Healthcare Waste Management Policy in a Lower-Middle-Income Country: A Case for the Adoption of the RADICAL Framework

Abstract

The COVID-19 pandemic raised the salience of Healthcare
Waste Management (HCWM). Various studies have shown
that the level of HCWM in lower-middle-income countries
falls below international standards and global best practice,
indicating that the national policy on HCWM is either nonexistent or has not been embedded in practice. The renewed
salience affords an opportunity to revisit, update and embed
the national policy on HCWM. In seizing this opportunity, the
elemental thinking must change from a linear model to the
complex adaptive model that takes account of the interrelationships and contextual factors that could impede or
facilitate implementation of the policy. These complexities
account for the ‘policy-implementation gap’ associated with
policy failure. This paper presents a framework that could be
applied in developing, implementing, and monitoring the
national HCWM policy in a lower-middle-income country.
The integrative framework, identified by the acronym
RADICAL, comprises the following domains in an integrated
grid: Raise awareness; Apply formal quality improvement
methods; Design for quality and safety: Involve stakeholders;
Collect and Analyse pertinent data; Learn from shared
experience. The pertinence of each domain to HCWM is
described.