Waste Management Policies, Practices, and Public Health Outcomes in Developing Countries: A Systematic Review and Meta-Analysis

Rapid urbanization, industrialization, and consumerism have caused an unprecedented rise in waste generation across low- and middle-income countries (LMICs), creating a severe waste management crisis. Municipal solid waste volumes are currently 200–400% higher than the capacity of the infrastructure to handle them. Projections show that LMICs will produce more than half of the world's solid waste by 2050. Despite the increasing waste volumes, the existing rules and institutions remain inadequate. This leads to a lot of open dumping and burning, which makes up more than 90% of waste disposal in low-income countries. These practices produce toxic leachates, air pollutants, and disease vectors, disproportionately impacting vulnerable populations residing near unmanaged sites. This systematic review and meta-analysis (2010–2023) consolidates findings from 78 studies, including 45 in the meta-analysis, to assess the correlation between waste management policies, practices, and public health outcomes in low- and middle-income countries (LMICs). Findings confirm significant associations between unsanitary waste practices and heightened disease burdens, including diarrheal diseases (pooled OR 3.1; 95% CI: 2.4–4.0; I²=72%), acute respiratory infections (OR 2.8; 95% CI: 2.2–3.6; I²=65%), and dermatological conditions (OR 2.1; 95% CI: 1.6–2.8; I²=61%). There are about 15 million informal waste workers around the world who face serious risks on the job, including exposure to heavy metals, injuries, and health risks that affect future generations. Case studies from Rwanda, Kerala, and Brazil demonstrate that integrated approaches combining regulatory enforcement, community engagement, and circular economy infrastructure can reduce health burdens by up to 50% within five years. Key barriers include financial constraints, institutional fragmentation, corruption, and exclusion of the informal sector. Policy recommendations emphasize binding bans on open dumping and burning, extended producer responsibility (EPR) schemes, formalization of waste pickers, and investment in decentralized, climate-resilient waste systems. Future research should focus on longitudinal evaluations of the impacts of plastic and electronic waste, standardized biomarker surveillance, and governance frameworks that reduce corruption and disparities. This review highlights waste management as a modifiable determinant of health in developing countries and underscores the urgency of integrated, evidence-based reforms to achieve Sustainable Development Goals 3 (Good Health and Well-being) and 11 (Sustainable Cities and Communities).