Between Infrastructure Deficit and Informal Disposal: Solid Waste Management Practices, Challenges, and Health–Economic Impacts Among Traders at Kumasi Central Market, Ghana

Open-air markets in Sub-Saharan Africa generate large waste volumes but remain understudied as waste management environments. This study examined waste management practices, infrastructure conditions, and health–economic impacts among 149 randomly sampled traders at the Kumasi Central Market, Ghana, using a quantitative cross-sectional design. Structured questionnaires were supplemented by semi-structured interviews with the Kumasi Metropolitan Assembly Environmental Health Unit officers, and trader-reported waste volumes were cross-validated against institutional estimates. A probability-weighted mean daily waste estimate and Challenge Severity Index (CSI) were computed. The market generates 220–230 tonnes of solid waste daily; organic matter comprises 68–87% of the total volume, and the mean waste per trader is 8.26 kg per day. Lack of bins (CSI = 1.00), irregular collection (CSI = 0.94), and high disposal costs (CSI = 0.90) were ranked higher than knowledge deficits (CSI = 0.72). A total of 81% of traders experienced waste-related health consequences, and 71.8% reported income losses. The findings suggest that infrastructure deficits are the primary constraint on disposal outcomes, outweighing knowledge-related factors in severity, providing quantitative evidence linking sanitation infrastructure gaps to health and livelihood impacts in informal market settings.