Sustainability drivers to circular economy integration into the healthcare supply chain to address waste: Implications for net-zero emission

The increased demand for healthcare services, as driven by rapid population growth and socio-economic development, has led to unprecedented levels of waste across the healthcare supply chain (HSC). Healthcare waste can adversely affect the environment by contributing to greenhouse gas emissions through incineration and chemical treatment, fossil fuel-based transportation, and improper landfilling that leads to unwanted chemical reactions. Therefore, it has become necessary to incorporate a transformative approach into the HSC to effectively address escalating levels of waste and contribute to achieving net-zero emissions. The circular economy (CE) approach has the potential to realize this; however, our understanding of its integration into the HSC in terms of the associated drivers is limited. Therefore, this research aims to explore sustainability drivers and their relative importance to CE integration into the HSC to address healthcare waste. To this end, we identified potential sustainability drivers for CE adoption in the HSC via a literature review, which were evaluated through semi-structured expert interviews and subsequently assessed using the situation-actors-processlearning-action-performance (SAP-LAP) analysis. Following this, based on survey inputs from 20 HSC experts in Bangladesh on 14 drivers, the most and least influential drivers and their ranking were determined via a BestWorst method. It was found that the 'economic' driver was the most influential main category of sustainability drivers, followed by 'environment' and 'social'. Among the driver sub-criteria, 'Better resource utilization' was the most important driver, while 'financial benefit (tax rebate)' was the least. This study provides valuable insights for HSC managers and policymakers alike.