Barriers to Sustainable Healthcare Waste Management: A Grey Method Approach for Barrier Ranking

Healthcare Waste Management (HCWM) is critical for public health and environmental sustainability. However, healthcare facilities face significant barriers to implementing sustainable HCWM practices, particularly in developing regions. Identifying and prioritizing these barriers is essential to developing practical solutions. This study aims to identify and rank barriers to sustainable HCWM using an integrated methodology. It seeks to provide actionable insights for policymakers and healthcare administrators to improve HCWM practices. The study employed a multi-method approach, combining a comprehensive literature review, expert consultations, and Grey Relational Analysis (GRA). The literature review identified 17 potential barriers across economic, social, technical, and regulatory dimensions. Eight experts from diverse sectors evaluated these barriers based on ten criteria. GRA was used to rank the barriers, and sensitivity analysis assessed the robustness of the rankings under varying parameters. The findings revealed that the most critical barriers include the lack of standardized guidelines and protocols, ineffective waste segregation, awareness and knowledge gaps, and inadequate training. Financial constraints and disposal infrastructure also ranked highly, highlighting systemic challenges in HCWM. Sensitivity analysis demonstrated that these rankings remained stable across varying conditions, affirming the robustness of the results. Addressing the prioritized barriers—mainly through policy standardization, enhanced training programs, and improved resource allocation—can significantly improve HCWM practices. This study underscores the need for a holistic approach integrating technical, social, and regulatory interventions to enhance sustainability in healthcare waste management.