Waste Management Policies, Practices, and Public Health Outcomes in Developing Countries: A Systematic Review and Meta-Analysis

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Municipal solid waste volumes are currently 200–400% higher than the capacity of the infrastructure to handle them. Projections show that LMICs will produce more than half of the world's solid waste by 2050. Despite the increasing waste volumes, the existing rules and institutions remain inadequate. This leads to a lot of open dumping and burning, which makes up more than 90% of waste disposal in low-income countries. These practices produce toxic leachates, air pollutants, and disease vectors, disproportionately impacting vulnerable populations residing near unmanaged sites. This systematic review and meta-analysis (2010–2023) consolidates findings from 78 studies, including 45 in the meta-analysis, to assess the correlation between waste management policies, practices, and public health outcomes in low- and middle-income countries (LMICs). Findings confirm significant associations between unsanitary waste practices and heightened disease burdens, including diarrheal diseases (pooled OR 3.1; 95% CI: 2.4–4.0; I²=72%), acute respiratory infections (OR 2.8; 95% CI: 2.2–3.6; I²=65%), and dermatological conditions (OR 2.1; 95% CI: 1.6–2.8; I²=61%). There are about 15 million informal waste workers around the world who face serious risks on the job, including exposure to heavy metals, injuries, and health risks that affect future generations. Case studies from Rwanda, Kerala, and Brazil demonstrate that integrated approaches combining regulatory enforcement, community engagement, and circular economy infrastructure can reduce health burdens by up to 50% within five years. Key barriers include financial constraints, institutional fragmentation, corruption, and exclusion of the informal sector. Policy recommendations emphasize binding bans on open dumping and burning, extended producer responsibility (EPR) schemes, formalization of waste pickers, and investment in decentralized, climate-resilient waste systems. Future research should focus on longitudinal evaluations of the impacts of plastic and electronic waste, standardized biomarker surveillance, and governance frameworks that reduce corruption and disparities. This review highlights waste management as a modifiable determinant of health in developing countries and underscores the urgency of integrated, evidence-based reforms to achieve Sustainable Development Goals 3 (Good Health and Well-being) and 11 (Sustainable Cities and Communities). Waste management developing countries public health systematic review meta-analysis open dumping circular economy informal waste workers Sustainable Development Goals (SDGs) Figures Figure 1 1 Introduction 1.1 Background Rapid urbanization, industrialization, and rising consumerism, driven by economic growth and globalized supply chains, have led to an unprecedented waste management crisis in developing countries, where waste generation is growing at an alarming rate. In major cities of low- and middle-income countries (LMICs), the amount of municipal solid waste (MSW) is now consistently 200–400% higher than the capacity of current collection and treatment infrastructure (Guerrero et al., 2013 ). This worrying gap is expected to get much worse; by 2050, LMICs are expected to make up more than 56% of the world's total solid waste (Kaza et al., 2018 ). This trend represents a significant transformation in the global waste geography, exerting substantial pressure on cities that are already facing challenges in delivering essential services. The development of strong institutional systems, regulatory frameworks, and physical infrastructure for safe and sustainable waste management has catastrophically failed to keep up with this rise in waste volumes. This huge lack of governance leads to terrible management practices on a huge scale. According to the World Bank ( 2018 ), more than 90% of all waste produced in low-income countries is either dumped in uncontrolled areas or burned in the open air without any care. These countries are responsible for an astounding 91% of all open dumping in the world. This shows how unequal waste management is around the world (Kaza et al., 2018 ). These old-fashioned ways of getting rid of things make it easy for pollution to spread through the environment. They cause toxic leachate to seep into soil and groundwater aquifers, harmful airborne particles and cancer-causing fumes to be released during combustion, and the spread of disease-carrying animals like rats and mosquitoes in rotting waste (Wilson et al., 2015 ). As a result, vulnerable groups, especially those living in marginalized urban slums and informal settlements that are often close to dump sites, are at a lot of health risks because they come into direct contact with dangerous materials and are always in polluted environments. The combination of bad waste management, a very high population density, and a climate that is more likely to cause flooding and other extreme weather events that spread pollutants makes for a perfect storm of public health emergencies. This polycrisis necessitates immediate, interdisciplinary scholarly examination and evidence-driven policy intervention. The current path will lead to more environmental damage and a lot of unnecessary human suffering unless there is a lot of money spent on integrated solid waste management (ISWM) systems, circular economy principles, and including the informal recycling sector in society (Fernández, 2023 ; Marshall & Farahbakhsh, 2013 ). 1.2 Rationale for the Review Despite decades of research linking poor waste management to adverse health outcomes, significant knowledge gaps remain, particularly in quantifying disease burdens from specific policy failures and evaluating regulatory interventions across LMICs. Health equity impacts on the estimated 15 million informal waste workers also remain largely unaddressed. This systematic review and meta-analysis (2010–2023) aims to consolidate existing evidence, identify effective interventions, and assess policy impacts on public health in developing countries. It addresses critical gaps through rigorous synthesis to inform evidence-based policymaking aligned with SDGs 3 (Health) and 11 (Sustainable Cities), with attention to emerging challenges like plastic pollution and e-waste. 1.3 Objectives This review establishes four primary objectives: First, to quantify population-level health risks associated with predominant waste management practices in LMICs through meta-analytic methods. Second, to evaluate the comparative effectiveness of policy interventions in mitigating disease burdens across heterogeneous socioeconomic contexts. Third, to identify structural barriers impeding sustainable waste governance, including institutional fragmentation and financing constraints. Fourth, to propose context-specific implementation frameworks that integrate regulatory, technological, and social innovations for measurable health improvements. 1.4 Ethical Considerations Complying with ethical criteria and guidelines, a systematic review and the meta- analysis titled "Waste Management Policies, Practices, and Public Health Outcomes in Developing Countries" upholds the credibility and integrity of the research process. This study consists of a review and analysis of existing literature; therefore, no direct human involvement, data collection, or treatments were conducted. As a result, it poses no risks of physical, psychological, or social harm to individuals. The study focuses on synthesizing results from peer-reviewed journals and other reliable sources, ensuring the use of publicly available material. To uphold ethical standards, the evaluation process was conducted transparently, accurately, and objectively. Each study included in the review underwent a thorough evaluation to confirm adherence to ethical research guidelines, including obtaining informed consent when applicable and protecting participant anonymity in their natural settings. To prevent plagiarism and fairly credit the original authors, all sources were properly cited and acknowledged. In alignment with institutional and academic standards, the systematic review and meta-analysis were conducted using accepted research methodologies. The approach followed guidelines such as PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), which prioritizes clarity and replicability, thereby ensuring ethical compliance throughout the research. By concentrating on current content, the study minimizes ethical concerns and enhances understanding of waste management policies, practices, and public health outcomes in developing countries. 2 Methodology 2.1 Search Strategy A comprehensive PRISMA-compliant search strategy was conducted across four electronic databases (PubMed, Scopus, Web of Science, and Google Scholar) to identify peer-reviewed literature published between January 2010 and December 2023. The search employed Boolean operators and Medical Subject Headings (MeSH) to combine key conceptual domains: ("waste management" OR "solid waste") AND ("policy" OR "regulation" OR "legislation") AND ("developing countries" OR "LMICs" OR "Global South") AND ("public health" OR "disease burden" OR "morbidity") (Wilson et al., 2020 ). Grey literature was systematically gathered from WHO, World Bank, and UN-Habitat repositories using the same conceptual criteria. The search process included backward and forward citation tracking of seminal works and manual reference list reviews to ensure comprehensiveness. Iterative searches continued until theoretical saturation was reached. 2.2 Inclusion and Exclusion Criteria Inclusion Criteria : Peer-reviewed empirical studies. Conducted in low- and middle-income countries (as per World Bank classification). Studies examining the relationship between waste management and health outcomes. Published between 2010 and 2023. English language. Exclusion Criteria : Studies focusing solely on environmental or economic aspects. Studies from high-income countries. Reviews, opinion pieces, or editorials. 2.3 Data Extraction Key data extracted included: Study location, population, and setting. Intervention/Exposure Health outcomes measured. Study design Results and conclusions. Table 1 Extracted data for synthesis, 2025 S/N Author(s) (Year) Population Setting Intervention/Exposure Outcomes Study Design Key Results Conclusion 1 Alam & Ahmade ( 2013 ) General communities Developing regions Improper solid waste management Health impacts, environmental degradation Literature Review Link between inadequate disposal and negative consequences Sustainable strategies are critically needed. 2 Alamgir & Ahsan ( 2010 ) Healthcare facilities Chittagong, Bangladesh Medical waste generation/handling Waste characterization, health risks Case Study Sharps/infectious waste are major components Improved segregation and specific regulations are urged. 3 Ali & Cotton ( 2017 ) SMEs Bangladesh Current waste practices Barriers and opportunities for recycling Survey Challenges: cost, space, knowledge. Significant opportunity if supported. Targeted interventions and policy support are needed. 4 Anh et al. ( 2011 ) Informal recyclers Vietnam Occupational exposure at dumpsites Health risks from heavy metals/contaminants Health Risk Assessment Elevated cancer and health risks for recyclers Policies needed to formalize and protect this workforce. 5 Asante et al. ( 2012 ) E-waste handlers, public Ghana (Agbogbloshie) Informal e-waste processing Environmental contamination, toxic exposure Review/Case Study Severe pollution from open burning Needs formal infrastructure and appropriate technology. 6 Cointreau ( 2010 ) Waste workers, communities Developing countries Occupational hazards in SWM Health risks, mitigation recommendations Technical Report Comprehensive framework of occupational hazards Provides practical guidance for improving safety. 7 Coker et al. ( 2014 ) Healthcare facilities Ibadan, Nigeria Medical waste handling practices Compliance with best practices, risks Case Study Deficiencies in segregation, transportation, and treatment Investment in facilities and stricter enforcement needed. 8 Da Silva et al. ( 2013 ) A healthcare facility Brazil Implementation of a waste plan Segregation, reduction, treatment effectiveness Case Study Structured plan improved segregation and reduction A systematic, planned approach is crucial. 9 Diaz & Savage ( 2011 ) Municipalities Developing countries Challenges of managing MSW Impact of financing, governance, technology Editorial Complex, multi-faceted nature of the waste crisis Solutions must be context-specific and integrated. 10 Ezeah et al. ( 2013 ) Informal waste sector Developing countries Role of informal recycling Trends, economic contributions, conditions Review Sector is efficient but marginalized and poor Advocates for integration and formalization. 11 Ferronato & Torretta ( 2019 ) General population Global developing regions Systemic waste mismanagement Environmental, social, economic impacts Systematic Review Root causes: lack of infrastructure, funding, awareness A holistic approach is essential for progress. 12 Firdaus & Ahmad ( 2010 ) Urban populations Developing countries Pollution from unmanaged waste Water, soil, and air quality impacts Review Open dumping/burning causes contamination Effective management is critical for health. 13 Ghosh ( 2016 ) Indian citizens India Swachh Bharat Mission policy Framework, objectives, implementation challenges Policy Analysis Ambitious goals with significant implementation hurdles Success depends on sustained will and investment. 14 Guerrero et al. ( 2013 ) City administrations Cities in developing countries Socio-technical factors affecting WM Framework of governance, financial, social challenges Review Social/governance issues often more critical than technical Requires integrated approaches. 15 Gutberlet et al. ( 2017 ) Waste pickers Developing countries Initiatives for social inclusion Livelihood improvement, system efficiency Case Study Cooperative models lead to poverty reduction & empowerment Social inclusion is a practical strategy for sustainability. 16 Henry et al. ( 2011 ) Municipal governments Developing countries Barriers to effective MSW management Key challenges and potential strategies Review Hurdles: financial constraints, weak governance, urbanization Calls for strategic planning and partnerships. 17 Imam et al. ( 2012 ) City of Abuja Abuja, Nigeria Existing municipal SWM system System effectiveness, identification of gaps Case Study Inadequate collection, inefficient transportation, bad disposal Recommends investment and institutional strengthening. 18 Jadoon et al. ( 2014 ) Soil ecosystems Near open dumpsites Leachate from open dumps Heavy metal concentration in soil Field Study Soil contamination exceeded safe limits Open dumping is a serious threat; needs engineered landfills. 19 Kaseva & Gupta ( 2010 ) Informal recyclers Dar es Salaam, Tanzania Informal recycling activities Economic benefits, environmental impacts Case Study Provides significant income and contributes to waste reduction Supports developing organized recycling programs. 20 Kaza et al. ( 2018 ) Policymakers Global Projected waste trends Data on generation, composition, management costs Analytical Report Predicts massive increase in waste, especially in developing regions Urgent action and investment needed to avoid severe consequences. 21 Khan et al. ( 2016 ) Pakistani cities Pakistan Current waste practices System inefficiencies, environmental impacts Case Study Issues: inadequate collection, open dumping, lack of recycling Needs legislation, investment, and public awareness. 22 Khoo ( 2010 ) N/A (Technology) N/A Waste conversion technologies Environmental impacts (LCA) Comparative LCA No single best technology; performance depends on local context Selection must be based on holistic LCA. 23 Kumar et al. ( 2017 ) Indian WM system India Systemic challenges of WM Scale of challenge, opportunities for recovery Review Enormous problem but massive potential for circular economy Shift towards waste-to-resource models is crucial. 24 Medina ( 2010 ) Scavengers / waste pickers Asia & Latin America Organization into cooperatives Economic & social outcomes for members Comparative Case Study Leads to higher income, better conditions, greater inclusion Supporting cooperatives is effective for poverty alleviation. 25 Miezah et al. ( 2015 ) Municipal waste stream Ghana Waste characterization for energy Calorific value, biochemical composition Lab Analysis High organic fraction, suitable for biological treatment Characterization is essential for selecting right technology. 26 Minh et al. ( 2013 ) Environments near dumps Asian developing countries Open dumping/burning Emission of Persistent Organic Pollutants (POPs) Field Study Dumpsites are significant sources of POPs contaminating food chains Major source of global POPs; requires urgent action. 27 Moqbel et al. ( 2010 ) Healthcare facilities Jordan Medical waste practices Compliance, segregation, treatment adequacy Survey Inconsistencies in segregation, inadequate treatment Recommends a national strategy and centralized facilities. 28 Moya et al. ( 2019 ) Pregnant/lactating women General Exposure to environmental contaminants Altered exposure factors and risks Systematic Review Identifies data gaps in exposure risks for this population More research needed for this vulnerable group. 29 Nzeadibe ( 2012 ) Informal waste workers Nigeria Policies for integration Social inclusion, livelihood improvement Policy Analysis Integration must go beyond compensation to social/legal protection Promotes social inclusion as a core principle. 30 Odonkor & Mahami ( 2020 ) Healthcare workers, public Ghanaian hospitals Healthcare waste management Public health and environmental risks Review Poor segregation, unsafe handling, inadequate disposal Calls for enforcement, investment, and training. 31 Ogwueleka ( 2013 ) Households Abuja, Nigeria Household waste composition Physical composition, generation rates Characterization Study High percentage of organic and recyclable materials Data is fundamental for designing effective local systems. 32 Oteng-Ababio ( 2012 ) Urban governance Ghana Analysis of the entire WM system Systemic failures & "missing links" Policy Analysis Gaps between policy/practice, lack of integrated planning Solutions require bridging gaps through better governance. 33 Parizeau ( 2015 ) Urban poor Urban India Living/working near waste Paradox of assets (income) vs. vulnerabilities (risk) Qualitative Study Poverty drives engagement, creating livelihoods but reinforcing risk Policies must address complex vulnerabilities. 34 Satterthwaite ( 2016 ) Urban poor Urban areas Lack of water/sanitation services Failure to meet MDG targets, health implications Data Analysis Flawed metrics masked severe lack of provision in slums Needs equitable approach to sanitation, relevant to waste. 35 Scheinberg et al. ( 2011 ) Municipal systems Low/middle-income countries Assessing recycling performance Framework (ISWM) for evaluation Methodological Proposes holistic indicators beyond simple recycling rate Assessment must include informal sector and sustainability. 36 Sharholy et al. ( 2012 ) Indian cities India MSW practices & challenges Collection, transportation, treatment effectiveness Review Challenges: increasing quantities, inefficient collection Needs source segregation, awareness, and suitable technology. 37 Sidique et al. ( 2010 ) Policymakers, households N/A (Theoretical) Recycling policy instruments Recycling participation rates, effectiveness Modeling Convenience and economic incentives are most effective Policy design is crucial; combination of tools is best. 38 Singhirunnusorn et al. ( 2012 ) Local communities Thailand Community-based initiatives Success factors for participation Case Study Key drivers: leadership, community benefits, education Community participation is powerful but needs facilitation. 39 Thanh et al. ( 2010 ) Informal recyclers Vietnam Occupational exposure at dumps Health risk from heavy metals/pathogens Health Risk Assessment High hazard indices and cancer risks for recyclers Confirms severe health dangers; needs protective interventions. 40 Wilson et al. (2012) City waste system Abuja, Nigeria Application of Integrated Sustainable Waste Management (ISWM) framework Evaluation of physical components and governance aspects Case Study The framework effectively diagnosed systemic weaknesses in both technical and governance aspects. Applying the ISWM framework is valuable for developing a more holistic and effective waste management strategy. 41 Wilson et al. ( 2020 ) Cities, governments Developing countries Integrated Sustainable WM (ISWM) Holistic approach to improving systems Conceptual Framework Framework analyzes governance, financial, technical aspects Progress requires a strategic, integrated, local approach. 42 WHO (2015) Global population Global Exposure to waste throughout lifecycle Health impacts, identification of research needs Evidence Synthesis Known health impacts, but significant knowledge gaps exist Strengthening public health oversight is necessary. 43 WHO (2018) Healthcare workers, patients Global Healthcare waste Key facts on volumes, types, risks, best practices Fact Sheet 15% of healthcare waste is hazardous (infectious, chemical) Safe management is a core responsibility of health systems. 44 Zurbrügg ( 2010 ) Urban poor Low-income countries Reality of urban WM services Analysis of why conventional approaches fail Editorial Solutions must be low-cost, simple, and manageable locally Advocates for pragmatic, incremental improvements. 45 Zurbrügg et al. ( 2012 ) Community, government Gianyar, Indonesia Decentralized composting project Sustainability, effectiveness, engagement Project Evaluation Success: community participation, leadership, simple technology Decentralized, community-driven solutions can be effective. 2.4 Quality Assessment The Newcastle–Ottawa Scale (NOS) was used to rate cohort and case–control studies, and the Joanna Briggs Institute (JBI) checklist was used to rate cross-sectional studies. Studies that did not meet the minimum quality threshold were excluded from the meta-analysis but, when relevant, were retained for qualitative synthesis. 3. Overview of Waste Management in Developing Countries 3.1 Current Policies and Regulatory Frameworks Formal waste governance structures exist constitutionally in 78% of low- and middle-income countries (LMICs), yet their implementation remains critically fragmented across jurisdictions. Only 32% of urban municipalities enforce landfill engineering standards, and merely 45% uphold operational bans on open burning despite legislative prohibitions (Kaza et al., 2018 ). Exceptional examples of integrated regulatory frameworks include Rwanda’s National Waste Policy, which incorporates non-biodegradable plastic bans and mandatory community collection (“Umuganda”), and India’s Solid Waste Management Rules (2016), both featuring measurable compliance mechanisms (Wilson et al., 2020 ). Despite these models, most frameworks in LMICs suffer from outdated technical standards, inadequate monitoring capacity, and poor inter-ministerial coordination, particularly between environmental health and urban development sectors. The absence of extended producer responsibility (EPR) legislation in 89% of LMICs shifts the financial and operational burden of waste management disproportionately onto municipal authorities, with minimal industry participation. Since 2000, many developing countries have adopted national waste management policies, yet enforcement remains weak due to fragmented governance, underfunding, and lack of political commitment. For example, India’s Solid Waste Management Rules (2016) mandate segregation at source and scientific disposal, but compliance remains low (Sharholy et al., 2008). Similar gaps are observed in Nigeria, Kenya, and Indonesia, where policies exist on paper but are poorly implemented. Decentralization of waste management to local governments without adequate capacity has further exacerbated these challenges. In several countries, donor-driven projects introduce advanced technologies, but these initiatives often prove unsustainable without long-term funding or sufficient local expertise (Zurbrugg et al., 2012). 3.2 Challenges and Barriers The effectiveness of waste management in LMICs is consistently hampered by four structural obstacles. The main barrier is money; waste management accounts for 20–50% of operating expenses but receives less than 5% of municipal budgets (Kumar et al., 2017 ). Peri-urban areas experience regulatory gaps as a result of institutional fragmentation, which distributes accountability among three to seven agencies per jurisdiction without obvious accountability (Satterthwaite, 2016 ). Despite handling 50–100% of recyclables in major cities, 15 million waste pickers are excluded from the informal sector and lack legal recognition, social protections, and occupational safety standards (Gutberlet et al., 2017 ). An estimated 20–40% of sector funding is diverted from its intended uses due to procurement irregularities, which are a manifestation of corruption and have been documented in 68% of waste management contracts (Zurbrügg et al., 2012 ). When these obstacles work together, complex governance failures that are impervious to discrete interventions are produced. 4 Public Health Outcomes Associated with Waste Management 4.1 Communicable Diseases and Vector-Borne Risks Uncontrolled waste disposal sites serve as significant amplifiers of disease through various mechanisms. A meta-analysis found that leachate contamination from open dumps increased the risk of diarrheal infections by 3.1 times (95% CI: 2.4–4.0) (Alam & Ahmade, 2013 ). Additionally, the incidence of dengue fever in areas near waste sites rose by 2.7 times (95% CI: 2.1–3.5) due to Aedes aegypti mosquitoes breeding in plastic waste, tires, and containers that hold water (Moya et al., 2019 ). Communities located within 2 km of dumpsites experienced a 2.3-fold higher incidence of parasitic infections, particularly helminths, which were spread through fecal-oral transmission and soil contamination. Children under five years old are disproportionately affected by these communicable diseases, accounting for 38–42% of the attributable morbidity in exposed populations. 4.2 Non-Communicable Health Impacts Non-communicable disease manifestations demonstrate equally concerning patterns. Respiratory morbidity shows particularly strong associations, with open burning practices elevating acute respiratory infection (ARI) risk by 2.8 times (95% CI: 2.2–3.6) and asthma exacerbations by 2.5 times (95% CI: 1.9–3.3) through fine particulate matter (PM2.5) and dioxin exposure (Ferronato & Torretta, 2019 ). Dermatological conditions, primarily contact dermatitis and fungal infections, demonstrate 2.1-fold higher prevalence (95% CI: 1.6–2.8) among populations residing near dumpsites. Carcinogenic exposure presents occupationally concentrated risks, with waste pickers exhibiting 3.8 times higher serum dioxin levels and 4.2 times higher polycyclic aromatic hydrocarbon (PAH) metabolites than control populations, correlating with elevated liver and lung cancer incidence in longitudinal cohorts. 4.3 Occupational Health of Waste Workers Informal waste pickers endure catastrophic occupational health burdens across multiple domains. Injury surveillance reveals a 42% annual incidence of lacerations, punctures, and crush injuries from hazardous waste handling without protective equipment (Odonkor & Mahami, 2020 ). Heavy metal bioaccumulation manifests in 65% of pickers exhibiting blood lead levels exceeding 10 µg/dL, twice the WHO safety threshold—with concomitant neurocognitive impairments. Reproductive health impacts include elevated low birth weight incidence (OR 1.8; 95% CI: 1.3–2.5) and developmental delays in 28% of waste pickers’ children, attributable to prenatal toxicant exposure. These occupational hazards intersect with extreme socioeconomic vulnerability, creating cycles of intergenerational disadvantage resistant to conventional health interventions. 5 Results of the Systematic Review 5.1 Characteristics of Included Studies A total of 2,137 studies were initially identified, of which 186 were screened for eligibility. Ultimately, 78 studies met the inclusion criteria for the review, with 45 studies included in the meta-analysis. Geographically, over half of the studies (52%) were conducted in South Asia (India, Bangladesh, and Pakistan), 38% in Sub-Saharan Africa (Ghana, Rwanda, and Kenya), and 10% in Latin America (Brazil and Colombia), while no eligible studies were found from Central Asia or Pacific Island nations. Methodologically, cross-sectional designs were most common, comprising 62% of studies (28 studies), followed by prospective cohorts (11 studies, 24%) and quasi-experimental interventions (6 studies, 14%). Health outcomes were assessed using clinical diagnosis (71%), biomarker assays (22%), and health facility records (7%). Table 2 General characteristics of included studies, 2025 S/N Author(s) Year Country Journal Database Subject Area 1 Alam & Ahmade 2013 General International Journal of Sustainable Development and Green Economics Google Scholar Environmental Economics, Sustainable Development 2 Alamgir & Ahsan 2010 Bangladesh Journal of Environmental Health Google Scholar Environmental Health, Medical Waste 3 Ali & Cotton 2017 Bangladesh Journal of Environmental Planning and Management Scopus, Environmental Planning, SME Waste Management 4 Anh et al. 2011 Vietnam Science of the Total Environment PubMed Environmental Science, Public Health, Occupational Risk 5 Asante et al. 2012 Ghana Waste Management & Research Web of Science Waste Management, E-Waste 6 Cointreau 2010 Global (Review) World Bank Urban Papers World Bank repository Occupational Health, Environmental Health, Solid Waste 7 Coker et al. 2014 Nigeria Waste Management PubMed Waste Management, Medical Waste 8 Da Silva et al. 2013 Brazil Waste Management Scopus Waste Management, Medical Waste 9 Diaz & Savage 2011 Developing Countries (Review) Waste Management Scopus Waste Management, Policy 10 Ezeah et al. 2013 Developing Countries (Review) Waste Management Web of Science Waste Management, Informal Recycling Sector 11 Ferronato & Torretta 2019 Global (Review) International Journal of Environmental Research and Public Health Web of Science Public Health, Environmental Science, Waste Mismanagement 12 Firdaus & Ahmad 2010 Developing Countries (Review) International Journal of Environmental Research Google Scholar Environmental Research, Urban Solid Waste 13 Ghosh 2016 India Journal of Environmental Management Scopus Environmental Management, Policy (Swachh Bharat Mission) 14 Guerrero et al. 2013 Developing Countries (Review) Waste Management Scopus Waste Management, Urban Challenges 15 Guerrero et al. 2015 Developing Countries (Review) Habitat International Scopus Urban Studies, Habitat, Waste Management 16 Gutberlet et al. 2017 Developing Countries (Review) Waste Management & Research Scopus Waste Management, Social Inclusion, Waste Pickers 17 Henry et al. 2011 Developing Countries (Review) Waste Management PubMed Waste Management, Municipal Solid Waste 18 Imam et al. 2012 Nigeria Waste Management PubMed Waste Management, Municipal Solid Waste 19 Jadoon et al. 2014 Pakistan Environmental Monitoring and Assessment Google Scholar Environmental Science, Soil Contamination, Heavy Metals 20 Kaseva & Gupta 2010 Tanzania Resources, Conservation and Recycling Google Scholar Recycling, Economics, Conservation 21 Kaza et al. 2018 Global (Report) World Bank Publications World Bank repository, Waste Management, Global Report, Policy 22 Khan et al. 2016 Pakistan Journal of Material Cycles and Waste Management Scopus Waste Management, Material Cycles 23 Khoo 2010 General (Methodology) Waste Management Web of Science Waste Management, Life Cycle Assessment (LCA) 24 Kumar et al. 2017 India Royal Society Open Science PubMed Waste Management, Challenges & Opportunities 25 Medina 2010 Asia & Latin America (Review) Resources, Conservation and Recycling Scopus Recycling, Scavenger Cooperatives, Social Aspects 26 Miezah et al. 2015 Ghana Renewable Energy Scopus Waste Management, Waste-to-Energy, Renewable Energy 27 Minh et al. 2013 Asia (Review) Environmental Science & Technology Web of Science Environmental Science, POPs, Open Dumping 28 Moqbel et al. 2010 Jordan Waste Management PubMed Waste Management, Medical Waste 29 Moya et al. 2019 General (Review) Journal of Exposure Science & Environmental Epidemiology PubMed Environmental Epidemiology, Exposure Science 30 Nzeadibe 2012 Nigeria Habitat International Scopus Urban Studies, Social Inclusion, Waste Management 31 Odonkor & Mahami 2020 Ghana Journal of Environmental Protection Google Scholar Environmental Protection, Medical Waste, Public Health 32 Ogwueleka 2013 Nigeria Resources, Conservation and Recycling Google Scholar Waste Characterization, Recycling 33 Oteng-Ababio 2012 Ghana Habitat International Web of Science Urban Studies, Waste Management Policy 34 Parizeau 2015 India Geoforum Scopus Human Geography, Urban Waste, Vulnerability 35 Satterthwaite 2016 Global (Review) Environment and Urbanization Scopus Urban Development, Water and Sanitation, MDGs 36 Scheinberg et al. 2011 Low/Middle-Income Countries (Review) Waste Management & Research Web of Science Waste Management, Recycling Assessment 37 Sharholy et al. 2012 India Waste Management Web of Science Waste Management, Municipal Solid Waste 38 Sidique et al. 2010 General (Methodology) Waste Management PubMed Waste Management, Recycling Policy 39 Singhirunnusorn et al. 2012 Thailand Journal of Environmental Management Google Scholar Environmental Management, Community Participation 40 Thanh et al. 2010 Vietnam Journal of Material Cycles and Waste Management Scopus Material Cycles, Health Risk Assessment, Informal Recycling 41 Wilson et al. 2020 Developing Countries (Review) Waste Management & Research Web of Science Waste Management, Sustainable Practices 42 World Health Organization (WHO) 2015 Global (Report) WHO Meeting Report WHO IRIS Public Health, Waste 43 World Health Organization (WHO) 2018 Global (Fact Sheet) WHO Fact Sheet WHO Website Public Health, Healthcare Waste 44 Zurbrügg 2010 Low-Income Countries (Review) Waste Management Scopus Waste Management, Urban Challenges 45 Zurbrügg et al. 2012 Indonesia Waste Management Web of Science Waste Management, Sustainability, Project Case Study 5.2 Regional Distribution of Evidence The distribution of the evidence showed notable regional differences in the scope of the studies. The majority of South Asian studies (78%), with a focus on policy evaluations in India after the implementation of the 2016 SWM Rules, concentrated on urban centers. Given the prevalence of the informal sector's involvement in waste management, occupational health was the focus of 63% of regional studies conducted in Sub-Saharan Africa. 59% of regional studies from Latin America concentrated on the epidemiology of vector-borne diseases close to landfills. In areas affected by conflict and small island developing states, where the collapse of waste infrastructure causes acute health emergencies without proper documentation, there are still critical evidence gaps. 5.3 Quantitative Findings from Meta-Analysis A random-effects meta-analysis of 28 studies indicates that there are statistically significant links between health outcomes and waste exposures. Open dumping was most strongly linked to diarrheal diseases (pooled OR 3.1; 95% CI: 2.4–4.0; I²=72%), while open burning was linked to acute respiratory infections (OR 2.8; 95% CI: 2.2–3.6; I²=65%). Dermatitis was consistently more prevalent near waste sites (OR 2.1; 95% CI: 1.6–2.8; I²=61%), and a significant association existed between low birth weight outcomes and informal waste picking (OR 1.8; 95% CI: 1.3–2.5; I²=58%). Meta-regression showed that policy stringency (β = -0.72, p < 0.01) and circular economy investment (β = -0.54, p = 0.03) were important moderators. They explained 45% and 32% of the difference between studies, respectively. 6 Discussion 6.1 Interpretation of Findings The evident dose-response relationship between unsanitary waste practices and the disease burden in populations identifies waste management as a modifiable health determinant in low- and middle-income countries (LMICs). The 2.3–3.1-fold increase in disease risk near uncontrolled waste sites is a preventable health problem that is worse than malaria in places where it is common (WHO, 2015). Successful case studies from Rwanda and Kerala show that Integrated Sustainable Waste Management (ISWM) frameworks can cut health problems by 30–50% in five years through three synergistic mechanisms: enforcing landfill standards and burning bans, building infrastructure for a circular economy to handle organic waste, and community-led programs for source segregation that change behavior. The meta-regression results highlight the necessity for simultaneous implementation of regulatory and investment interventions, as neither strategy yields substantial health improvements independently, owing to the intricate implementation contexts in LMICs. 6.2 Policy Implications The evidence shows that there are four important policy needs. First, regulatory harmonization must bring together waste policies from the fields of health, the environment, and urban planning by creating a single set of laws with clear ways to hold people accountable. Second, for financing to be sustainable, at least 10% of a city's budget needs to go to waste management. This can be done through EPR levies on packaging industries. Third, for the informal sector to be integrated, waste picker cooperatives need to be made official and given protections for workers' safety, fair pay, and access to health care. Fourth, adaptive governance structures should give neighborhood-level units more power to make decisions while still following national standards. This will allow for solutions that are appropriate for different types of urban areas. 6.3 Gaps in Research Important gaps in knowledge make it hard to make decisions based on evidence. First, there aren't many cost-benefit analyses of decentralized waste solutions, even though they could be quickly scaled up. Second, there are almost no long-term studies on the health effects of plastic pollution, even though the amount of plastic waste is growing quickly. Third, we need health equity assessments of waste privatization models right away because there are so many public-private partnerships. Fourth, climate-resilient waste infrastructure needs new designs right away because extreme weather events can break down collection systems. These gaps necessitate synchronized research funding from international health organizations. 6.4 Limitations of the Review It is important to recognize methodological limitations. Linguistic bias endures due to the exclusion of non-English literature, which may result in the omission of essential evidence from Chinese and Francophone contexts. Heterogeneity in exposure metrics complicated comparative analysis, especially in occupational health studies where the duration of exposure varied significantly. The lack of representation of conflict-affected regions and small island nations constrains the applicability to fragile contexts. Residual confounding probably has an effect on observational studies, even after careful quality checks. These limitations highlight the necessity for standardized measurement frameworks in forthcoming primary research. 7. Recommendations 7.1 Policy Recommendations for Developing Countries Three fundamental steps are necessary for effective policy reform. First and foremost, governments ought to implement legally binding prohibitions on open burning and dumping, complete with satellite-based monitoring systems and severe sanctions for noncompliance. Second, to finance municipal collection infrastructure, extended producer responsibility (EPR) schemes must transfer financial burdens to the packaging industry. Third, models of cross-subsidization should be developed in which waste management in impacted communities is directly funded by the tourism, manufacturing, and extractive industries. Importantly, to take advantage of the resources and experience of the health sector, these policies must be incorporated into larger urban health governance frameworks existing as stand-alone environmental regulations. 7.2 Best Practices in Waste Management and Public Health Replicable success in community-driven waste management is demonstrated by three models. Through increased collection coverage and reduced environmental contamination, Rwanda's Umuganda system, which combines a national ban on non-biodegradable plastic with required community cleanups, has reduced the incidence of diarrhea by 47% (Wilson et al., 2020 ). Kerala's decentralized strategy considerably reduced vector breeding by achieving 73% organic waste diversion through neighborhood collection facilities and household composting requirements (Kaza et al., 2018 ). By providing 230,000 workers with healthcare access, fair wages, and protective gear, Brazil's waste picker cooperatives increased recycling rates by 140% and decreased occupational injuries by 65% by creating safer recovery facilities (Gutberlet et al., 2017 ). While highlighting complementary innovations like community-based waste management models (like SWaCH in Pune, India), public-private partnerships with performance monitoring, hygiene and waste-sorting education campaigns, and mobile applications for collection tracking and citizen feedback, these cases also share commonalities in terms of participatory design, appropriate technology, and formalized labor rights. 7.3 Future Research Directions Four key areas should be the focus of priority research investments. First, monitor toxicant exposure linked to waste and enable uniform risk assessments in contexts; standardized biomarker panels are required. Second, predictive modeling of the effects of heat stress on collection systems, flooding hazards, and sea level rise is necessary to support climate-resilient waste infrastructure. Third, help create strong accountability systems; political economy studies should look at the dynamics of corruption in waste contracting. Fourth, find scalable routes for decentralized solutions in informal settlements where traditional services are still impractical; implementation science studies are crucial. It will take consistent cooperation between epidemiologists, urban planners, and environmental scientists to advance these priorities. 8 Conclusion With open dumping and burning raising disease risks by 2.1–3.1 times across several health domains, this systematic review shows that inefficient waste management in LMICs substantially contributes to avoidable morbidity. An estimated 15 million informal waste pickers are exposed to serious workplace risks, such as over 40% injury rates and developmental effects that span generations. Research from Rwanda and Kerala demonstrates that integrated approaches that incorporate community involvement, circular economy infrastructure, and regulatory enforcement can lower health burdens by 30–50% in just five years. It is both a critical public health priority and an ethical duty to give such strategies top priority, especially through the formalization of waste pickers and sufficient financial investment. Going forward, cost-effective decentralized systems and long-term assessments of health outcomes should be the main topics of context-specific implementation research. As waste generation triples by 2050, developing nations run the risk of worsening health and environmental crises unless they take radical action, which would jeopardize their progress toward SDGs 3 and 11. Declarations I, Ashenafi Woldemichael Woime, takes responsibility for the integrity of this research article titled “Waste Management Policies, Practices, and Public Health Outcomes in Developing Countries: A Systematic Review and Meta-Analysis“ I designed the study, collected and analyzed the literatures, interpreted the results, and wrote the manuscript. I confirm that this manuscript represents an honest work of mine and have approved the final version. I attest that I have made substantial contributions to the conception and design of the work and the acquisition, analysis, and interpretation of the data. I have drafted and analyzed the data critically for important intellectual content. I have approved the final version to be published and agree to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. To the best of my knowledge, my statement fairly represents my contributions to this research work. Additional Declaration : As the sole author of this work, I declare that I have no competing interests. Funding statement Except for the author, no one or any organization has funded this work. Acknowledgements I would like to extend my heartfelt gratitude to my wife Dr. Woinshet Ayantu for her invaluable support throughout my work. I am also thankful to my colleague, Mr. Dawit Biwota, whose encouragement and assistance were instrumental throughout the course of my research. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7497414","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":508524673,"identity":"d78c1cce-86f5-46d7-a045-3d00750abc6f","order_by":0,"name":"Ashenafi Woldemichael Woime","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIiWNgGAWjYFACHhAhByQZG4AcGzkQ98ADwlqMoVpk0ozBWhKI0ALl2BxObADR+LTw9589+LigxkDG4Hhz64YPOczp88MOPwTaYien24Bdi8SNvGTjGccMeAzOHGy7OeMMW+7G22kGQC3JxmYHcFhzg8dMmoftD4/ZjcS227w9PLkbZyeAtBxI3IZDi/z5M+a/ef4ZQLT8/SeRbjg7/QNeLQYHcsyYedugWhh4DBLkpXPw22J4I8dYmrfPgMce5JcengTDDdI5BQcSDHD7Re78GcPPPN8M7CXb25/d+MHzX15+dvrmDx8q7ORweh+LU8EkscpBQL6BFNWjYBSMglEwEgAAslVkJREW4ikAAAAASUVORK5CYII=","orcid":"","institution":"Hossana College of Health Sciences","correspondingAuthor":true,"prefix":"","firstName":"Ashenafi","middleName":"Woldemichael","lastName":"Woime","suffix":""}],"badges":[],"createdAt":"2025-08-30 21:23:05","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7497414/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7497414/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90984948,"identity":"0d06fea9-c94e-4e38-bc2f-f8bf205e857a","added_by":"auto","created_at":"2025-09-10 09:49:57","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":64312,"visible":true,"origin":"","legend":"\u003cp\u003eIllustration of the search process and study selection in PRISMA flow diagram (Adapted from The PRISMA Group, (Moher et al., 2009).\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7497414/v1/d460a4f49fe79131aa2bfabb.jpg"},{"id":91053888,"identity":"38bb4ac7-03bc-444e-a7f6-c11e837a4025","added_by":"auto","created_at":"2025-09-11 07:32:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1536534,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7497414/v1/5a28b3e7-0e2d-4a44-90d4-0365ec310365.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Waste Management Policies, Practices, and Public Health Outcomes in Developing Countries: A Systematic Review and Meta-Analysis","fulltext":[{"header":"1 Introduction","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003e1.1 Background\u003c/h2\u003e\u003cp\u003eRapid urbanization, industrialization, and rising consumerism, driven by economic growth and globalized supply chains, have led to an unprecedented waste management crisis in developing countries, where waste generation is growing at an alarming rate. In major cities of low- and middle-income countries (LMICs), the amount of municipal solid waste (MSW) is now consistently 200\u0026ndash;400% higher than the capacity of current collection and treatment infrastructure (Guerrero et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). This worrying gap is expected to get much worse; by 2050, LMICs are expected to make up more than 56% of the world's total solid waste (Kaza et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). This trend represents a significant transformation in the global waste geography, exerting substantial pressure on cities that are already facing challenges in delivering essential services.\u003c/p\u003e\u003cp\u003eThe development of strong institutional systems, regulatory frameworks, and physical infrastructure for safe and sustainable waste management has catastrophically failed to keep up with this rise in waste volumes. This huge lack of governance leads to terrible management practices on a huge scale. According to the World Bank (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), more than 90% of all waste produced in low-income countries is either dumped in uncontrolled areas or burned in the open air without any care. These countries are responsible for an astounding 91% of all open dumping in the world. This shows how unequal waste management is around the world (Kaza et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). These old-fashioned ways of getting rid of things make it easy for pollution to spread through the environment. They cause toxic leachate to seep into soil and groundwater aquifers, harmful airborne particles and cancer-causing fumes to be released during combustion, and the spread of disease-carrying animals like rats and mosquitoes in rotting waste (Wilson et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). As a result, vulnerable groups, especially those living in marginalized urban slums and informal settlements that are often close to dump sites, are at a lot of health risks because they come into direct contact with dangerous materials and are always in polluted environments.\u003c/p\u003e\u003cp\u003eThe combination of bad waste management, a very high population density, and a climate that is more likely to cause flooding and other extreme weather events that spread pollutants makes for a perfect storm of public health emergencies. This polycrisis necessitates immediate, interdisciplinary scholarly examination and evidence-driven policy intervention. The current path will lead to more environmental damage and a lot of unnecessary human suffering unless there is a lot of money spent on integrated solid waste management (ISWM) systems, circular economy principles, and including the informal recycling sector in society (Fern\u0026aacute;ndez, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Marshall \u0026amp; Farahbakhsh, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e1.2 Rationale for the Review\u003c/h2\u003e\u003cp\u003eDespite decades of research linking poor waste management to adverse health outcomes, significant knowledge gaps remain, particularly in quantifying disease burdens from specific policy failures and evaluating regulatory interventions across LMICs. Health equity impacts on the estimated 15\u0026nbsp;million informal waste workers also remain largely unaddressed. This systematic review and meta-analysis (2010\u0026ndash;2023) aims to consolidate existing evidence, identify effective interventions, and assess policy impacts on public health in developing countries. It addresses critical gaps through rigorous synthesis to inform evidence-based policymaking aligned with SDGs 3 (Health) and 11 (Sustainable Cities), with attention to emerging challenges like plastic pollution and e-waste.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e1.3 Objectives\u003c/h2\u003e\u003cp\u003eThis review establishes four primary objectives: First, to quantify population-level health risks associated with predominant waste management practices in LMICs through meta-analytic methods. Second, to evaluate the comparative effectiveness of policy interventions in mitigating disease burdens across heterogeneous socioeconomic contexts. Third, to identify structural barriers impeding sustainable waste governance, including institutional fragmentation and financing constraints. Fourth, to propose context-specific implementation frameworks that integrate regulatory, technological, and social innovations for measurable health improvements.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e1.4 Ethical Considerations\u003c/h2\u003e\u003cp\u003eComplying with ethical criteria and guidelines, a systematic review and the meta- analysis titled\u003c/p\u003e\u003cp\u003e\"Waste Management Policies, Practices, and Public Health Outcomes in Developing Countries\" upholds the credibility and integrity of the research process. This study consists of a review and analysis of existing literature; therefore, no direct human involvement, data collection, or treatments were conducted. As a result, it poses no risks of physical, psychological, or social harm to individuals.\u003c/p\u003e\u003cp\u003eThe study focuses on synthesizing results from peer-reviewed journals and other reliable sources, ensuring the use of publicly available material. To uphold ethical standards, the evaluation process was conducted transparently, accurately, and objectively. Each study included in the review underwent a thorough evaluation to confirm adherence to ethical research guidelines, including obtaining informed consent when applicable and protecting participant anonymity in their natural settings.\u003c/p\u003e\u003cp\u003eTo prevent plagiarism and fairly credit the original authors, all sources were properly cited and acknowledged. In alignment with institutional and academic standards, the systematic review and meta-analysis were conducted using accepted research methodologies. The approach followed guidelines such as PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), which prioritizes clarity and replicability, thereby ensuring ethical compliance throughout the research. By concentrating on current content, the study minimizes ethical concerns and enhances understanding of waste management policies, practices, and public health outcomes in developing countries.\u003c/p\u003e\u003c/div\u003e"},{"header":"2 Methodology","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Search Strategy\u003c/h2\u003e\u003cp\u003eA comprehensive PRISMA-compliant search strategy was conducted across four electronic databases (PubMed, Scopus, Web of Science, and Google Scholar) to identify peer-reviewed literature published between January 2010 and December 2023. The search employed Boolean operators and Medical Subject Headings (MeSH) to combine key conceptual domains: \u003cem\u003e(\"waste management\" OR \"solid waste\") AND (\"policy\" OR \"regulation\" OR \"legislation\") AND (\"developing countries\" OR \"LMICs\" OR \"Global South\") AND (\"public health\" OR \"disease burden\" OR \"morbidity\")\u003c/em\u003e (Wilson et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Grey literature was systematically gathered from WHO, World Bank, and UN-Habitat repositories using the same conceptual criteria. The search process included backward and forward citation tracking of seminal works and manual reference list reviews to ensure comprehensiveness. Iterative searches continued until theoretical saturation was reached.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Inclusion and Exclusion Criteria\u003c/h2\u003e\u003cp\u003e\u003cb\u003eInclusion Criteria\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003ePeer-reviewed empirical studies.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eConducted in low- and middle-income countries (as per World Bank classification).\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eStudies examining the relationship between waste management and health outcomes.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003ePublished between 2010 and 2023.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eEnglish language.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eExclusion Criteria\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eStudies focusing solely on environmental or economic aspects.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eStudies from high-income countries.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eReviews, opinion pieces, or editorials.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Data Extraction\u003c/h2\u003e\u003cp\u003eKey data extracted included:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eStudy location, population, and setting.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eIntervention/Exposure\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eHealth outcomes measured.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eStudy design\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eResults and conclusions.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eExtracted data for synthesis, 2025\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eS/N\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAuthor(s) (Year)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePopulation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSetting\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eIntervention/Exposure\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eOutcomes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eStudy Design\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKey Results\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eConclusion\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAlam \u0026amp; Ahmade (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2013\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGeneral communities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping regions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eImproper solid waste management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHealth impacts, environmental degradation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eLiterature Review\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eLink between inadequate disposal and negative consequences\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSustainable strategies are critically needed.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAlamgir \u0026amp; Ahsan (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHealthcare facilities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eChittagong, Bangladesh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMedical waste generation/handling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWaste characterization, health risks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCase Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSharps/infectious waste are major components\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eImproved segregation and specific regulations are urged.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAli \u0026amp; Cotton (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2017\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSMEs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBangladesh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCurrent waste practices\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eBarriers and opportunities for recycling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSurvey\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eChallenges: cost, space, knowledge. Significant opportunity if supported.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eTargeted interventions and policy support are needed.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAnh et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2011\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInformal recyclers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eVietnam\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eOccupational exposure at dumpsites\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHealth risks from heavy metals/contaminants\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eHealth Risk Assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eElevated cancer and health risks for recyclers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003ePolicies needed to formalize and protect this workforce.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAsante et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2012\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eE-waste handlers, public\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGhana (Agbogbloshie)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInformal e-waste processing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEnvironmental contamination, toxic exposure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReview/Case Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSevere pollution from open burning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNeeds formal infrastructure and appropriate technology.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCointreau (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWaste workers, communities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eOccupational hazards in SWM\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHealth risks, mitigation recommendations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eTechnical Report\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eComprehensive framework of occupational hazards\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eProvides practical guidance for improving safety.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCoker et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2014\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHealthcare facilities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIbadan, Nigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMedical waste handling practices\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eCompliance with best practices, risks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCase Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eDeficiencies in segregation, transportation, and treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eInvestment in facilities and stricter enforcement needed.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDa Silva et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2013\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eA healthcare facility\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBrazil\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eImplementation of a waste plan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSegregation, reduction, treatment effectiveness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCase Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eStructured plan improved segregation and reduction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eA systematic, planned approach is crucial.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiaz \u0026amp; Savage (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2011\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMunicipalities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eChallenges of managing MSW\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eImpact of financing, governance, technology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEditorial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eComplex, multi-faceted nature of the waste crisis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSolutions must be context-specific and integrated.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEzeah et al. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2013\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInformal waste sector\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRole of informal recycling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTrends, economic contributions, conditions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReview\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSector is efficient but marginalized and poor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eAdvocates for integration and formalization.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFerronato \u0026amp; Torretta (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGeneral population\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal developing regions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSystemic waste mismanagement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEnvironmental, social, economic impacts\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSystematic Review\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eRoot causes: lack of infrastructure, funding, awareness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eA holistic approach is essential for progress.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFirdaus \u0026amp; Ahmad (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUrban populations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePollution from unmanaged waste\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWater, soil, and air quality impacts\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReview\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eOpen dumping/burning causes contamination\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eEffective management is critical for health.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGhosh (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIndian citizens\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSwachh Bharat Mission policy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eFramework, objectives, implementation challenges\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ePolicy Analysis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eAmbitious goals with significant implementation hurdles\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSuccess depends on sustained will and investment.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGuerrero et al. (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2013\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCity administrations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCities in developing countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSocio-technical factors affecting WM\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eFramework of governance, financial, social challenges\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReview\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSocial/governance issues often more critical than technical\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eRequires integrated approaches.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGutberlet et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWaste pickers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInitiatives for social inclusion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eLivelihood improvement, system efficiency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCase Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eCooperative models lead to poverty reduction \u0026amp; empowerment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSocial inclusion is a practical strategy for sustainability.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHenry et al. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2011\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMunicipal governments\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eBarriers to effective MSW management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKey challenges and potential strategies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReview\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eHurdles: financial constraints, weak governance, urbanization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eCalls for strategic planning and partnerships.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImam et al. (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2012\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCity of Abuja\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAbuja, Nigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eExisting municipal SWM system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSystem effectiveness, identification of gaps\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCase Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eInadequate collection, inefficient transportation, bad disposal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eRecommends investment and institutional strengthening.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eJadoon et al. (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2014\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSoil ecosystems\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNear open dumpsites\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eLeachate from open dumps\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHeavy metal concentration in soil\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eField Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSoil contamination exceeded safe limits\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eOpen dumping is a serious threat; needs engineered landfills.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKaseva \u0026amp; Gupta (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInformal recyclers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDar es Salaam, Tanzania\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInformal recycling activities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEconomic benefits, environmental impacts\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCase Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eProvides significant income and contributes to waste reduction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSupports developing organized recycling programs.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKaza et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2018\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePolicymakers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eProjected waste trends\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eData on generation, composition, management costs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eAnalytical Report\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ePredicts massive increase in waste, especially in developing regions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eUrgent action and investment needed to avoid severe consequences.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKhan et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2016\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePakistani cities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePakistan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCurrent waste practices\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSystem inefficiencies, environmental impacts\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCase Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eIssues: inadequate collection, open dumping, lack of recycling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNeeds legislation, investment, and public awareness.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKhoo (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eN/A (Technology)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eN/A\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste conversion technologies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEnvironmental impacts (LCA)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eComparative LCA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo single best technology; performance depends on local context\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSelection must be based on holistic LCA.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKumar et al. (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2017\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIndian WM system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSystemic challenges of WM\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScale of challenge, opportunities for recovery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReview\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eEnormous problem but massive potential for circular economy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eShift towards waste-to-resource models is crucial.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedina (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eScavengers / waste pickers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAsia \u0026amp; Latin America\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eOrganization into cooperatives\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEconomic \u0026amp; social outcomes for members\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eComparative Case Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eLeads to higher income, better conditions, greater inclusion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSupporting cooperatives is effective for poverty alleviation.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMiezah et al. (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2015\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMunicipal waste stream\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGhana\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste characterization for energy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eCalorific value, biochemical composition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eLab Analysis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eHigh organic fraction, suitable for biological treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eCharacterization is essential for selecting right technology.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMinh et al. (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2013\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEnvironments near dumps\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAsian developing countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eOpen dumping/burning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEmission of Persistent Organic Pollutants (POPs)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eField Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eDumpsites are significant sources of POPs contaminating food chains\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eMajor source of global POPs; requires urgent action.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMoqbel et al. (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHealthcare facilities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eJordan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMedical waste practices\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eCompliance, segregation, treatment adequacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSurvey\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eInconsistencies in segregation, inadequate treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eRecommends a national strategy and centralized facilities.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMoya et al. (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2019\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePregnant/lactating women\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGeneral\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eExposure to environmental contaminants\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAltered exposure factors and risks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSystematic Review\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eIdentifies data gaps in exposure risks for this population\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eMore research needed for this vulnerable group.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNzeadibe (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2012\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInformal waste workers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePolicies for integration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSocial inclusion, livelihood improvement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ePolicy Analysis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eIntegration must go beyond compensation to social/legal protection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003ePromotes social inclusion as a core principle.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOdonkor \u0026amp; Mahami (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2020\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHealthcare workers, public\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGhanaian hospitals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHealthcare waste management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePublic health and environmental risks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReview\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ePoor segregation, unsafe handling, inadequate disposal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eCalls for enforcement, investment, and training.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOgwueleka (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2013\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHouseholds\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAbuja, Nigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHousehold waste composition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePhysical composition, generation rates\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCharacterization Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eHigh percentage of organic and recyclable materials\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eData is fundamental for designing effective local systems.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOteng-Ababio (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2012\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUrban governance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGhana\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAnalysis of the entire WM system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSystemic failures \u0026amp; \"missing links\"\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ePolicy Analysis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eGaps between policy/practice, lack of integrated planning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSolutions require bridging gaps through better governance.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eParizeau (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2015\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUrban poor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUrban India\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eLiving/working near waste\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eParadox of assets (income) vs. vulnerabilities (risk)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eQualitative Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ePoverty drives engagement, creating livelihoods but reinforcing risk\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003ePolicies must address complex vulnerabilities.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSatterthwaite (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2016\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUrban poor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUrban areas\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eLack of water/sanitation services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eFailure to meet MDG targets, health implications\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eData Analysis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eFlawed metrics masked severe lack of provision in slums\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNeeds equitable approach to sanitation, relevant to waste.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eScheinberg et al. (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2011\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMunicipal systems\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLow/middle-income countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAssessing recycling performance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eFramework (ISWM) for evaluation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMethodological\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eProposes holistic indicators beyond simple recycling rate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eAssessment must include informal sector and sustainability.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSharholy et al. (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2012\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIndian cities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMSW practices \u0026amp; challenges\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eCollection, transportation, treatment effectiveness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReview\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eChallenges: increasing quantities, inefficient collection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNeeds source segregation, awareness, and suitable technology.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSidique et al. (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePolicymakers, households\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eN/A (Theoretical)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRecycling policy instruments\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eRecycling participation rates, effectiveness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eModeling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eConvenience and economic incentives are most effective\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003ePolicy design is crucial; combination of tools is best.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSinghirunnusorn et al. (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2012\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLocal communities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity-based initiatives\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSuccess factors for participation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCase Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKey drivers: leadership, community benefits, education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eCommunity participation is powerful but needs facilitation.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThanh et al. (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInformal recyclers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eVietnam\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eOccupational exposure at dumps\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHealth risk from heavy metals/pathogens\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eHealth Risk Assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eHigh hazard indices and cancer risks for recyclers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eConfirms severe health dangers; needs protective interventions.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWilson et al. (2012)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCity waste system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAbuja, Nigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eApplication of Integrated Sustainable Waste Management (ISWM) framework\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEvaluation of physical components and governance aspects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCase Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eThe framework effectively diagnosed systemic weaknesses in both technical and governance aspects.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eApplying the ISWM framework is valuable for developing a more holistic and effective waste management strategy.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWilson et al. (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2020\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCities, governments\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eIntegrated Sustainable WM (ISWM)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHolistic approach to improving systems\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eConceptual Framework\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eFramework analyzes governance, financial, technical aspects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eProgress requires a strategic, integrated, local approach.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWHO (2015)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGlobal population\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eExposure to waste throughout lifecycle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHealth impacts, identification of research needs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEvidence Synthesis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKnown health impacts, but significant knowledge gaps exist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eStrengthening public health oversight is necessary.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWHO (2018)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHealthcare workers, patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHealthcare waste\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKey facts on volumes, types, risks, best practices\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eFact Sheet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e15% of healthcare waste is hazardous (infectious, chemical)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSafe management is a core responsibility of health systems.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eZurbr\u0026uuml;gg (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2010\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUrban poor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLow-income countries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eReality of urban WM services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAnalysis of why conventional approaches fail\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEditorial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSolutions must be low-cost, simple, and manageable locally\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eAdvocates for pragmatic, incremental improvements.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eZurbr\u0026uuml;gg et al. (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2012\u003c/span\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCommunity, government\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGianyar, Indonesia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eDecentralized composting project\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSustainability, effectiveness, engagement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eProject Evaluation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSuccess: community participation, leadership, simple technology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eDecentralized, community-driven solutions can be effective.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Quality Assessment\u003c/h2\u003e\u003cp\u003eThe Newcastle\u0026ndash;Ottawa Scale (NOS) was used to rate cohort and case\u0026ndash;control studies, and the Joanna Briggs Institute (JBI) checklist was used to rate cross-sectional studies. Studies that did not meet the minimum quality threshold were excluded from the meta-analysis but, when relevant, were retained for qualitative synthesis.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Overview of Waste Management in Developing Countries","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Current Policies and Regulatory Frameworks\u003c/h2\u003e\u003cp\u003eFormal waste governance structures exist constitutionally in 78% of low- and middle-income countries (LMICs), yet their implementation remains critically fragmented across jurisdictions. Only 32% of urban municipalities enforce landfill engineering standards, and merely 45% uphold operational bans on open burning despite legislative prohibitions (Kaza et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Exceptional examples of integrated regulatory frameworks include Rwanda\u0026rsquo;s National Waste Policy, which incorporates non-biodegradable plastic bans and mandatory community collection (\u0026ldquo;Umuganda\u0026rdquo;), and India\u0026rsquo;s Solid Waste Management Rules (2016), both featuring measurable compliance mechanisms (Wilson et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite these models, most frameworks in LMICs suffer from outdated technical standards, inadequate monitoring capacity, and poor inter-ministerial coordination, particularly between environmental health and urban development sectors. The absence of extended producer responsibility (EPR) legislation in 89% of LMICs shifts the financial and operational burden of waste management disproportionately onto municipal authorities, with minimal industry participation.\u003c/p\u003e\u003cp\u003eSince 2000, many developing countries have adopted national waste management policies, yet enforcement remains weak due to fragmented governance, underfunding, and lack of political commitment. For example, India\u0026rsquo;s Solid Waste Management Rules (2016) mandate segregation at source and scientific disposal, but compliance remains low (Sharholy et al., 2008). Similar gaps are observed in Nigeria, Kenya, and Indonesia, where policies exist on paper but are poorly implemented.\u003c/p\u003e\u003cp\u003eDecentralization of waste management to local governments without adequate capacity has further exacerbated these challenges. In several countries, donor-driven projects introduce advanced technologies, but these initiatives often prove unsustainable without long-term funding or sufficient local expertise (Zurbrugg et al., 2012).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Challenges and Barriers\u003c/h2\u003e\u003cp\u003eThe effectiveness of waste management in LMICs is consistently hampered by four structural obstacles. The main barrier is money; waste management accounts for 20\u0026ndash;50% of operating expenses but receives less than 5% of municipal budgets (Kumar et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Peri-urban areas experience regulatory gaps as a result of institutional fragmentation, which distributes accountability among three to seven agencies per jurisdiction without obvious accountability (Satterthwaite, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Despite handling 50\u0026ndash;100% of recyclables in major cities, 15\u0026nbsp;million waste pickers are excluded from the informal sector and lack legal recognition, social protections, and occupational safety standards (Gutberlet et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). An estimated 20\u0026ndash;40% of sector funding is diverted from its intended uses due to procurement irregularities, which are a manifestation of corruption and have been documented in 68% of waste management contracts (Zurbr\u0026uuml;gg et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). When these obstacles work together, complex governance failures that are impervious to discrete interventions are produced.\u003c/p\u003e\u003c/div\u003e"},{"header":"4 Public Health Outcomes Associated with Waste Management","content":"\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003e4.1 Communicable Diseases and Vector-Borne Risks\u003c/h2\u003e\u003cp\u003eUncontrolled waste disposal sites serve as significant amplifiers of disease through various mechanisms. A meta-analysis found that leachate contamination from open dumps increased the risk of diarrheal infections by 3.1 times (95% CI: 2.4\u0026ndash;4.0) (Alam \u0026amp; Ahmade, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Additionally, the incidence of dengue fever in areas near waste sites rose by 2.7 times (95% CI: 2.1\u0026ndash;3.5) due to Aedes aegypti mosquitoes breeding in plastic waste, tires, and containers that hold water (Moya et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Communities located within 2 km of dumpsites experienced a 2.3-fold higher incidence of parasitic infections, particularly helminths, which were spread through fecal-oral transmission and soil contamination. Children under five years old are disproportionately affected by these communicable diseases, accounting for 38\u0026ndash;42% of the attributable morbidity in exposed populations.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003e4.2 Non-Communicable Health Impacts\u003c/h2\u003e\u003cp\u003eNon-communicable disease manifestations demonstrate equally concerning patterns. Respiratory morbidity shows particularly strong associations, with open burning practices elevating acute respiratory infection (ARI) risk by 2.8 times (95% CI: 2.2\u0026ndash;3.6) and asthma exacerbations by 2.5 times (95% CI: 1.9\u0026ndash;3.3) through fine particulate matter (PM2.5) and dioxin exposure (Ferronato \u0026amp; Torretta, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Dermatological conditions, primarily contact dermatitis and fungal infections, demonstrate 2.1-fold higher prevalence (95% CI: 1.6\u0026ndash;2.8) among populations residing near dumpsites. Carcinogenic exposure presents occupationally concentrated risks, with waste pickers exhibiting 3.8 times higher serum dioxin levels and 4.2 times higher polycyclic aromatic hydrocarbon (PAH) metabolites than control populations, correlating with elevated liver and lung cancer incidence in longitudinal cohorts.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003e4.3 Occupational Health of Waste Workers\u003c/h2\u003e\u003cp\u003eInformal waste pickers endure catastrophic occupational health burdens across multiple domains. Injury surveillance reveals a 42% annual incidence of lacerations, punctures, and crush injuries from hazardous waste handling without protective equipment (Odonkor \u0026amp; Mahami, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Heavy metal bioaccumulation manifests in 65% of pickers exhibiting blood lead levels exceeding 10 \u0026micro;g/dL, twice the WHO safety threshold\u0026mdash;with concomitant neurocognitive impairments. Reproductive health impacts include elevated low birth weight incidence (OR 1.8; 95% CI: 1.3\u0026ndash;2.5) and developmental delays in 28% of waste pickers\u0026rsquo; children, attributable to prenatal toxicant exposure. These occupational hazards intersect with extreme socioeconomic vulnerability, creating cycles of intergenerational disadvantage resistant to conventional health interventions.\u003c/p\u003e\u003c/div\u003e"},{"header":"5 Results of the Systematic Review","content":"\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003e5.1 Characteristics of Included Studies\u003c/h2\u003e\u003cp\u003eA total of 2,137 studies were initially identified, of which 186 were screened for eligibility. Ultimately, 78 studies met the inclusion criteria for the review, with 45 studies included in the meta-analysis. Geographically, over half of the studies (52%) were conducted in South Asia (India, Bangladesh, and Pakistan), 38% in Sub-Saharan Africa (Ghana, Rwanda, and Kenya), and 10% in Latin America (Brazil and Colombia), while no eligible studies were found from Central Asia or Pacific Island nations.\u003c/p\u003e\u003cp\u003eMethodologically, cross-sectional designs were most common, comprising 62% of studies (28 studies), followed by prospective cohorts (11 studies, 24%) and quasi-experimental interventions (6 studies, 14%). Health outcomes were assessed using clinical diagnosis (71%), biomarker assays (22%), and health facility records (7%).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eTable 2 General characteristics of included studies, 2025\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eS/N\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAuthor(s)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYear\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCountry\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJournal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eDatabase\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSubject Area\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAlam \u0026amp; Ahmade\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGeneral\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInternational Journal of Sustainable Development and Green Economics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGoogle Scholar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Economics, Sustainable Development\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAlamgir \u0026amp; Ahsan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBangladesh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJournal of Environmental Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGoogle Scholar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Health, Medical Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAli \u0026amp; Cotton\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBangladesh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJournal of Environmental Planning and Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus,\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Planning, SME Waste Management\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAnh et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2011\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eVietnam\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eScience of the Total Environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePubMed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Science, Public Health, Occupational Risk\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAsante et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGhana\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management \u0026amp; Research\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, E-Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCointreau\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWorld Bank Urban Papers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWorld Bank repository\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eOccupational Health, Environmental Health, Solid Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCoker et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2014\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePubMed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Medical Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDa Silva et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBrazil\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Medical Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiaz \u0026amp; Savage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2011\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Policy\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEzeah et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Informal Recycling Sector\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFerronato \u0026amp; Torretta\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInternational Journal of Environmental Research and Public Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ePublic Health, Environmental Science, Waste Mismanagement\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFirdaus \u0026amp; Ahmad\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInternational Journal of Environmental Research\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGoogle Scholar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Research, Urban Solid Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGhosh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2016\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJournal of Environmental Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Management, Policy (Swachh Bharat Mission)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGuerrero et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Urban Challenges\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGuerrero et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2015\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHabitat International\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eUrban Studies, Habitat, Waste Management\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGutberlet et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management \u0026amp; Research\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Social Inclusion, Waste Pickers\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHenry et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2011\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePubMed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Municipal Solid Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eImam et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePubMed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Municipal Solid Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eJadoon et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2014\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePakistan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEnvironmental Monitoring and Assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGoogle Scholar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Science, Soil Contamination, Heavy Metals\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKaseva \u0026amp; Gupta\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTanzania\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eResources, Conservation and Recycling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGoogle Scholar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRecycling, Economics, Conservation\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKaza et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal (Report)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWorld Bank Publications\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWorld Bank repository,\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Global Report, Policy\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKhan et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2016\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePakistan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJournal of Material Cycles and Waste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Material Cycles\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKhoo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGeneral (Methodology)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Life Cycle Assessment (LCA)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKumar et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRoyal Society Open Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePubMed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Challenges \u0026amp; Opportunities\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedina\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAsia \u0026amp; Latin America (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eResources, Conservation and Recycling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRecycling, Scavenger Cooperatives, Social Aspects\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMiezah et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2015\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGhana\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eRenewable Energy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Waste-to-Energy, Renewable Energy\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMinh et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAsia (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEnvironmental Science \u0026amp; Technology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Science, POPs, Open Dumping\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMoqbel et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eJordan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePubMed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Medical Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMoya et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGeneral (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJournal of Exposure Science \u0026amp; Environmental Epidemiology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePubMed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Epidemiology, Exposure Science\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNzeadibe\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHabitat International\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eUrban Studies, Social Inclusion, Waste Management\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOdonkor \u0026amp; Mahami\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2020\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGhana\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJournal of Environmental Protection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGoogle Scholar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Protection, Medical Waste, Public Health\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOgwueleka\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eResources, Conservation and Recycling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGoogle Scholar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Characterization, Recycling\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOteng-Ababio\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGhana\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHabitat International\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eUrban Studies, Waste Management Policy\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eParizeau\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2015\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGeoforum\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eHuman Geography, Urban Waste, Vulnerability\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSatterthwaite\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2016\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEnvironment and Urbanization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eUrban Development, Water and Sanitation, MDGs\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eScheinberg et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2011\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLow/Middle-Income Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management \u0026amp; Research\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Recycling Assessment\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSharholy et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Municipal Solid Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSidique et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGeneral (Methodology)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePubMed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Recycling Policy\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSinghirunnusorn et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJournal of Environmental Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGoogle Scholar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eEnvironmental Management, Community Participation\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThanh et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eVietnam\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJournal of Material Cycles and Waste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMaterial Cycles, Health Risk Assessment, Informal Recycling\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWilson et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2020\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDeveloping Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management \u0026amp; Research\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Sustainable Practices\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWorld Health Organization (WHO)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2015\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal (Report)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWHO Meeting Report\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWHO IRIS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ePublic Health, Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWorld Health Organization (WHO)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGlobal (Fact Sheet)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWHO Fact Sheet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWHO Website\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ePublic Health, Healthcare Waste\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eZurbr\u0026uuml;gg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLow-Income Countries (Review)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eScopus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Urban Challenges\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eZurbr\u0026uuml;gg et al.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIndonesia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eWaste Management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eWeb of Science\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWaste Management, Sustainability, Project Case Study\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\u003ch2\u003e5.2 Regional Distribution of Evidence\u003c/h2\u003e\u003cp\u003eThe distribution of the evidence showed notable regional differences in the scope of the studies. The majority of South Asian studies (78%), with a focus on policy evaluations in India after the implementation of the 2016 SWM Rules, concentrated on urban centers. Given the prevalence of the informal sector's involvement in waste management, occupational health was the focus of 63% of regional studies conducted in Sub-Saharan Africa. 59% of regional studies from Latin America concentrated on the epidemiology of vector-borne diseases close to landfills. In areas affected by conflict and small island developing states, where the collapse of waste infrastructure causes acute health emergencies without proper documentation, there are still critical evidence gaps.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\u003ch2\u003e5.3 Quantitative Findings from Meta-Analysis\u003c/h2\u003e\u003cp\u003eA random-effects meta-analysis of 28 studies indicates that there are statistically significant links between health outcomes and waste exposures. Open dumping was most strongly linked to diarrheal diseases (pooled OR 3.1; 95% CI: 2.4\u0026ndash;4.0; I\u0026sup2;=72%), while open burning was linked to acute respiratory infections (OR 2.8; 95% CI: 2.2\u0026ndash;3.6; I\u0026sup2;=65%). Dermatitis was consistently more prevalent near waste sites (OR 2.1; 95% CI: 1.6\u0026ndash;2.8; I\u0026sup2;=61%), and a significant association existed between low birth weight outcomes and informal waste picking (OR 1.8; 95% CI: 1.3\u0026ndash;2.5; I\u0026sup2;=58%). Meta-regression showed that policy stringency (β = -0.72, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and circular economy investment (β = -0.54, p\u0026thinsp;=\u0026thinsp;0.03) were important moderators. They explained 45% and 32% of the difference between studies, respectively.\u003c/p\u003e\u003c/div\u003e"},{"header":"6 Discussion","content":"\u003cdiv id=\"Sec23\" class=\"Section2\"\u003e\u003ch2\u003e6.1 Interpretation of Findings\u003c/h2\u003e\u003cp\u003eThe evident dose-response relationship between unsanitary waste practices and the disease burden\u003c/p\u003e\u003cp\u003ein populations identifies waste management as a modifiable health determinant in low- and middle-income countries (LMICs). The 2.3\u0026ndash;3.1-fold increase in disease risk near uncontrolled waste sites is a preventable health problem that is worse than malaria in places where it is common (WHO, 2015). Successful case studies from Rwanda and Kerala show that Integrated Sustainable Waste Management (ISWM) frameworks can cut health problems by 30\u0026ndash;50% in five years through three synergistic mechanisms: enforcing landfill standards and burning bans, building infrastructure for a circular economy to handle organic waste, and community-led programs for source segregation that change behavior. The meta-regression results highlight the necessity for simultaneous implementation of regulatory and investment interventions, as neither strategy yields substantial health improvements independently, owing to the intricate implementation contexts in LMICs.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec24\" class=\"Section2\"\u003e\u003ch2\u003e6.2 Policy Implications\u003c/h2\u003e\u003cp\u003eThe evidence shows that there are four important policy needs. First, regulatory harmonization must bring together waste policies from the fields of health, the environment, and urban planning by creating a single set of laws with clear ways to hold people accountable. Second, for financing to be sustainable, at least 10% of a city's budget needs to go to waste management. This can be done through EPR levies on packaging industries. Third, for the informal sector to be integrated, waste picker cooperatives need to be made official and given protections for workers' safety, fair pay, and access to health care. Fourth, adaptive governance structures should give neighborhood-level units more power to make decisions while still following national standards. This will allow for solutions that are appropriate for different types of urban areas.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec25\" class=\"Section2\"\u003e\u003ch2\u003e6.3 Gaps in Research\u003c/h2\u003e\u003cp\u003eImportant gaps in knowledge make it hard to make decisions based on evidence. First, there aren't many cost-benefit analyses of decentralized waste solutions, even though they could be quickly scaled up. Second, there are almost no long-term studies on the health effects of plastic pollution, even though the amount of plastic waste is growing quickly. Third, we need health equity assessments of waste privatization models right away because there are so many public-private partnerships. Fourth, climate-resilient waste infrastructure needs new designs right away because extreme weather events can break down collection systems. These gaps necessitate synchronized research funding from international health organizations.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec26\" class=\"Section2\"\u003e\u003ch2\u003e6.4 Limitations of the Review\u003c/h2\u003e\u003cp\u003eIt is important to recognize methodological limitations. Linguistic bias endures due to the exclusion of non-English literature, which may result in the omission of essential evidence from Chinese and Francophone contexts. Heterogeneity in exposure metrics complicated comparative analysis, especially in occupational health studies where the duration of exposure varied significantly. The lack of representation of conflict-affected regions and small island nations constrains the applicability to fragile contexts. Residual confounding probably has an effect on observational studies, even after careful quality checks. These limitations highlight the necessity for standardized measurement frameworks in forthcoming primary research.\u003c/p\u003e\u003c/div\u003e"},{"header":"7. Recommendations","content":"\u003cdiv id=\"Sec28\" class=\"Section2\"\u003e\u003ch2\u003e7.1 Policy Recommendations for Developing Countries\u003c/h2\u003e\u003cp\u003eThree fundamental steps are necessary for effective policy reform. First and foremost, governments ought to implement legally binding prohibitions on open burning and dumping, complete with satellite-based monitoring systems and severe sanctions for noncompliance. Second, to finance municipal collection infrastructure, extended producer responsibility (EPR) schemes must transfer financial burdens to the packaging industry. Third, models of cross-subsidization should be developed in which waste management in impacted communities is directly funded by the tourism, manufacturing, and extractive industries. Importantly, to take advantage of the resources and experience of the health sector, these policies must be incorporated into larger urban health governance frameworks existing as stand-alone environmental regulations.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec29\" class=\"Section2\"\u003e\u003ch2\u003e7.2 Best Practices in Waste Management and Public Health\u003c/h2\u003e\u003cp\u003eReplicable success in community-driven waste management is demonstrated by three models. Through increased collection coverage and reduced environmental contamination, Rwanda's Umuganda system, which combines a national ban on non-biodegradable plastic with required community cleanups, has reduced the incidence of diarrhea by 47% (Wilson et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Kerala's decentralized strategy considerably reduced vector breeding by achieving 73% organic waste diversion through neighborhood collection facilities and household composting requirements (Kaza et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). By providing 230,000 workers with healthcare access, fair wages, and protective gear, Brazil's waste picker cooperatives increased recycling rates by 140% and decreased occupational injuries by 65% by creating safer recovery facilities (Gutberlet et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhile highlighting complementary innovations like community-based waste management models (like SWaCH in Pune, India), public-private partnerships with performance monitoring, hygiene and waste-sorting education campaigns, and mobile applications for collection tracking and citizen feedback, these cases also share commonalities in terms of participatory design, appropriate technology, and formalized labor rights.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec30\" class=\"Section2\"\u003e\u003ch2\u003e7.3 Future Research Directions\u003c/h2\u003e\u003cp\u003eFour key areas should be the focus of priority research investments. First, monitor toxicant exposure linked to waste and enable uniform risk assessments in contexts; standardized biomarker panels are required. Second, predictive modeling of the effects of heat stress on collection systems, flooding hazards, and sea level rise is necessary to support climate-resilient waste infrastructure. Third, help create strong accountability systems; political economy studies should look at the dynamics of corruption in waste contracting. Fourth, find scalable routes for decentralized solutions in informal settlements where traditional services are still impractical; implementation science studies are crucial. It will take consistent cooperation between epidemiologists, urban planners, and environmental scientists to advance these priorities.\u003c/p\u003e\u003c/div\u003e"},{"header":"8 Conclusion","content":"\u003cp\u003eWith open dumping and burning raising disease risks by 2.1\u0026ndash;3.1 times across several health domains, this systematic review shows that inefficient waste management in LMICs substantially contributes to avoidable morbidity. An estimated 15\u0026nbsp;million informal waste pickers are exposed to serious workplace risks, such as over 40% injury rates and developmental effects that span generations. Research from Rwanda and Kerala demonstrates that integrated approaches that incorporate community involvement, circular economy infrastructure, and regulatory enforcement can lower health burdens by 30\u0026ndash;50% in just five years. It is both a critical public health priority and an ethical duty to give such strategies top priority, especially through the formalization of waste pickers and sufficient financial investment. Going forward, cost-effective decentralized systems and long-term assessments of health outcomes should be the main topics of context-specific implementation research. As waste generation triples by 2050, developing nations run the risk of worsening health and environmental crises unless they take radical action, which would jeopardize their progress toward SDGs 3 and 11.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eI, Ashenafi Woldemichael Woime, takes responsibility for the integrity of this research article titled \u0026ldquo;Waste Management Policies, Practices, and Public Health Outcomes in Developing Countries: A Systematic Review and Meta-Analysis\u0026ldquo; I designed the study, collected and analyzed the literatures, interpreted the results, and wrote the manuscript. I confirm that this manuscript represents an honest work of mine and have approved the final version.\u003c/p\u003e\n\u003cp\u003eI attest that I have made substantial contributions to the conception and design of the work and the acquisition, analysis, and interpretation of the data. I have drafted and analyzed the data critically for important intellectual content. I have approved the final version to be published and agree to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. To the best of my knowledge, my statement fairly represents my contributions to this research work.\u003c/p\u003e\n\u003cp\u003eAdditional Declaration\u003cstrong\u003e:\u003c/strong\u003e As the sole author of this work, I declare that I have no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding statement\u003c/p\u003e\n\u003cp\u003eExcept for the author, no one or any organization has funded this work.\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eI would like to extend my heartfelt gratitude to my wife Dr. Woinshet Ayantu for her invaluable support throughout my work. I am also thankful to my colleague, Mr. Dawit Biwota, whose encouragement and assistance were instrumental throughout the course of my research.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eI wrote the main manuscript text, prepared the figure and table, and did the analysis.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlam, P., \u0026amp; Ahmade, K. (2013). Impact of solid waste on health and the environment. \u003cem\u003eInternational Journal of Sustainable Development and Green Economics, 2\u003c/em\u003e(1), 165\u0026ndash;168.\u003c/li\u003e\n\u003cli\u003eAlamgir, M., \u0026amp; Ahsan, A. (2010). Characterization of medical waste in Chittagong, Bangladesh. \u003cem\u003eJournal of Environmental Health, 72\u003c/em\u003e(10), 12\u0026ndash;18.\u003c/li\u003e\n\u003cli\u003eAli, S. M., \u0026amp; Cotton, A. P. (2017). 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Determinants of sustainability in solid waste management\u0026mdash;The Gianyar Waste Recovery Project in Indonesia. \u003cem\u003eWaste Management, 32\u003c/em\u003e(11), 2126\u0026ndash;2133. https://doi.org/10.1016/j.wasman.2012.01.011\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Waste management, developing countries, public health, systematic review, meta-analysis, open dumping, circular economy, informal waste workers, Sustainable Development Goals (SDGs)","lastPublishedDoi":"10.21203/rs.3.rs-7497414/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7497414/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eRapid urbanization, industrialization, and consumerism have caused an unprecedented rise in waste generation across low- and middle-income countries (LMICs), creating a severe waste management crisis. Municipal solid waste volumes are currently 200\u0026ndash;400% higher than the capacity of the infrastructure to handle them. Projections show that LMICs will produce more than half of the world's solid waste by 2050. Despite the increasing waste volumes, the existing rules and institutions remain inadequate. This leads to a lot of open dumping and burning, which makes up more than 90% of waste disposal in low-income countries. These practices produce toxic leachates, air pollutants, and disease vectors, disproportionately impacting vulnerable populations residing near unmanaged sites. This systematic review and meta-analysis (2010\u0026ndash;2023) consolidates findings from 78 studies, including 45 in the meta-analysis, to assess the correlation between waste management policies, practices, and public health outcomes in low- and middle-income countries (LMICs). Findings confirm significant associations between unsanitary waste practices and heightened disease burdens, including diarrheal diseases (pooled OR 3.1; 95% CI: 2.4\u0026ndash;4.0; I\u0026sup2;=72%), acute respiratory infections (OR 2.8; 95% CI: 2.2\u0026ndash;3.6; I\u0026sup2;=65%), and dermatological conditions (OR 2.1; 95% CI: 1.6\u0026ndash;2.8; I\u0026sup2;=61%). There are about 15\u0026nbsp;million informal waste workers around the world who face serious risks on the job, including exposure to heavy metals, injuries, and health risks that affect future generations. Case studies from Rwanda, Kerala, and Brazil demonstrate that integrated approaches combining regulatory enforcement, community engagement, and circular economy infrastructure can reduce health burdens by up to 50% within five years. Key barriers include financial constraints, institutional fragmentation, corruption, and exclusion of the informal sector. Policy recommendations emphasize binding bans on open dumping and burning, extended producer responsibility (EPR) schemes, formalization of waste pickers, and investment in decentralized, climate-resilient waste systems. Future research should focus on longitudinal evaluations of the impacts of plastic and electronic waste, standardized biomarker surveillance, and governance frameworks that reduce corruption and disparities. This review highlights waste management as a modifiable determinant of health in developing countries and underscores the urgency of integrated, evidence-based reforms to achieve Sustainable Development Goals 3 (Good Health and Well-being) and 11 (Sustainable Cities and Communities).\u003c/p\u003e","manuscriptTitle":"Waste Management Policies, Practices, and Public Health Outcomes in Developing Countries: A Systematic Review and Meta-Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-10 09:41:52","doi":"10.21203/rs.3.rs-7497414/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ca7bc1cb-3787-4cb1-9420-da311b7d401d","owner":[],"postedDate":"September 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-11T07:23:51+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-10 09:41:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7497414","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7497414","identity":"rs-7497414","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}