Health care waste management is undoubtedly an important element in healthcare. Proper health care waste management helps in promoting safety of health workers and waste handlers through the elimination of occupational hazards. Considering that part of the waste produced by health facilities can be hazardous, there is a dire need for all health facilities to comply to the stipulated healthcare waste management policies and guidelines. Kenya and other countries in Africa lag in implementing these policies and guidelines developed from the guide of World Health Organization (WHO). This implies that although many countries have the right policies and guidelines, weak health care waste management systems, challenges in financing and lack of the leadership’s goodwill have slowed down the implementation of the same. In this cross-sectional study, four health facilities in Machakos Sub County in Machakos County, Kenya were assessed to aid in meeting five main research objectives related to health care waste management: determining health workers’ training in HCWM, evaluating health workers’ knowledge in HCWM, assessing HCWM practices, investigating occupational health & safety measures in relation to HCWM and assessing financial aspects linked to HCWM. The health facilities involved in the study were Machakos Level 5, Bishop Kioko Level 4, Mutituni Level 3 and Katumani Level 2. Questionnaires were administered to medical specialists, medical officers, clinical officers, nurses and laboratory technicians (n=281). The findings of the study indicated that Machakos County has not invested significantly in proper HCWM as evidenced by the low level of training at a score of 37.1%, fair knowledge at a score of 50.72%, poor HCWM practices score of 25.8%, health workers fair occupational health & safety score of 65.0% and very poor financial aspect of HCWM score of 0%. The aggregate score on HCWM compliance was poor at 35.7%. In conclusion, there was poor compliance to the guidelines given in the National Health Care Waste Management Plan of 2008-2012 with surprising low score in financial aspects linked to HCWM noted in all health facilities in this study.

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