There are three interdependent and intercon-nected dimensions of ISWM, which need to

be addressed simultaneously when designing a solid waste management system: stakeholders, elements, and aspects. Please refer to Box 4 for further details on the interconnected dimensions

of ISWM.

An alternative framework is provided by UN-HABITAT,

which identifies three key system elements in ISWM: public health, environmental protection, and resource management (UN-Habitat 2009).Public Health: In most jurisdictions, public health concerns have been the basis for solid waste management programs, as solid waste management is essential to maintaining public health. Solid waste that is not properly collected and disposed can be a breeding ground for insects, vermin, and scavenging animals, and can thus pass on air- and water-borne diseases. Surveys conducted by UN-Habitat show that in areas where waste is not collected frequently, the incidence of diarrhea is twice as high and acute respiratory

infections six times higher than in areas where collection is frequent (UN-Habitat 2009).

Environmental Protection: Poorly collected

or improperly disposed of waste can have a detri- mental impact on the environment. In low- and middle-income countries, MSW is often dumped in low-lying areas and land adjacent to slums. Lack of enforced regulations enables potentially infec-tious medical and hazardous waste to be mixed with MSW, which is harmful to waste pickers and

the environment. Environmental threats include contamination of groundwater and surface water cost of virgin materials and their environmental impact increases, the relative value of secondary materials is expected to increase.