Article Text

Medical waste management-related factors affecting health and experiences of health risks among medical waste handlers in low and middle-income countries: a systematic review protocol of qualitative studies
  1. Md Nazmul Huda1,2,
  2. Tewodros Getachew Hailemariam3,
  3. Syeda Zakia Hossain4,
  4. James Sujit Malo5,
  5. Sajedul Khan6,
  6. Setho Hadisuyatmana7,
  7. Afsana Ferdous8,
  8. Blessing Akombi-Inyang9,
  9. Rakibul M Islam10,11,
  10. Andre M N Renzaho12
  1. 1School of Liberal Arts and Social Sciences (SLASS), Independent University, Dhaka, Bangladesh
  2. 2School of Health Sciences, Western Sydney University, Campbeltown, New South Wales, Australia
  3. 3School of Public Health, Wolaita Sodo University, Sodo, Ethiopia
  4. 4Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  5. 5The Leprosy Mission International Bangladesh, Dhaka, Bangladesh
  6. 6School of Social Work, Massey University, Auckland, New Zealand
  7. 7Faculty of Nursing, Universitas Airlangga, Surabaya, Jawa Timur, Indonesia
  8. 8Department of Political Science, University of Dhaka, Dhaka, Bangladesh
  9. 9UNSW, Sydney, New South Wales, Australia
  10. 10School of Public Health & Preventive Medicine, Monash University, Clayton, Victoria, Australia
  11. 11South Asian Institute for Social Transformation, Dhaka, Bangladesh
  12. 12Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
  1. Correspondence to Dr Md Nazmul Huda; hudasoc2020{at}


Introduction Medical waste management (MWM)-related factors affecting the health of medical waste handlers (MWHs) and their health risks in low and middle-income countries (LMICs) are an important public health concern. Although studies of MWM-related factors and health risks among MWHs in LMICs are available, literature remains undersynthesised and knowledge fragmented. This systematic review will provide a comprehensive synthesis of evidence regarding the individual, system and policy-level MWM-related factors that affect MWHs’ health and their experiences of health risks in LMICs.

Methods and analysis All qualitative studies published in peer-reviewed journals between 1 July 2011 and 30 June 2021 with full texts available and accessible will be included in the review. Seven specific electronic databases (eg, Scopus, Ovid MEDLINE, EMBASE, Global Health, CINAHL, ProQuest and PsycINFO) will be searched. Two authors will review the citations and full texts, extract data and complete the quality appraisal independently. A third reviewer will check discrepancies when a consensus cannot be reached on differences between the two reviewers. Data extraction will be conducted using the Joanna Briggs Institute standardised data extraction form for qualitative research. The quality of articles will be assessed using a Critical Appraisal Skills Programme checklist. Results from eligible articles will be synthesised into a set of findings using the thematic framework analysis approach and will be reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement.

Ethics and dissemination This review is based on published articles, which does not require ethical approval because there is no collection of primary data. Findings from this review will be published in a peer-reviewed journal and presented at relevant public health conferences. This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO).

PROSPERO registration number CRD42020226851.

  • health & safety
  • public health
  • occupational & industrial medicine
  • COVID-19
  • risk management
  • infection control

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Twitter @nazmul_bakhtiar, @BlessingAkombi

  • Contributors MNH, SK and AF conceptualised the idea and designed the review. MNH, JSM, SK, SH and AF drafted the initial protocol. MNH and SK developed the search strategy. MNH interpreted, analysed and revised the manuscript with intellectual input from TGH, SZH, BA-I, RMI and AMNR. All authors read and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.