Background: The aim of healthcare services is to reduce health problems and to preventrnpotential health risks. On the other hand health facilities generate hazardous and nonrnhazardous waste that is potentially harmful to public health and the environment if notrnsegregated and dispose properly.rnObjective: To assess the waste generation rate and its management system in health centersrnof West Gojjam zone. .rnMethods: Cross-sectional study was employed to estimate waste generation rate and evaluaterntheir management system in health centers from March 2007 to April 2007. Ten health centersrnwere included in the study. Observational checklist, key informant interview and weightingrnscale were used to assess the management and to quantify the generation rate. Weighing ofrnhealthcare waste was done for eight days in each health center. Data collectors and supervisorrnwere recruited and trained. Training of data collectors and calibration of weighing scale withrnstandard weights were done during data collection to assure data quality. Data were compiledrnand analyzed with EPi Info version 6.04d & SPSS version 13.0.rnResults: The mean (Â±SD) healthcare waste generation rate was 1.79 Â±0.57 kg/day orrn0.035kg/patient/dayÂ±0.07, of which (52.0%) 0.93Â±0.3 kg/day was general or non-hazardousrnwaste and (48.0%) 0.86 Â± 0.33 kg/day was hazardous. The mean healthcare waste generationrnrate between health centers did not significantly vary with Kurskal-Wallis test (x2=8.105, pvalue=rn0.524). Only six health centers used safety boxes for collection of sharp wastes and allrnhealth centers used plastic buckets with out lid for collection of healthcare waste. Segregationrnof wastes and pre treatment of infectious wastes were not employed by any of the healthrncenters. Only four out of ten health centers used incinerators and the rest six health centersrnused open burning for disposal of healthcare wastes. All study health centers had placenta pitrnfor disposal of pathological waste however only three pits had proper covering material.rnTraining about healthcare waste management was not given for waste handlers and healthcarernworkers. Operational standards and healthcare waste management committee were not foundrnin any of the study health centers.rnConclusion and Recommendation: The mean healthcare waste was 0.035rnkg/patient/day or 1.79 kg/day per health center of HCW was generated. It is managed andrndisposed in manner that pose health risk to healthcare workers, waste handlers and thernviirncommunity in addition to contaminate the surrounding environment (air, soil and water).rnSegregation of wastes at point of generation with appropriate collected material and prerntreatment of infectious waste before disposal should be practiced. Training of healthcarernworkers and waste handlers should be given. Incinerators must be constructed in a mannerrnthat facilitates complete combustion and the lining of placenta pit should be constructed inrnwatertight material.