Pharmaceutical waste management knowledge, practice gaps, and environmental risks in community pharmacies and dispensaries in Dodoma City, Tanzania

Pharmaceutical waste generated in community pharmacies and dispensaries is often managed outside formal hospital systems, creating avoidable risks to public health and the environment. A mixed‑methods assessment was conducted in Dodoma City, Tanzania, covering 20 community healthcare facilities. Data included structured questionnaires with 40 healthcare professionals, key‑informant interviews, direct observations, and facility‑level audits. Although most staff demonstrated strong theoretical awareness of proper pharmaceutical waste management (87.5%), audits revealed widespread non‑compliance. Only 34% of facilities adhered to segregation protocols in practice, and commingling of pharmaceutical and general waste was observed in 40% of facilities. Reported final disposal pathways included incineration (55%), landfill disposal (30%), and open burning (25%), with rare use of take‑back/return systems (< 5%). Key barriers were limited infrastructure (secure storage, labeled containers), high costs of compliant disposal services, inconsistent guidance, and weak enforcement. A pronounced knowledge–practice gap persists in community facilities in Dodoma. Policy reform, routine monitoring, and urgent investment in fit‑for‑purpose segregation, storage, transport, and treatment infrastructure are needed. Competency‑based training, feasible take‑back mechanisms, and strengthened oversight can reduce environmental contamination and public‑health risks, including antimicrobial resistance.