Background: Developing countries face difficulties in implementing safe healthcare waste management (HWM) practices. It is important to holistically probe the ground situation to meet this challenge.

Methods: In this study we surveyed 12 public and private hospitals in a major city of Pakistan, Gujranwala. The survey consisted of waste characterization as well as targeted interviews using standardized questionnaires.

Results: The results indicated issues including lack of waste segregation, lack of sufficient knowledge & awareness regarding HWM and a high prevalence of Hepatitis C among hospital housekeeping staff. We also discovered that organizational and administrative solutions for effective HWM are as important as preventive monitoring and control.

Conclusions: Apart from technical improvement, behavioral changes are vital for a positive change regarding HWM. Overall, this study led to an increased awareness of public health issues related to HWM that had hitherto gone unnoticed by hospital staff as well as relevant public authorities in the city.