The sound management of Health Care Waste (HCW) has been receiving increasing global attention, now even more so given the urgency of the COVID-19 pandemic. The spread of COVID-19 throughout Africa has significantly influenced the already overburdened Health Care Waste Management (HCWM) systems in many countries. A lack of infrastructure, inadequate budgets and capacity gaps make it difficult to achieve environmentally sound HCWM, which underscores the urgency of realising sustainable and inclusive HCWM systems and infrastructure in African countries, in order to improve resilience to health emergencies such as COVID-19 and mitigate impacts on development, the environment and society. This rapid assessment of HCWM in Ethiopia and Kenya, thus aims to identify gaps and propose strategic recommendations for a holistic approach to improving the sustainability of HCWM systems. It examines other policies and practices such as green procurement (environmentally preferable purchasing), green buildings (energy saving & renewable energy supply), green facility management (environmental management system) in the broader context of green health infrastructure in Africa. The scope of this report is thus focused on Health Care Waste (HCW) generated from Health Care Facilities (HCFs) and sustainable HCWM systems using the waste-management hierarchy, which is largely based on the concept of the 3Rs, namely reduce, reuse and recycle, and broadly relates to the sustainable use of resources. The report also considers broader sustainable infrastructure, and the use of locally acceptable best available technologies (BAT) and best environment practices (BEP), which in turn are expected to help minimize exposure to health risk and thus help promote public health and well-being and improve the ecosystem. Through undertaking this rapid assessment, consisting of (i) secondary data collection (literature review) and (ii) semi-structured interviews based on a questionnaire, strategic directions and recommendations were identified to improve HCWM in Ethiopia and Kenya, with connections to the wider region.