Sustainable and low-cost radiation shielding materials in developing countries

The expansion of diagnostic radiology services in developing countries has improved access to medical imaging but has simultaneously increased demand for effective and affordable radiation protection infrastructure. Conventional shielding materials such as Lead and concrete remain widely used because of their high attenuation performance; however, their cost, environmental burden, structural requirements, and dependence on imported supply chains limit implementation in low-resource settings. This PRISMA-informed review synthesizes evidence published between 2022 and 2026 to evaluate sustainable and low-cost radiation shielding alternatives applicable to developing countries, with contextual relevance to Uganda and similar healthcare environments. A total of 90 references were analyzed, covering agricultural residues, forestry by-products, glass-based systems, industrial waste-derived materials, and engineered hybrid composites. Findings indicate that bio-based and hybrid shielding materials can provide attenuation suitable for selected diagnostic energy ranges when optimized through densification, increased thickness, layered design, and incorporation of mineral additives. Hybrid bio–mineral composites demonstrated the most favorable balance between shielding performance, affordability, and implementation feasibility. However, adoption remains constrained by material variability, limited standardization, inadequate testing infrastructure, and insufficient regulatory recognition. Coordinated advances in research, policy development, local manufacturing, and institutional capacity building are essential to support sustainable radiological safety in resource-constrained healthcare systems.