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P.5 Acess to Solid Waste Management (SWM), Health Care Waste Management (HCWM) and Vector Control

Solid waste is defined as the unwanted solid products generated by society; they are the by-products of any process, or the unwanted objects that are discarded after use. Solid waste management includes all the steps and processes required to manage waste from households and within communities until its reuse or final disposal. 

An important part of SWM in humanitarian settings is health care waste management (HCWM). This refers to the safe handling and disposal of any medical waste (such as syringes and dressings) generated within health structures such as hospitals, nutritional feeding centres and temporary vaccination sites. 

The management of solid waste needs to be regulated by the government. The separation of waste streams at the household level is necessary to achieve high levels of recycling and re-use. The collection and disposal of solid waste is usually a municipal responsibility, although usually - where it exists - this service is restricted to the removal of un-separated solid waste to a local landfill. Uncollected solid waste can accumulate in streets or other public spaces and become a source of pollution and a breeding ground for vectors. Residents sometimes set it on fire, creating a fire hazard and the release of toxic chemicals into the environment, polluting air, earth and groundwater. Poor SWM services can create severe health risks and environmental pollution. Waste management in humanitarian contexts requires close collaboration with the community, municipal and health authorities. Municipal humanitarian SWM interventions should prioritise community-based sustainable outcomes using a circular economy approach, reducing waste and pollution and increasing recycling. Waste that must be transported for final disposal or storage should be minimised and disposed of in a sanitary landfill that prevents groundwater pollution and access to vectors. Organic waste makes up a considerable amount of the total solid waste; it can be separated, collected and recycled into value products (e.g. compost), used as an energy or food source for insect larvae, which can then be used as fish or poultry food. The balance of waste consists of plastics, paper, metals and textiles. Recycling possibilities for these dry waste streams exist but are context-specific. Cost recovery aspects of SWM should be considered to ensure sustainability. 

HCWM is critical to prevent the spreading of diseases, for example, from contaminated waste during epidemics such as Ebola, cholera and COVID-19. During epidemics, personal protective equipment (PPE) must to be provided for staff working in HCWM; however, as a result the volume of single-use PPE may substantially increase. Contaminated waste must be correctly treated to prevent a threat to the health and sanitation personnel in health facilities and the public in neighbouring or local communities. Health care waste should be separated at source, collected, treated and safely destroyed in centralised specialised incinerators. Regulations on HCWM are set nationally and vary from country to 

country, e.g. in some countries, low tech, high-temperature, decentralised medical waste incinerators are permitted, but in others not. National regulations will also cover the separation of waste at the point of production.  

Sanitation workers rarely get recognition for their work, are often badly paid and, as a result, may be unmotivated. To motivate staff it can be useful, with the agreement of the authorities or hospital/clinic department in charge of cleaning, to set up a ‘WASH’ department within health care facilities and provide training in various WASH and infection prevention and control disciplines for health care sanitation staff. 

Vector control is any method to limit or eradicate the mammals, birds, insects or other arthropods which transmit disease pathogens. Vectors are disease-carrying living organisms that transport a disease from human to human or from animal to human. Vectors account for more than 17% of all infectious diseases globally, causing more than 700,000 deaths annually. The most common types of vector are different blood-sucking insects that transmit the disease by transporting the disease-carrying microorganism from one host to another. The most common vector-borne diseases are malaria (spread through Anopheline mosquitoes), dengue (spread through Aedes mosquitoes) and leishmaniasis (spread through sandflies). Pools of standing water, due to poor drainage of grey and rainwater, are breeding grounds for mosquitoes. There is a strong link between liquid and solid wastes and diseases spread by vectors. Open defecation or poor excreta management increases the transmission of faeco-oral diseases such as cholera due to the presence of flies contaminating food. Inadequate SWM leads to the proliferation of disease-carrying vectors such as rats and sand flies. Solid waste such as plastic bags can also block drainage and lead to stagnant pools of water. Hygiene messaging and information sharing should make residents aware of possible vector-borne diseases. The humanitarian response must ensure that individuals, communities and local governments have the correct tools and resources to determine sources and reduce or eliminate possible infections.  

Sphere provides a list of standards and indicators for SWM, HCWM and vector control. 

Process & Good Practice

  • Plan and implement SWM services and vector control measures in coordination with users, relevant agencies and authorities and potential or existing service providers P.9

  • Discuss and make community plans for the removal of debris, standing water (from rain or greywater) and solid waste around their location to protect themselves against vectors. 

  • Consider engaging expert advice on how to deal with waste, especially local experts who may understand the context and opportunities better. Ensure that the affected community is involved in the decision-making process and share information on community practices and psychosocial determinants.

  • Consider how solid waste can affect other areas of sanitation. For example, litter can clog storm-water channels, creating standing water and overflows leading to flooding. Solid waste thrown into pit latrines can hamper the desludging, process and reuse/dispose of the faecal sludge collected in the pits. 

  • Adapt behaviour change strategies (chapter  B ), frameworks and approaches (chapter  F ) to address SWM issues.

  • Advocate for and invest in staff. In many societies, working with waste is considered low status and can be stigmatised, although waste separation, recycling and reuse are highly skilled tasks. Communication (chapter  C ), Advocacy P.10 and investment in staff through training, protective clothing and equipment are important.

  • Identify ways to make waste recovery profitable if possible. Provide technical support as well as training and investment in business skills such as bookkeeping and marketing recycled or upcycled wastes if required.

  • Minimise the additional waste brought by a humanitarian intervention whenever possible and/or consider the additional waste management needs caused by the intervention e.g. hygiene kit packaging or the distribution of bottled water can create significant waste. This could also involve advocacy P.10 to other sectors (e.g. to avoid food delivery in single use containers)

  • Give particular consideration to the disposal of menstrual products P.7 in schools and other education facilities.

  • Identify mitigation measures for vector control and the spread of disease, including the use of long lasting insecticidal nets or curtains, fumigation and the spraying of insecticides, removal of solid waste, improvements to drainage and the elimination of standing water in or around homes. All these measures require Community Engagement (chapter  E ) to be effective.



To protect public health and the environment by interrupting the transmission of vector-borne diseases in the community, at health centres and in educational facilities. 


  • Solid waste management (SWM) plays an important role in humanitarian contexts to protect health and to reduce damage to the natural environment. It describes the separation of waste streams, waste reduction, up/recycling of waste and its safe disposal.

  • Health care waste has specific requirements for segregation, containment, treatment and disposal. Medical waste and by-products cover a diverse range of materials that must be managed safely to control infection and create a safe and healthy environment for patients, caregivers and personnel.

  • The incorrect treatment and disposal of liquid and solid waste can facilitate vector-borne diseases transmitted by vectors such as rats, flies and mosquitoes. The removal of solid waste will prevent the obstruction of drainage channels and protect the community against flooding.

  • Hygiene promoters can facilitate collaboration between affected populations and other WASH stakeholders to address various SWM issues.

  • There is evidence that when plastic waste breaks down into microplastics, they are ingested by animals and fish and pass into the food chain, affecting humans. Microplastics alter the physical and biological properties of soils and ultimately affect plants.

  • Human proximity to domestic (or wild) animals and birds and their faeces creates health risks. A ‘one health’ approach (which includes measures for the health of people, animals and the environment) should be adopted. 


Standards and indicators for SWM, HCWM and vector control

Sphere Association (2018): The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response 4th Edition

Practical guidelines for managing solid waste

IFRC (2020): Managing Solid Waste: Sector-Specific Guidelines for the Red Cross Red Crescent

Examples of waste recycling, reuse and upcycling of bio-waste

Zurbrügg, C. (2017): Biowaste Management: The Key to Sustainable Municipal Solid Waste Management, Eawag

WasteAid (undated): Projects

Information on medical and HCWM

Chartier, Y., Emmanuel, J. et al. (2014): Safe Management of Wastes from Health-Care Activities 2nd Edition, WHO

ACF (2017): Medical Waste Management for WASH Practitioners. Incinerators and Sharps Management

Guidance on how to respond to malaria outbreaks in emergencies

WHO (2013): Malaria Control in Humanitarian Emergencies

Malaria Consortium (2018): A Guide to Implementing the Community Dialogue Approach