Abstract
OBJECTIVE: Chattogram, a major economic hub with an expanding population, requires additional healthcare facilities. This study identifies current pharmaceutical waste management practices throughout the district and assesses their impact on public health in both urban and rural settings. METHODS: A descriptive cross-sectional study was conducted in Chattogram, Bangladesh (January 2023-December 2024) to assesse pharmaceutical waste management in urban, peri-urban, and rural areas. Four semi-structured questionnaires targeted 506 university students, 116 pharmacists, 10 healthcare professionals, and three pharmaceutical companies, selected via stratified and simple random sampling. Face-to-face interviews and field observations evaluated disposal practices and infrastructure. Data were analyzed using descriptive statistics and thematic analysis in Excel and R. RESULTS: All participating pharmaceutical companies generated waste (50% hazardous, e.g., expired drugs; 50% non-hazardous, e.g., packaging), using incineration and minimization, but only 33.33% had trained personnel. All healthcare professionals (100%) knew waste hazards, yet only 50% were trained; 80% used segregated disposal, with 70% incineration and 40% landfilling. Of 116 pharmacists, 90% returned expired drugs, but 91% lacked training; 95% deemed expired medicines most harmful. Among 506 students, 51.38% were unaware of medication waste, 51.19% of take-back systems, 44.07% stored unused prescriptions, and 56.52% noted no university waste facilities. In addition, 42.89% agreed that improper disposal poses environmental risks, and 52.96% health risks, suggesting critical needs for training and infrastructure. CONCLUSION: In Chattogram, pharmaceutical waste management was found to be a major issue due to a lack of awareness, training, and infrastructure. Despite some basic practices, major gaps persist, particularly in rural areas, emphasizing the need for education, regulation, and improved disposal systems.