HECAF 360 is not just about health care waste management. 

Our work in health care settings also extends to:

  • eliminating mercury-containing devices; 

  • instituting safe injection systems;  

  • planning and instituting renewable energy projects; 

  • promoting climate smart healthcare solutions; 

  • encouraging green building design; 

  • ensuring effective Water Sanitation, and Hygiene (WASH); 

  • building safe waste water treatment systems; 

  • implementing safer chemical substitution; 

  • safely managing pharmaceutical waste; 

  • safely disposing of menstrual sanitary waste; 

  • and advocating for sustainable green procurement.



Health Care Foundation Nepal (HECAF) is a national non-governmental and not-for-profit organization established in 1994. HECAF is registered in Kathmandu District Administration Office with the mandate to work in three areas: health care, environmental health and emergency medicine. 

The first major activity under HECAF was the establishment of a National Kidney Center in 1997 with the largest dialysis facility in Nepal; the only other establishment that offered dialysis services at that time was Bir Hospital which had very limited access. The main objective of the National Kidney Center was to increase accessibility and affordability of dialysis services to patients in need. Still the largest dialysis facility in the country, the Center has now expanded out of the capital city Kathmandu and has five satellite centers. 

While operating the Center, the health care waste generated was a major problem. Various solutions were explored. The commonly used options by hospitals in Nepal were incineration, open burning or dumping the waste into the municipal waste stream. HECAF determined that these options were all unsuitable because of serious environmental concerns as well as risk to public health. Thus, HECAF pioneered an optional health care waste management system that used non-burn technology: autoclaving infectious waste. This system of waste management was very successful and later replicated to other hospitals in the country in collaboration with WHO Nepal and the hospitals.

HECAF also works in the field of emergency medicine and offers training programs on emergency medical aid and hospital emergency preparedness to various hospitals.

Rationale for Health Care Waste Management Work


Health care waste is all the waste generated by health care facilities, medical laboratories and biomedical research facilities as well as waste from minor or scattered sources. The bulk of health care waste is produced by hospitals. Improper treatment and disposal of health care waste pose serious hazards of disease transmission due to exposures to infectious agents among waste pickers, waste workers, health workers, patients, and the community in general.

HECAF has played a leading role in bringing state-of-the-art health care waste management systems to Nepal. In 2007, WHO Nepal requested HECAF to share the experience of developing an environment-friendly waste management system in the National Kidney Center and replicating it in other hospitals and institutions. To date, HECAF has provided technical assistance to develop and replicate the system in Bir Hospital, National Government Hospital, Norvic International Hospital, Kathmandu Model Hospital, Tilganga Institute of Opthalmology, Paropakar Maternity Hospital, and Kathmandu Medical College and Teaching Hospital. Similar system is being replicated in Tribhuvan University Teaching Hospital. HECAF is working closely with WHO, Health Care Without Harm, FHI 360, GIZ, Shanti Med Nepal and others on issues of health care waste management. 

HECAF’s goal is to create a healthy society by properly managing infectious and hazardous waste generated from health care facilities and its potential hazards using environment-friendly, safe, local technology.

Key Competencies


Management of health care waste is a cross cutting issue. HECAF has built a team with a wide range of expertise in engineering, environmental science, public health, nursing and other areas. The HECAF team has extensive experience in health care waste assessment, system design and implementation, selection of proper technology for waste management, audits of waste management system and  training on waste management.

Capacity Statement


Under the Health Care Waste Management Program, HECAF offers various services on management of health care waste.

  • Conduct diagnostic assessment of health care waste management systems in health care facilities.

  • Design safe health care waste management systems for health care facilities.

  • Implement safe waste management systems in hospitals and small health care facilities (e.g. health centers and clinics)

  • Conduct trainings to medical and non-medical staff on safe health care waste management.

  • Monitor and evaluate established health care waste management systems in the health care facilities. 

  • Promote Green Hospital activities and help hospitals to be green and healthy

  • Provide academic support to students of various universities to conduct research related to health care waste management.  



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