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Primary Health Centre (PHC) known as Puskesmas is one of the first-tier of health facilities that serve as primary care providers and simultaneously drive the development vision of health. The government has regulated the availability of healthy environment and avoid any of its adverse effects as part of human rights in law number 36, 2009.1 Thus, regarding health care facilities, efficient medical waste disposal is pre-requisite in every health center including those located in rural area. Today, several PHC provide inpatient treatment services, especially which located in the rapidly developing area. Basic Health Research Data Ministry of Health RI reported that in Indonesia, there was 9792 health center which consists of 3,378 health centers with 121 996 inpatient beds in 2015.2 Health centers in Indonesia can be divided into two categories: urban and rural health centers. It could also categorize as inpatient and non-inpatient health center. PH with inpatient care is of particular importance because it produces a large amount of medical waste each year and, thus, need to be disposed of safely.3 PHC has its policy to implement environmental health programs to manage the medical waste disposal. Nevertheless, patient-oriented services and service quality management system are needed. A study in Nigeria stated that it is important to prepare medical waste management in every part of the region and ensure its continuity by formulating guidelines, regulatory policy, and governmental supports.4 Although medical waste management is usually problematic for larger health care institution such as a hospital, the development of the PHC by providing inpatient care also raise concern regarding the amount of medical waste it produced and the method to dispose of it. The condition of PHC in Indonesia and medical waste production is represented in Figure 1. The negative impact of medical waste in health centers that are not managed appropriately is very detrimental to the environment and the public. It is ranging from simple annoyance from the ash produced by installation to more serious health problem including infection by antibiotic resistant bacteria.5 The workers of the installation are ABSTRACT

Medical waste management strategy in the inpatient primary health care center with system approach: a SWOT Analysis