Comparison of Health-care Waste Management in Urban and Rural Areas in Iran: Application of Multi-criteria Decision Making Method


Nourooz Ali Azizkhani ORCID 1 , Soheyla Gholami ORCID 2 , Salifu Yusif ORCID 3 , Saeideh Moosavi ORCID 4 , Seyedeh Fatemeh Miri ORCID 1 , Rohollah Kalhor ORCID 1 , *

1 Social Determinants of Health Research Center, Research Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran

2 University of Rome Tor Vergata, Rome, Italy

3 School of Management and Enterprise, University of Southern Queensland, Springfield Queensland, Australia.

4 Occupational Health Department, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran

How to Cite: Azizkhani N A , Gholami S , Yusif S , Moosavi S , Miri S F , et al. Comparison of Health-care Waste Management in Urban and Rural Areas in Iran: Application of Multi-criteria Decision Making Method, Health Scope.2021 In Press(In Press): e113282. doi: 10.5812/jhealthscope.113282.


Health Scope: In Press (In Press); e113282
Published Online: June 05, 2021
Article Type: Research Article
Received: January 26, 2021
Revised: May 08, 2021
Accepted: May 14, 2021


Background: Globally, population has grown and is still growing. This growth is happening in the cities more than in rural areas given the continual search for economic opportunities. The implication of this growth and shift is growth in healthcare centers to meet the growing healthcare demand. Accordingly, healthcare waste production pose a big challenge to health waste disposal and management.

Objectives: This study aimed to prioritize and select the best method of waste management in the health sector with multi-criteria decision making (MCDM) approaches.

Methods: The cross-sectional present study was carried out in order to select the best method to manage health-care wastes through MCDM approaches in Qazvin.The sampling was selected and assigned to two groups of 28 experts (five categories) who evaluated the criteria and a group of 22 individuals (four categories) to rank disposal methods of health-care waste. First, 6 waste disposal methods and 12 criteria for designing a questionnaire were identified. After designing the questionnaire, the Analytic Hierarchy Process (AHP) was used to calculate the weight of criteria. Then, TOPSIS method was used to rank different waste disposal methods. EC (ver. 8), Excel (Microsoft, 2007), and Lingo (ver. 14) were used in analyzing the data.

Results: In the context of ranking of health wastes disposal methods based on existing common criteria, both urban and rural areas use different disposal methods. In urban areas, the best methods for disposal are irradiation (0.839) and microwave (0.794) and in rural areas are sterilized steam (0.867) and microwave (0.840), respectively. In both areas, incineration was ranked the last.

Conclusions: To achieve effective disposal and safety of health waste in urban and rural areas, varied but applicable disposable methods should be used in management of health waste disposal.


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