Abstract:
The inadequate managementof healthcare waste (HCW) presents a serious environmental and public health risks in Bangladesh. The primary objective of this research work was to identify, and prioritizethe (a)barriers associated with the management of HCW, and (b) selection parameters that impact the choice of appropriate HCW treatment technology in the context of Bangladesh. The questionnaire survey of experts from HCW management and relevant organizations, and utilization of Fuzzy Delphi Method (FDM) has aided in identification, prioritization and ranking of twenty-three barriersfor HCW management and thirteen selection parametersfor HCW technology. The research indicates that the absence of large-scale investment in HCW management is the most important barrier in establishing proper HCW management in Bangladesh. A hierarchical cluster analysis (HCA) was used to understand the intricate relationships among the identified barriers and this results in three major clusters for barriers; Cluster 1 includes barriers from social sustainability, for example, ignorance about the hazards of HCW, current practice of HCW handling, and lack of interest, policy and enforcement; Cluster 2includes barriers which are related to operational sustainability, for example, inadequate legal framework, and lack of eco-friendly framework, and less interest from private HCF to adopt HCW management; and Cluster 3includes barriers representing financial sustainability, for example, absence of large scale investment, shortage of land and lack of tax benefit for treating HCW properly. Similarly, the research indicates that type of HCW treatment technology is the most important selection parameter for choosingHCW technology in local perspective. The HCA results in three major clusters for parameters; Cluster 1 includes those parameters which are related to amount of treated waste; Cluster 2 includes operational parameters of technology; and Cluster 3 includes those parameters which are related to the nature of the technology and institutional capacity building.Finally, the study proposes a conceptual policy framework for HCW management in Bangladesh encompassing the national development plan, rules and regulations to handle HCW, the national coordination body and key policy framework components such as infrastructure development, information dissemination, capacity building, monitoring enforcement, and legal matters. It is expected that this frameworkmay find its application to cope with barriers of HCW management in Bangladesh.
