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Healthcare supply chains face increasing pressure to adopt circular economy (CE) principles that reduce environmental impact and improve service efficiency. However, there is limited guidance for decision-makers on how to prioritize Circular Supply Chain Management (CSCM) practices in service-oriented contexts, particularly in developing countries. This study develops and validates a CSCM prioritization framework for Colombian Healthcare Providers (HCPs) using the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method. Six categories of CSCM practices, i.e. Management Initiative Practices (MIP), Cleaner Production Practices (CPP), Technological and Infrastructure Practices (TIP), Circular Design Practices (CDP), Economy Based Practices (EBP), and Social and Cultural Practices (SCP), and 25 sub-practices were identified and evaluated based on expert judgment. Quantitative results show that MIP and CPP are the most influential (cause-group), suggesting that leadership and eco-efficiency are key enablers of circularity in healthcare. In contrast, TIP, EBP, SCP, and CDP were found to be more reactive (effect-group), influenced by cause-group practices. The framework was qualitatively validated through a focus group, confirming its utility as a decision-support tool to allocate resources, sequence interventions, and guide transformation towards sustainability. Barriers such as resistance to change, regulatory restrictions, and limited incentives were identified, emphasizing the need for contextualized strategies. This research contributes both theoretically and practically to CSCM literature, offering a replicable, expert-driven prioritization model to support circular transitions in service-based supply chains, especially in emerging economies
Vargas-Muñoz et al. (Thu,) studied this question.