Risk-Based Identification and Prioritisation of Plastic Waste Hotspots in Malawi Using a Transferable Decision Framework

Plastic waste presents a significant environmental and public health concern in Malawi, where rapid urban growth, limited waste collection services, and informal disposal practices contribute to persistent plastic waste hotspots. In Lilongwe City, the waste collection rate has been reported ranges from 10% to 30%. This means that out of the 500 to 600 tons of municipal solid waste produced each day, only about 50 to 150 tons are collected daily. These hotspots occur in settings such as drains, markets, settlement edges, riverbanks, and lakeshore environments. They intensify health-relevant exposure pathways by encouraging stagnant water, increasing flood risk, facilitating open burning, and supporting the formation of plastisphere biofilms that can contain pathogenic and antimicrobial resistant organisms. This research synthesises evidence on the main sources of plastic waste in Malawi, the mechanisms of leakage across different environments, and the associated health implications. It uses a scoping approach aligned with PRISMA-ScR guidance and is informed by the UK Research and Innovation (UKRI) funded Sustainable Plastic Attitudes to benefit Communities and their Environments (SPACES project), which highlights the influence of behavioural, governance, and environmental factors on plastic pollution. A two phase, risk-based decision framework to support targeted management of plastic waste hotspots is described. Phase 1 focuses on rapid harm reduction through the identification and ranking of hotspots according to risk severity, spatial extent, and feasibility, guiding timely interventions such as drain clearance, waste capture, and temporary stabilisation. Phase 2 addresses longer term prevention by tackling upstream drivers through policy measures, improved services, reuse and reduction schemes, and community engagement. The framework has been developed using evidence from Malawi; however, its methodology could be applied to other low- and middle-income countries that experience similar constraints and exposure pathways. The framework offers a transparent and practical tool for decision makers seeking to allocate limited resources effectively while reducing environmental and health risks associated with plastic waste.