Household disposal practices of unused and expired medicines in a rural district of Ghana: a cross-sectional study in Nsawkaw

Abstract

Abstract Background Inappropriate disposal of unused and expired medicines has implications for household safety, pharmaceutical pollution, and antimicrobial resistance. In Ghana, published evidence on household medicine disposal remains limited and rural data are especially sparse. This study assessed knowledge of unused and expired medicine disposal, described household disposal methods, and examined reasons associated with disposal choices in Nsawkaw, Tain District, Ghana. Methods A community-based descriptive cross-sectional study was conducted among 260 household respondents in Nsawkaw. Multistage sampling, involving clustering by electoral area and systematic household selection, was used. Data were collected with a structured questionnaire covering socio-demographic characteristics, knowledge of medicine disposal, actual disposal methods, and reasons associated with disposal choices. Data were analysed in SPSS version 21 using descriptive statistics and multiple linear regression. Results Of the 260 respondents, 56.9% were male, 68.4% were aged 26–60 years, and 33.8% were farmers. Knowledge of safe disposal was limited: 53.5% did not know that unused or expired medicines constitute medical waste, 60.8% were unaware of disposal instructions on patient leaflets, and only 45.8% knew that improper disposal could harm health and the environment. Seventy per cent believed that disposal in household garbage was the most appropriate method, and 74.2% reported that garbage disposal was their actual practice. Other reported practices were flushing into toilets or sinks (8.5%), storage for future use (6.5%), sharing with friends or relatives (5.4%), burying in soil (1.9%), burning (1.5%), hazardous waste deposition (1.2%), and returning to a pharmacy (0.8%). Inadequate knowledge (54.2%) and lack of a disposal protocol (27.8%) were the leading reasons associated with disposal choice. In regression analysis, inadequate knowledge showed the strongest standardised effect (beta = 0.521, p < 0.001), followed by lack of a protocol (beta = 0.297, p = 0.001), misinformation from advertisements (beta = -0.258, p = 0.022), and leaflet instructions (beta magnitude about 0.21, p < 0.05). Conclusions Unsafe household disposal of medicines is common in Nsawkaw, and the pattern is strongly linked to poor knowledge and the absence of a clear consumer-level disposal system. Public education, pharmacist counselling, consumer disposal guidance on medicine packs, and a national take-back or return framework are warranted.