Background: Mismanagement of healthcare waste (HCW) during the COVID-19 pandemic can facilitate the transmission of coronavirus . Regarding this problem, there is gap of evidence in Ethiopia, and this study aimed to assess the HCW generation rate and management in Tepi General Hospital, southwest Ethiopia .

Methods: Institution-based cross-sectional and case studies were conducted . The total amount of waste generated and its type among various case teams were compared using the Kruskal-Wallis test . Spearman's rank correlation coefficient (r) was used to assess the correlation between the total numbers of patients and the total amount of HCW generated . Qualitative data were transcribed verbatim, translated to English, and analyzed with Open Code version 4.02 software, and content analysis was followed .

Results: The total mean weight (±SD) of waste generation rate in all service units of the hospital was 492.5 ± 11.5 kg/day . The higher proportion (61.9 %) of the total HCW produced was general waste and the remaining (38.1 %) was hazardous waste . There was a statistically significant (X 2 = 82.1, p <0.001) difference in daily HCW generation rate among different case teams . Similarly, the hospital waste generation amount and total patient flow had a strong positive linear relationship (r = 0.7, p=0.032). COVID-19-related medical wastes were not properly handled, segregated, stored, and disposed . There was a scarcity of resources needed to manage HCW, and available resources were utilized poorly . Overall, healthcare wastes were managed as usual (pre-COVID-19). Conclusion: The mean HCW generation rate in Tepi General Hospital was high . Overall, wastes were mismanaged, and COVID-19-related HCWs have been managed as usual . Availing of important resources and training the concerned bodies should be considered during the crisis of COVID-19.