Proper management of pharmaceutical waste is crucial for safeguarding public health and the environment. This study aimed to comprehensively assess pharmaceutical waste management practices in hospitals, pharmacies, and households within Bushenyi-Ishaka Municipality, Uganda. The study employed a qualitative case study design, gathering data through observations, interviews, and questionnaires administered to five pharmacies, two hospitals, and 100 households. The results revealed that the mean amount of pharmaceutical waste generated by pharmacies and hospitals in Ishaka was 40.5 kg ± 32.39 kg per month, of which 26.83 kg ± 29.10 kg were disposed of safely. However, 60% of the waste was categorized as hazardous. The study found that while most facilities used labeled or color-coded containers for waste segregation, the practice of segregation was inconsistent, with 71.43% of the facilities not segregating their waste. Incineration (42.86%) and dilution followed by flushing in protected soak pits (42.86%) were the primary disposal methods employed by the facilities. Concerningly, only 4% of households returned unused or expired medications to pharmacies, with the majority disposing of them in dustbins (46%) or flushing them down toilets (41%). The findings also highlighted gaps in awareness and training, with 50% of pharmacy staff not receiving any training on proper pharmaceutical waste disposal, and only 14.29% of the facilities having established waste management guidelines. These deficiencies in knowledge and practices contribute to the suboptimal management of pharmaceutical waste, posing significant risks to public health and the environment. The study underscores the urgent need for comprehensive policies, targeted training programs, and community-based initiatives to enhance pharmaceutical waste management practices in Bushenyi-Ishaka Municipality and similar settings. Addressing these challenges is crucial for mitigating the adverse impacts of improper pharmaceutical waste disposal and promoting sustainable healthcare waste management. Keywords: Pharmaceutical waste, Waste management, Disposal practices, Awareness, Hazardous waste.
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