STUDY OF WASTE MANAGEMENT ISSUES IN INDIAN HEALTHCARE SUPPLY CHAIN

Abstract

Healthcare Waste Management (HCWM) is now the key focus in the national health polices in many of the countries. The hazardous Medical Waste (MW) has become the big threat for the Government and Healthcare Facilities (HCFs), as it adversely affects the public and environment health. With increase in population and growing HCFs, the quantity of per capita Healthcare Waste (HCW) being generated is escalating day by day. HCW today poses grave challenges to hospitals and medical institutions, especially in developing nations, where MW is very often mixed with municipal waste, threatening the health and safety of the handling staff, general public and the environment. Due to these reasons, World Health Organization (WHO) and researchers over the past few years, have turned their attention to find effective ways to manage HCW. Although, tremendous efforts have been made by the environmental regulatory authority and waste handlers, but still they have not been successful to protect the environment from the health hazards caused by HCW. In countries like India, where there is huge population burden and also the resources are limited, the HCWM system is full of challenges and threats. Hence, there is a need to resolve the problems related to HCWM in India and provide the recommendations to the Government and other HCFs in order to improve the existing ineffective and inefficient HCWM strategies and standards. In this research work, a structured literature review has been conducted of all the articles published in eight related journals from 2005 to 2014, in order to identify the gaps in HCWM system in India. Also, the field surveys and brainstorming sessions were held with the experts, in order to finalize the objectives of the study. A model based on grey theory approach and Analytic Hierarchy Process (AHP) suggested that the HCFs in Uttarakhand, should go for outsourcing in order to lower the operational costs and meeting the environmental obligations. Another model based on, Analytic iv Network Process (ANP) and TOPSIS under grey environment had been developed to select the outsourcing partner. Furthermore, the generation rates and patterns of MW were analyzed from the sample collected from various HCFs. The barriers for implementation of HCWM system were assessed using Interpretive Structural Modeling (ISM) and Fuzzy-MICMAC analysis. This resulted into defining the key areas which must be focused in order to implement the effective and robust HCWM system in India. Subsequently, some hypotheses were formulated and questionnaire survey was done to collect the perception of the respondents on various issues of HCWM system. The main contributions of this research may be summarized as follows:  A model has been developed based on grey theory and AHP to select the best HCWD strategy.  A framework based on ANP and TOPSIS under grey environment has been developed to select the best outsourcing partner for disposing the HCW.  The generation patterns and composition of MW have been analyzed through MLR and ANN modeling techniques.  The barriers interrelationships have been analyzed through ISM methodology.  The barriers of implementing HCWM system in India have been classified into four groups using Fuzzy-MICMAC analysis.  The hypotheses related to: importance, objectives, enablers and barriers of implementing HCWM system in India have been tested empirically