Healthcare Waste Management in Developing Countries: Challenges, Risks, and Solutions

Abstract

Healthcare waste management (HCWM) represents one of the most persistent yet underappreciated public health and environmental governance challenges in developing countries. Across low- and middle-income countries (LMICs), healthcare facilities continue to generate substantial quantities of hazardous, infectious, and pharmaceutical waste, much of which is inadequately segregated, poorly treated, and unsafely disposed of. This critical review synthesises peer-reviewed and authoritative institutional literature to examine the scale and composition of healthcare waste generation, the persistent policy and regulatory gaps that undermine effective management, the structural and operational challenges that impede implementation, and the resultant public health and environmental consequences. The literature search was conducted across the following databases: Web of Science, Scopus, PubMed, Google Scholar, Global Health (CAB International), EMBASE, LILACS (Latin American and Caribbean Health Sciences Literature), Africa Wide Information, WHO Global Health Library, and the Environmental Science and Pollution Research database administered by the European Environment Agency.  Evidence drawn from Sub-Saharan Africa, South and Southeast Asia, Latin America, and the Middle East and North Africa reveal a consistent pattern of institutional deficit: weak or absent national legislation, limited enforcement capacity, inadequate financial allocations, poorly maintained infrastructure, and insufficient healthcare worker training. Open burning, co-disposal with municipal waste, and direct environmental discharge remain commonplace practices that expose communities and healthcare workers to infectious diseases, chemical hazards, and dioxin-contaminated emissions. The COVID-19 pandemic has further exacerbated these challenges by substantially increasing the volume of infectious and plastic-based waste. This review identifies critical evidence gaps and provides a synthesis of policy-relevant recommendations, including the adoption of integrated HCWM plans, sustained capacity building, context-appropriate technologies, and enhanced international cooperation. The findings underscore the need for a paradigm shift that repositions healthcare waste management as a fundamental component of health system strengthening and environmental stewardship in developing countries.