SEWAGE DISPOSAL

UNDP AND DOH

INDICATORS
Edalyn R. Capili, R.N.
Metropolitan Medical Center
College of Medicine
 Percent of the Population with
Adequate Sewage Disposal
Facilities
Definition: Proportion of population with access to a sanitary
facility for human excreta disposal in the dwelling or immediate
vicinity
POLICY RELEVANCE
Purpose: To monitor progress in the accessibility of the
population to sanitation facilities.
Relevance to Sustainable/Unsustainable Development: This
represents a basic indicator useful for assessing sustainable
development, especially human health. Accessibility to
adequate excreta disposal facilities is fundamental to decrease
the fecal risk and the frequency of associated diseases.
 Percent of the Population with
Adequate Sewage Disposal
Facilities
•.Its association with socioeconomic characteristics (education,
income) and its contribution to general hygiene and quality of
life also make it a good universal indicator of human
development. When broken down by geographic (such as
rural/urban zones) or social or economic criteria, it also provides
tangible evidence of inequities.
International Conventions and Agreements: Agenda 21
UNCED (1992) indicates the need for universal coverage and
the Second World Water Forum and Ministerial Conference,
The Hague, March 2000 established the target of universal
coverage by the year 2025.
 Percent of the Population with
Adequate Sewage Disposal
Facilities
International Targets/Recommended Standards: International
targets for this indicator have been established under the
auspices of the World Health Organization (WHO). The
Vision 21 of the Water Supply and Sanitation Collaborative
Council provides targets of 100% coverage by the year 2025.
Linkages to Other Indicators: The indicator is closely
associated with other socioeconomic indicators, particularly
the proportion of population with access to improved water
sources. The indicator represents two of the eight elements of
primary health care.
 Percent of the Population with
Adequate Sewage Disposal
Facilities
METHODOLOGICAL DESCRIPTION
UN Commission on Sustainable Development 76 WHO
(a) Underlying Definitions and Concepts:
Sanitary facility: "A unit for disposal of human excreta which
isolates feces from contact with people, animals, crops and
water sources. Suitable facilities range from simple but
protected pit latrines to flush toilets with sewerage. All
facilities, to be effective, must be correctly constructed and
properly maintained".
Population covered: Includes urban and rural population served
by connections to public sewers; (pit privies, pour-flush
latrines, septic tank, etc.)
 Percent of the Population with
Adequate Sewage Disposal
Facilities
(b) Measurement Methods: This indicator may be calculated as
follows: Numerator: number of people with improved excreta-
disposal facilities available multiplied by 100. Denominator:
total population.
(c) Limitations of the Indicator: The availability of facilities does
not always translate into their utilization.
METHODOLOGICAL DESCRIPTION
(a) The amount of waste treated or disposed of under different
methods is closely related to the national policy on waste
management: incentives for minimization, recycling/recovery,
stricter legislation for waste to be land filled (e.g. ban on land
filling of combustible waste) and differentiated taxation.
 Percent of the Population with
Adequate Sewage Disposal
Facilities
Recycling - any reprocessing of material in a production process
that diverts it from the waste stream, except reuse as fuel. Both
reprocessing as the same type of product, and for different
purposes should be included. Direct recycling within industrial
plants at the place of generation should be excluded.
Composting - biological process that submits biodegradable waste
to anaerobic or aerobic decomposition, resulting in a product
(compost) that is added to soil to improve fertility.
 Percent of the Population with
Adequate Sewage Disposal
Facilities
Incinerating - thermal treatment of waste during which chemically
fixed energy of combusted matters is transformed into thermal
energy. Combustible compounds are transformed into
combustion gases leaving the system as flue gases.
Incombustible inorganic matters remain in the form of slag
and fly ash. Incinerating includes incinerating with or without
energy recovery.
 Percent of the Population with
Adequate Sewage Disposal
Facilities
Landfilling - depositing waste into or onto land, in a controlled
manner. It includes specially engineered landfill and
temporary storage of over one year on permanent sites. The
definition covers both landfill in internal sites (i.e. where a
generator of waste disposes of its own waste at the place of
generation) and in external sites. Landfill waste includes all
amounts going to landfill, either directly or after sorting and/or
treatment. Controlled landfilling requires submission to a
permit system and technical control procedures in compliance
with the national legislation in force.
Households with Sanitary Toilet, Satisfactory Disposal of
Solid Waste and Complete Basic Sanitation Facilities By
Region, Province and City Philippines, 2015
Households with Sanitary Toilet, Satisfactory Disposal of
Solid Waste and Complete Basic Sanitation Facilities By
Region, Province and City Philippines, 2015
Households with Sanitary Toilet, Satisfactory Disposal of
Solid Waste and Complete Basic Sanitation Facilities By
Region, Province and City Philippines, 2015
Households with Sanitary Toilet, Satisfactory Disposal of
Solid Waste and Complete Basic Sanitation Facilities By
Region, Province and City Philippines, 2015
Households with Sanitary Toilet, Satisfactory Disposal of
Solid Waste and Complete Basic Sanitation Facilities By
Region, Province and City Philippines, 2015
Households with Sanitary Toilet, Satisfactory Disposal of
Solid Waste and Complete Basic Sanitation Facilities By
Region, Province and City Philippines, 2015
Households with Sanitary Toilet, Satisfactory Disposal of
Solid Waste and Complete Basic Sanitation Facilities By
Region, Province and City Philippines, 2015
ACTION PLAN 2010-2013
ACTION PLAN 2010-2013
ACTION PLAN 2010-2013
The 2011-2016 Philippine Development Plan Results
Matrices
 Presidential Decree No. 856
“The Code on Sanitation of the
Philippines”
• mandates DOH to promote and preserve public health
and upgrade the standard of medical practice.
• Manual on Hospital Management was published in 1997
and the Implementing Rules and Regulations of Chapter
XVIII, Refuse Disposal of PD 856 was promulgated.
• The Manual on Hospital Management recommended
color-coding scheme for segregated wastes to avoid any
accidents or hazards to personnel.
• When the DOH released the IRR of Chapter XVIII, the
classification of refuse/solid waste was expanded by
recognizing the existence of different types of hospital
waste such as biodegradable waste, chemical waste,
infectious waste, pharmaceutical waste, pathological
waste, and radioactive waste.
 Presidential Decree No. 856
“The Code on Sanitation of the
Philippines”
• The IRR also provides the detailed sanitary requirements
for the segregation, storage, collection, transportation,
and disposal of refuse/solid waste.
• Health Care Waste Management Manual
• In 2002, the Bureau of Health Facilities and Services of
the DOH requires hospitals to submit the approved plan
on health care waste management prior to issuance or
renewal of license. The said office likewise required
hospital establishments to submit plans of wastewater
treatment facilities.
• Other DOH Requirements:
• DOH Department Circular No. 156-C, series of 1993
“Provides guidelines on hospital waste management”
 Presidential Decree No. 856
“The Code on Sanitation of the
Philippines”
• Specific instructions include:
• "All undevolved government hospitals, clinics,
laboratories, and research offices shall incorporate
satisfactory segregation, treatment, collection and
disposal systems."
• "All infectious and hazardous hospital waste shall be
treated before storage, collection and disposal."
• "The use of appropriate technologies and indigenous
materials for storage, treatment, collection and disposal of
hospital waste shall be utilized to support the country's
socioeconomic development program."
 Presidential Decree No. 856
“The Code on Sanitation of the
Philippines”
• "All hospitals and other related institutions shall inform
their staff and personnel about the proper treatment,
segregation (color coding) and storage, collection and
disposal of hospital waste"
DOH Memorandum No. 1-A, series of 2001
• “Requiring the Department of Health Central Office,
Centers for Health Development, and all concerned
hospitals to practice proper solid waste management”.
 Presidential Decree No. 1586
“Environmental Impact
Statement (EIS) System”
• Environmental Impact Statement (EIS) System of the
Philippines or PD 1586 requires projects like construction
of new hospital buildings or expansion of existing
hospitals to secure an Environmental Compliance
Certificate (ECC) prior to construction and operation of
the facility.
• ECC is required for the installation and operation of
health care waste treatment systems like pyrolysis,
autoclave, microwave, landfills, and other similar
treatment technology.
• Under the EIS System, a project proponent is tasked to
undertake an environmental impact assessment (EIA)
study and to prepare an EIS or an IEE, depending on the
scope of the project.
 Laws, Policies, Guidelines and
Protocols
DOH-DENR Joint Administrative Order No. 02 series of
2005 dated August 24, 2005 entitled “Policies and
Guidelines on Effective and Proper Handling, Collection,
Transport, Treatment, Storage and Disposal of HCW”
• Joint Administrative Order aims to: a) provide guidelines
to generators, transporters and operators/owners of TSD
Facilities on proper handling, collection, transport,
storage, treatment and disposal of HCW; b) clarify the
jurisdiction, authority and responsibility of the DENR and
DOH with regard to HCWM; and c) harmonize efforts of
DENR and DOH on HCWM.
Republic Act No. 9003 “Ecological Solid Waste
Management Act of 2000”
• The Act mandates segregation of solid wastes at the
source including households and institutions like
hospitals by using separate container for each type of
waste from all sources.
Comparison between UNDP and
DOH Indicators
• UNDP National goals are more ideal compared to what
Philippine Department of Health programs, laws and
guidelines, this is probably because of our economy
wherein a large budget and manpower will be necessary
in order to implement and achieve goals.
• DOH policies are somewhat inclined with the UNDP’s
example of which are programs pertaining to health
promotion and prevention such as promotion of hand
washing and having hand washing facilities particularly
at school.
• Also there is a thrust in the DOH program in creation of
public/community restrooms in communities that have no
access to a restrooms or doesn’t have proper sewage
disposal.
Comparison between UNDP and
DOH Indicators
• DOH programs are more focused on community level
and there is a lacking national policy on implementation
on programs of sanitation whereas UNDP’s program
focuses on large scale across the population.
• Most of those governments assets and facilities are
readily available in the urban areas and lesser to rural
areas which should be the main focus of DOH programs.
• DOH programs are emphasized to government
institutions more often and private hospitals have their
own guidelines and ways of implementing their programs
concerning sanitation and waste management.
 Recommendations
• The way a country manages its waste has significant
long-term implications for public health, the economy and
the natural environment.
• Therefore, it is critical to promote an environmentally
sound waste treatment and disposal program.
• Satisfactory waste management indicates that authorities
are aware of the health and the environmental risks and
that they support or impose suitable measures to prevent
or to reduce waste.
• Concern stems from both distrust of policies and
solutions proposed by all tiers of government for the
management of solid waste and a perception that many
solid waste management facilities use poor operating
procedures.
 Recommendations
• Healthcare personnel particularly frontline services like
sanitary inspectors and engineers should be trained
more and exposed on how international standards are
implemented.
• Policies/guidelines should be strictly implemented
together with necessary penalties cause by failure to
adhere to the said standards.
• There should be more consultative dialogues on
community people and leaders so that they will be more
aware of how they can participate with the
implementation of the programs
 Recommendations
• There should be a periodic unannounced audit from a
third party so as to ensure that goals are met and so that
necessary adjustments can me made based on the
evaluation and recommended.
• There should be a solid, not fragmentalized program of
sanitation and waste management and this can be
realized by making some amendments with our existing
laws like our Sanitation Code and Solid Waste
Management Act.
• Coordination with other international NGO’s and health
care organization might help us with regards to the
appropriate model we can use that is based on our
countries needs and current situation
 References
• National Objectives for Health 2011-2016
• DOH Epidemiology Bureau: Field Health Service
Information System Annual Report 2015
• The 2011-2016 Philippine Development Plan Results
Matrices
• Indicators of Sustainable Development: Framework and
Methodologies
• UNDP Indicators and a Monitoring Framework for the
Sustainable Development Goals June 12, 2015