Objectives To understand the collection and treatment facilities of medical waste and sewage in township hospitals in Hebei province, and to provide basis for guiding the establishment of environmental sanitation facilities in township hospitals.

Methods 40 township hospitals were sampled by multi-stage stratified random sampling method in Hebei province. Collection and treatment of medical waste and sewage in township hospitals were investigated in 2012 and 2018.

Results The medical wastes in township hospitals were equipped with collection facilities, and the first two places of medical wastes were infusion apparatuses and ampules. The first two sources of medical sewage were daily clean water and domestic sewage, and the main collection method was the flow into sewage pool. In 2012, the collection facilities of medical waste were sewage barrels and stacking points in 47.5% of township hospitals. The medical waste was disinfected before treatment in 60% of township hospitals and in-situ incineration at stacking points in 42.5% of township hospitals. The medical sewage was disinfected before treatment in 22.5% of township hospitals and discharged into infiltration wells in 57.5% of township hospitals. The average volume of sewage treatment pond was 16.3 m³. In 2018, the collection facilities of medical waste were covered sewage barrels and stacking points in 82.5% of township hospitals. The medical waste was disinfected before treatment in 67.5% of township hospitals. The medical sewage was disinfected before treatment in 62.5% of township hospitals and discharged into septic tank in 35% of township hospitals. The average volume of sewage treatment pond was 24 m³. Statistical analysis showed that in 2018, the production and pollution coefficient of medical waste in township hospitals were lower than those in 2012. In 2018, the proportion of township hospitals where medical waste was treated by professional institutions has increased. The disinfection rate and the satisfaction rate of the medical sewage treatment facilities in 2018 were higher than in 2012. There was no difference in the treatment method of medical sewage between the two surveys.

Conclusions The collection facilities, the disinfection before treatment, and the proportion of uniform treatment by professional institutions of medical waste and sewage should be increased in township hospitals.