In the health sector, environmental issues creating adverse impacts vary widely in nature. Of them Health Care Waste Management (HCWM) is considered to be one of the significant issues, although some other important issues like food safety, occupational health and safety, management of industrial carcinogens, indoor air pollution etc also deserve due attention. The objective of this report is to present a framework for improving HCWM in the country, the policy and legislative framework for HCWM in the country and related technical guidelines, evaluate HCWM practices, treatment and disposal technologies in use, provide an update of the achievements and gaps in the implementation of HCW systems (especially in view of the policy and national action plan prepared in 2001), present level of compliance with legal requirements and the presentation of an action plan for improving HCWM based on identified gaps. In addition, the report also provides safeguard requirements for managing impacts from civil works construction under the proposed 2nd HSDP.