A Comparative Analysis of Key Factors Influencing Compliance in Medical Solid Waste Management in Healthcare Facilities A Meta-Analysis of Studies in Indonesia vs. Other Southeast Asian Countries

Abstrak

Medical solid waste management is a crucial global challenge for healthcare systems due to therisk of nosocomial infections and the resulting environmental impacts. Although Indonesiahas strict regulations, implementation in the field still faces obstacles such as lack of training, inadequate infrastructure, and low awareness among healthcare workers. This contrasts withseveral other Southeast Asian countries that have successfully implemented integrated auditsystems and comprehensive training programs. This study aims to identifyand analyze key factors (knowledge and attitudes) influencing compliance with medical solid waste management inIndonesia and compare it with other Southeast Asian countries.This study used a meta-analysisdesign with a Comparative Systematic Review approach. Secondary data was obtained from asystematic search of PubMed, Scopus, ScienceDirect, and Google Scholar databases for articles published between 2018 and 2025. The analysis showed a significant relationship between staff knowledge and medical waste management compliance. Meanwhile, staff's positive attitudes consistently correlated with higher compliance across both geographic regions, with nosignificant difference in the strength of the effect. Knowledge and attitudes are the main determinants of medical waste management compliance. The dominance of knowledge in Indonesia indicates a gap in technical understanding that needs to be addressed. In general, ]countries with more integrated monitoring and training systems show more stable compliancerates. The Indonesian government and healthcare facility managers are advised to improve ongoing technical training programs and strengthen internal audit systems.