In 2020, India produced 774 tons of biomedical waste per day. Additionally, large amounts of used, unused and infected medications, instruments, safety gear, and packaging materials are disposed of by individuals and healthcare centres. Safe disposal of healthcare waste is a concern as the special methods and technologies needed for it are not easily available. Public awareness and professional training regarding healthcare waste disposal is inadequate and funds for proper planning and implementation of effective waste management systems are not enough.
A ‘reduce-reuse-recycle’ approach, termed as circular economy model, helps avoid and mitigate pollution and environment damage which a ‘take-make-dispose’ approach is likely to cause. Though the effectiveness of the circular economy model is well-proven for efficient waste management and minimisation in the non-healthcare sector, it is not explored enough in the healthcare sector. Implementing it for healthcare waste management has its own challenges.
Dr. Anuj Dixit and Prof. Pankaj Dutta from the Shailesh J. Mehta School of Management, Indian Institute of Technology Bombay (IIT Bombay) carried out a study to identify the key factors for effective implementation of the circular economy model for healthcare waste management. Their research was published in the journal Clean Technologies and Environmental Policy.
The IIT Bombay researchers studied prior research related to the practices, factors and barriers in adopting circular economy models at different global locations in industries such as healthcare, medical devices, stainless-steel surgical instruments, plastic healthcare products and biomedical waste. Most of these were qualitative studies.
“Various existing qualitative studies recommended the need for quantitative research within the healthcare sector to gain more insights into adopting circular economy in the domain,” explained Dr. Anuj Dixit while highlighting the need for analytical studies.
The researchers collected data about how the participants of the survey rate the importance of various factors such as awareness and training about waste management, budget, use of technology, waste segregation/collection, responsibilities of various stakeholders among others. This data was gathered through an objective questionnaire survey from medical practitioners and other professionals from 54 healthcare organisations in India. The organisations included hospitals, nursing homes, healthcare waste recycling units, pathological laboratories, and pharmaceutical companies in the private and public sectors operational for a minimum ten years with a minimum annual revenue of ₹100 million, indicating growing organisations.
“Our major challenge was to select appropriate health organisations according to their type and nature of healthcare waste,” Prof. Pankaj Dutta reported.
The researchers used a combination of well-established statistical techniques called ANOVA, F-DEMATEL and ISM, which gave qualitative as well as quantitative insights. Combination of these methods help prioritise contributing factors in a system, provide actionable insights and help decision-making in the face of uncertainty. The researchers believe that the conclusions drawn from this study offer a deeper, more structured, and analytically rigorous understanding of complex systems compared to simple surveys.
They identified 17 relevant and adequate factors called ‘critical success factors’ (CSFs) under five broad areas of impact—research and development, education and social behaviour, economic facets, responsibility, and tracking mechanism—called ‘implication dimensions’, critical to success of a circular economy model in healthcare waste management. The CSFs denote the actual activities to which the efforts can be allocated, and they include factors related to estimation, design, training, awareness, budget, responsibility and transparency to name a few.
Based on their analysis, the researchers further categorised the CSFs as causal and effect factors to offer better direction in planning for the implementation. Twelve CSFs were identified in the causal group, while the remaining five were in the effect group. The identified factors were also ranked depending on their impact intensity which can help in prioritising effort allocation during policy making.
Factors such as ‘government's responsibility’ and ‘stakeholders' participation’ were found to have the highest driving potential, whereas ‘segregation and collection’, though considered critical, were found to depend on other causal CSFs. ‘Information visibility and transparency’, ‘manufacturer/corporate responsibility’, ‘training and empowerment’ and ‘budget allocation’ were the factors found to impact healthcare waste management most.
Considering case-specific implication dimensions based on the goals of the policies, the efforts can be focused on the required factors. The research findings can help policymakers and Government bodies to create practical and feasible plans to enhance the success of the ongoing efforts for sustainable healthcare waste management.
The researchers believe that although the results obtained are specific to India, they can be useful for other developing economies as well. Including more experts and policy makers in the survey can broaden and strengthen the results.
“It is also important that when the circular economy model reaches a satisfactory level of success, the critical success factors must be re-evaluated,” concludes Prof. Pankaj Dutta.
Note: The article has been edited to correct the author name. Error is regretted.