title: Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip.
abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology, which involved a large number of stakeholders. Such an approach served to raise interest and awareness at different levels (public authorities, health providers, supporting actors, others), stimulate the discussion about the adoption of specific policies, and identify the effective way forward.
authors.affiliation: Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), University of Brescia, Brescia, Italy. Electronic address: marcocaniato@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Caniato
authors.affiliation: Centre for Sustainable Waste Management, School of Science and Technology, University of Northampton, Northampton, UK.
authors.forename: T
authors.initials: T
authors.lastname: Tudor
authors.affiliation: Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), University of Brescia, Brescia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Vaccari
mesh_terms: D002947:Cities; D008506:Medical Waste; D017744:Medical Waste Disposal / Q000379:methods*; D008877:Middle East; D011640:Public Policy; D012944:Social Support
chemical_list: D008506:Medical Waste; D017744:Medical Waste Disposal
keywords: Assessment method; Health-care waste management; Hierarchy process; Medical waste; Stakeholder social network analysis; Sustainability