Table 2.

Main and sub-criteria of medical waste management.

Criteria	Sub-Criteria	Description	References
Organizational Criteria (C1)	C11- Existence, content and implementation of the medical waste management plan	There may be differences between hospitals in terms of how the process will be carried out due to the lack of a medical waste management plan in hospitals or containing deficiencies in processes. Even if the ministry determines the basic draft on this subject, there may be differences in the application from hospital to hospital.	[[42], [161]]
	C12- Supply chain management and finance	Due to the difficulties in procuring the special equipment (boxes, bags) required for the collection of medical wastes separately at the source and also the financing of these products from the budget of the relevant hospital, the financial interests of the institution may be at the forefront during the implementation process.	[14,162]
	C13- Health institution infrastructure	During the transportation and storage of medical wastes, wastes should not come into contact with anyone except the relevant personnel. At this point, healthcare institutions should have separate stairs or elevators and they should never be used for other purposes. The physical structure is of great importance in the safe and effective transportation and storage of waste in a health institution.	[[5], [24], [42],121]
	C14 -Qualified personnel	Medical waste management with experts in the field ensures that the process is carried out more effectively and at minimum cost. For example, if an employee involved in the process does a mistake, it can cause harm that may be difficult to compensate.	[42]
Waste Related Criteria (C2)	C21- Type of medical waste	Although municipalities collect and transport household wastes free of charge, medical wastes are paid from the hospital budget or provincial health overheads. This situation led to the tendency of showing medical wastes as domestic wastes. The medical waste production amount of the hospital pushes the nature of the waste to change.	[14,162]
	C22- Material quality and type	Colored bags in which the wastes are placed must be resistant to heat and pressure. Bags that do not show the required quality during the collection of wastes and sterilization may cause the process to be carried out incorrectly.	[[5], [163]]
	C23- Control of wastes	Although the control and inspection process to be applied in hospitals is determined with the law by the ministry, it may differ in practice. For example, while a hospital checks waste bags every 2 h, another hospital can do it twice a day. Or, sanctions applied to malfunctions during controls and inspections may be among the factors affecting this process.	[42]
Non-Organizational Criteria (C3)	C31-Municipality services	The relevant municipality is authorized for the disposal or reuse of medical wastes converted into household waste. Therefore, the size and capabilities of the municipalities are of great importance in the reliable disposal or reuse of medical wastes converted.	[[1], [121],164]
	C32- Existence, competence and size of waste management facilities in the province	Another criterion in medical waste management is the existence of a waste management facility in that province. Only one firm in Erzurum makes the waste produced in Erzurum and Bayburt provinces harmless. Waste management facilities that can exist in cities and meet all required standards are of great importance in ending this process quickly and reliably. Medical waste that is stored or transported to other provinces is more likely to cause harm.	[[5], [24],164]
	C33- Training of the personnel involved in the process	Regular training is given by the Ministry, the hospital or the provincial health directorate regarding the medical waste process. However, it is thought that the training given is insufficient and the importance of this training is not understood or explained sufficiently. The training criterion is valid not only for in-hospital but also for non-hospital process workers.	[[42], [161]]