Health care workers' knowledge, policies, procedures and practices of medicines disposal in private clinics in Kampala Capital City

Abstract

Background Unused pharmaceuticals ought to be disposed of appropriately to avoid environmental contamination because they can harm the ecosystem. Detrimental effects on the growth, reproduction and behavior of birds, invertebrates, plants and bacteria have been associated with pharmaceuticals in the environment, even at very low concentrations. Objectives The general objective of this study was to assess health care workers' knowledge, policies, procedures and practices of medicines disposal in private clinics in Kampala Capital City. Justification According to recent ecotoxicity studies; improperly disposed environmental pharmaceutical pollutants affect the growth, reproduction and behavior of birds, invertebrates, plants, bacteria and cause antimicrobial resistance even at very low concentrations. Assessing knowledge and determining disposal practices of medicines by health care workers in private clinics will identify gaps that will inform private health sector capacity strengthening, supervisory and regulatory interventions by relevant authorities such as MOH, NDA, NEMA to mitigate pharmaceutical pollution of the environment. Methods A cross-sectional study was carried out, in 257 private clinics in Kampala Capital City using a structured questionnaire. Kish Leslie formula was used to determine a sample size of 257 private clinics, from which a health care worker in charge of medicines was the respondent. Data was entered into Microsoft Excel and exported to STATA version 15 for analysis. Descriptive statistics such as mean, standard deviation and proportions were computed for background characteristics of health care workers, knowledge of disposal, availability of internal policies or procedures and prevalence of different practices for pharmaceutical disposal. Association of background characteristics of health care workers, knowledge of disposal, and availability of internal policies and procedures for pharmaceutical disposal with practices of medicines disposal was analyzed using both multiple and binary logistic regressions. Results 72% private clinics had internal policies and procedures for disposal of unused medicines while 83.7% of health care workers were knowledgeable about proper disposal of unused medicines. Most (91.1%, n = 243) private clinics disposed of unused medicines into facility rubbish bins. Unused medicines were disposed of inappropriately by 246 (95.7%) private clinics. There was no statistically significant association of background characteristics, knowledge of disposal, and availability of internal policies/procedures for pharmaceutical disposal with practices of medicines disposal. Conclusion and recommendations Prevalence of improper disposal practices of unused medicines was high in private clinics in Kampala capital city. Therefore, sensitization programs on safe disposal of unused medicines for private clinics should be developed and implemented by policy makers in Kampala.