Abstract:

Background: A Pharmaceutical waste product is any pharmaceutical that should never be used and include; all expired pharmaceutical, all unsealed syrups or eye drops, all cold chain damaged unexpired pharmaceutical that should have been stored in a cold chain but were not and all unsealed tubes of creams, ointments, etc. and all bulk or loose tablets and capsules. For quite a long time, disposal of unwanted medicine e.g. especially expired pharmaceuticals in the country has not been done systematically and professionally due to a number of factors that are yet to be clearly explained. This has resulted to accumulation of unwanted medicines in health facilities and medicines outlets in the country.

Objectives: The study will examine current disposal practices as well as establishing the burden of unwanted pharmaceutical encountered in health facilities found in Nyamagana district.

Methodology: The study was a descriptive cross sectional survey. Data was collected through interview of medicines store in-charges from a sample of 40 randomly selected health facilities on relevant issues with regard to safe disposal of unwanted pharmaceuticals.

Results: Most of the health facilities’ pharmacy stores personnel (25.5%) were non-pharmaceutical professionals hence have inadequate essential pharmaceutical management skills and not enough knowledge hence leading to poor handling of unwanted medicines. Main disposal methods for unwanted drugs from the surveyed health facilities ever used were burning in the city dumpsites (7.5%), returning to city council (17.5%), returning to donor (10%) and 65% of health facilities have never done and disposal method.

Conclusion and Recommendations: Managing disposal of unwanted medicines at health facilities faces various challenges such as inadequate enforcement by TFDA, legal constraints, long procurement procedures at MSD, donation medicines (with short expiries), Change of prescribing patterns and inadequate number of pharmaceutical staff and inadequate costs of cover medicines disposal costs. Disposal method used were found to be influenced by factors like; presence of a pharmaceutical personnel, status of the health facility, unavailability of TFDA guidelines, experience of the respective health facility store-in-charge. It is recommended that TFDA should increase efforts such as frequent supportive supervisions at the health facilities; health facilities should only receive donations having at least 1 year shelf life remaining upon arrival and according to need; Ministry of Health should deploy staffs of pharmaceutical cadre with the demand of service provisions and further research can be carried out to cover the whole country to assess the magnitude of the problem.