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