infrastructure, and weak enforcement of institutional policies. South African facilities showed relatively better adherence to waste management protocols than their Nigerian counterparts, reflecting more structured institutional frameworks, yet significant operational gaps and inconsistencies remained across both settings.

Conclusion: Overall, the evidence suggests that the challenges of HCWM transcend individual behaviour and are rooted in systemic and structural weaknesses within healthcare systems. Sustainable improvement requires more than periodic training; it demands an integrated reform approach that links technical capacity building with institutional accountability and equitable resource allocation. Only through such structural alignment can hospitals effectively reduce the risk of nosocomial infections and safeguard both healthcare workers and patients.