Circular Transitions in Healthcare Waste Management in Vietnam: An Institutional Perspective

Healthcare waste management (HCWM) is a growing environmental and public health concern. This study explores how the institutional pressures that shape HCWM practices evolve toward circularity through coercive, normative, and mimetic isomorphisms and how these mechanisms influence organisational behaviour in Vietnam, a complex, highly regulated setting. Data were collected through focus groups with representatives from hospitals and waste management firms in Hanoi and Ho Chi Minh City. Findings reveal that coercive pressures, such as state regulations, still have significant influence in Vietnam's complex administrative environment. However, normative pressures are increasingly embedding values of responsibility and competence, while mimetic pressures promote circular innovations and technologies through international benchmarking. This paper contributes to circular economy literature, particularly in emerging economies, by highlighting that circularity transitions are fundamentally institutional rather than completely technology dependent.