A comprehensive review on applications of multi-criteria decision-making methods in healthcare waste management

Effective management of healthcare waste (HCW) imposes a great challenge to all countries. Specially in the developing countries, it is often mixed with municipal waste, adversely affecting the health and safety of the medical personnel, general public and environment. Healthcare waste management (HCWM) basically deals with segregation, collection and storage, routing and transportation, treatment and safe disposal of HCW, while obeying some national legislation. In every stage of HCWM, there are several alternative choices/strategies to be evaluated against a set of conflicting criteria. Numerous multi-criteria decision-making (MCDM) methods have appeared to resolve the issue. This article reviews 101 articles available in Scopus and other scholarly databases on applications of MCDM techniques in solving HCWM problems. Those articles are classified into six groups: (a) selection of the most effective HCW treatment technology, (b) identification of the best HCW disposal site, (c) assessment of the best-performing healthcare unit adopting ideal HCWM strategies, (d) selection of third party logistics providers, (e) identification of HCWM barriers and (f) evaluation of specific HCWM plans. It is observed that the past researchers have mostly preferred to apply MCDM tools for solving HCW treatment technology selection problems, whereas analytic hierarchy process, decision-making trial and evaluation laboratory and best-worst method and fuzzy set theory have been the mostly favoured MCDM tool, criteria weight measurement techniques and uncertainty model, respectively. The outcomes of this article would help the healthcare personnel/policymakers in unveiling the current status of HCWM research, exploring extant research gaps and challenges and providing future directions leading to sustainable environment.