Trends and future directions in circular economy research for healthcare waste management: Feasibility, constraints and system-level implications

The healthcare sector generates large volumes of hazardous and non-recyclable waste.. In response to growing concerns over sustainability and resource efficiency, the circular economy (CE) has emerged as a promising framework for transforming healthcare waste management (HCWM). This review examines the application of CE strategies across the healthcare value chain, the methods used to evaluate them, and the structural constraints limiting their implementation. Following PRISMA 2020 guidelines, a comprehensive search was conducted across Scopus, PubMed, and Web of Science, yielding 4,835 records, of which 30 peer-reviewed articles published between 2015 and 2025 met the inclusion criteria. The selected studies were analyzed in terms of thematic focus, methodological approaches, CE strategies and contextual application. The results reveal a rapidly expanding but uneven body of literature, dominated by studies from high-income countries and largely focused on recycling and energy recovery. In contrast, the integration of CE principles at the healthcare system-level integration remains limited, particularly in low- and middle-income contexts, where policy support and implementation frameworks are weak. Bibliometric and trend analyses further indicate a recent shift towards digital tracking technologies, sustainable procurement, and extended producer responsibility. By interpreting CE strategies through the 10R value-retention hierarchy, this study identifies which circular strategies are realistically feasible under healthcare-specific constraints and highlights priority areas for future research and policy intervention.