Given the growing global emphasis on sustainable transportation systems, this research presents a comprehensive approach to achieving economic, social, and environmental efficiency in transport within the waste management sector. To address the different challenges of sustainable transportation issues, this paper presents a hybrid multi-criteria decision-making (MCDM) approach that incorporates the analytic hierarchy process (AHP) along with data envelopment analysis (DEA) for sustainable route selection. By leveraging the strengths of both methods, this approach reconciles conflicting requirements and diverse perspectives, facilitating effective decision making. This paper involves identifying relevant criteria for route evaluation, engaging waste management company experts and stakeholders in pairwise comparisons using AHP. Furthermore, DEA is used to calculate route efficiency based on the inputs and outputs of the system. These evaluations enable the identification of the most effective and sustainable routes. This proposed methodology empowers decision makers and transportation policymakers to develop an effective decision-making tool for addressing waste transportation challenges in developing countries. The study contributes to the growing body of research on sustainable waste management practices and provides insights for waste management companies and decision makers on how to optimize waste transportation routes while reducing economic, social, and environmental impacts.

Background: The hospital supply chain (HSC) is one of the main levers for improving the performance of any healthcare organization. HSC stakeholders evolve in a dynamic environment marked by great complexity. This observation led us to conduct research, through which we examined several factors enabling operational performance to be achieved within the HSC. Methods: For the empirical verification, we opted for a survey of a relevant sample composed of health professionals operating in different Moroccan hospitals, particularly in the logistics departments. Afterwards, the data were analyzed using a Partial Least Squares-Structural Equation Modeling (PLS-SEM) method to test the hypothesized relationships in this study. Results: The results show that the adoption of Industry 4.0 technologies improve collaborative aspects between logistics processes and flows, and thus ensure better integration of HSC. The research also highlights the moderating effect of HSC complexity in the relationship between HSC integration and HSC operational performance, i.e., HSC integration increases HSC operational performance in a context marked by high complexity. Conclusions: This paper explores the impact of Industry 4.0 technologies on HSC operational performance. The study provides hospital managers and practitioners with insights to improve HSC operational performance through integration initiatives, ultimately better meeting the needs of healthcare professionals and contributing to improve the quality of care.