Views, Barriers and Facilitators  of Policymakers, Pharmacists and Health Community Representative in Managing Unused Medicine in a Socioeconomically Diverse District in Indonesia

<ns7:p>Background Unused medicine poses a serious risk to community and environmental health. Several studies have been conducted on how patient behave however little is known about how this issue is viewed through the lens of different stakeholders. Objective To explore the views, barriers and facilitators of policymakers, pharmacists and community-representative on community behavior in managing unused medicines in Garut Regency, Indonesia. Methods A qualitative study was conducted with policymakers, pharmacists and community -representatives. Data were analyzed inductively using thematic analysis framework. Emergent themes were further interpreted using the Socio-Ecological approach to situate behaviors and challenges within individual, community, organizational, and policy levels. Results Fourty one participants were recruited. Five themes were identified: (1) Storing and disposing medicines, (2) causes of unused medicines, (3) individual-level barriers including knowledge gaps and cultural beliefs, (4) structural barriers such as limited facilities, regulatory gaps, and institutional constraints, and (5) facilitators including rising awareness, supportive legal frameworks, and cross-sectoral initiatives. Mapping these findings onto the Socio-Ecological approach highlighted the interplay between patient practices, social norms, institutional resources, and policy environments. Conclusion Stakeholders recognize that unused medicine management is shaped by multi-level factors beyond individual awareness. Effective interventions will require a comprehensive approach that integrates patient education, community engagement, health system support, and regulatory frameworks.</ns7:p>