It is more than 5 years since the prescribed deadline, 30 December 2002, for all categories of towns covered by the Biomedical Waste Management (BMW) Rules 1998 elapsed. Various reports indicate that the implementation of the BMW Rules is not satisfactory even in the large towns and cities in India. Few studies have looked at the `macro system' of the biomedical waste management in India. In this context the present study describes the role of the important stakeholders who comprise the `macrosystem' namely the pollution control board, common waste management facilities, municipal corporation, state government (Directorate of Medical Education and Health Systems Development Project), professional agencies such as the India Medical Association and non-governmental organizations, in the implementation of BMW rules in a capital city of a state in south India. Brief descriptions of the `micro-system' (i.e. biomedical waste management practices within a hospital) of six hospitals of different types in the study city are also presented.
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