KNOWLEDGE ATTITUDE AND PRACTICE OF HOUSEHOLD DISPOSAL OF UNUSED AND EXPIRED MEDICATIONS IN DODOMA CITY TANZANIA DARLIN KOKWENDA BANAGA A DISSERTATION SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF MASTER OF ENVIRONMENTAL STUDIES (MES) DEPARTMENT OF ENVIRONMENTAL STUDIES OF THE OPEN UNIVERSITY OF TANZANIA 2020 ii CERTIFICATION The undersigned certifies that he has read and hereby recommend for acceptance by the Open University a dissertation titled: “Assessment of knowledge, attitude and practice of household disposal of unused and expired medications in Dodoma city,” in partial fulfillment of the requirements for the degree of Master of Environmental Studies –Health Stream of the Open University ofTanzania. ………………………………… Prof. Emmanuel Kigadye (Supervisor) ……………………………… Date iii COPYRIGHT No part of this dissertation may be reproduced, stored in any retrieval system, or transmitted in any form by any means, electronic, mechanical, photocopying, recording or otherwise without prior written permission of the author or the Open University of Tanzania. iv DECLARATION I, Darlin Kokwenda Banaga, do hereby declare that this dissertation is my original work and that it has not been presented and will not be presented to any other university for a similar or any other degree award. …………………………. Signature ……………………….. Date v DEDICATION This study work is dedicated to my husband Dr. George G. Mkumbi, my mother Sarah N. Banaga, my father David J. Banaga, my brother Josephat T. Banaga and my young sister Leah K. Banaga. Lastly, I would like to dedicate this work to my daughter Careen N. Kitogo, family, and friends for their support and encouragement to conduct this study. vi ACKNOWLEDGMENT First of all, thanks to God for enabling me to complete my research. I appreciate the encouragement and support offered by my lovely husband, family, and friends. I am grateful to the Regional Administrative Secretary of Dodoma City for allowing me to conduct the study. I appreciate all staff members and participants for their excellent support. I appreciate the cooperation of my supervisor, Professor Emmanuel Kigadye, for his contribution to ensure that research was conducted well as it was not easy to do it alone, but with help, together we were able to tackle all challenges that came on our way during the setting of the study. Great thanks to Dr. Josephat Saria, Senior lecturer at OUT and Program Coordinator, for his assistance and facilitation during my master’s study at the Open University of Tanzania.A lot of thanks to my husband, Dr. George G. Mkumbi for his love, patience, and support during the research. In addition, I appreciate work done by my research assistants, Leah Banaga, and Dr. George Mkumbi during data collection. I am grateful to Mr. Steven Challo for his support and assistance when carrying out the study.Lastly, I offer my regards and blessings to all people who supported me in any way until the completion of the research. vii ABSTRACT The improvement of healthcare systems has brought the subsequent increase in people’s access to medications. This increased access has raised the question of how well individual households are well equipped in handling the subsequent rise in medical waste. The objective of this study was to assess the knowledge, attitude, and practice of household disposal of unused and expired medications in Dodoma city. The study was a descriptive, cross-sectional survey, conducted through face-to-face interviews using a pre-validated structured questionnaire. The study has found that knowledge is lacking amongst a majority of respondents; where 83% of the respondents reported having not received any information on safe disposal practices, while 72% admitting to not have read and followed disposal instructions. 62% of the respondents perceive that lack of adequate information on safe disposal practices is a precursor to the risks and negative consequences of unused medicines. The study also found that the most preferred method of disposal was throwing into garbage bins. Research finding indicates that knowledge and attitude towards safe disposal practices by category did not differ across most of the demographic characteristics in this study (p>0.05), statistical significance was found when comparing awareness to the gender of the respondents (p=0.036), again when participants' practice of reading instructions of disposing drugs was compared to their gen