Biomedical waste management in independent dental practices: Interrogating regulatory challenges, sociocultural dynamics, and environmental health implications in Indonesia

Effective medical waste management is a critical intersection of public and environmental health that remains a persistent challenge within independent dental practices. These clinics generate hazardous biomedical waste introducing significant risks if inadequately handled due to constrained regulatory oversight and institutional capacity. This study investigated waste management practices among independent dental clinics in Pekanbaru, Indonesia to elucidate the regulatory hurdles, resource deficits, and social and environmental dynamics governing compliance and operational execution. A descriptive qualitative design was employed using an input, process, and output analytical framework. Data triangulation was achieved through detailed interviews, direct observations, and document analyses involving local health authorities, professional associations, and independent practitioners. The evaluation matrix assessed inputs including policy, human capital, financing, and infrastructure, processes ranging from waste identification to final destruction, and outputs such as regulatory adherence. Findings revealed pronounced deficiencies in policy dissemination, workforce competency, and disposal infrastructure. Although baseline waste identification and segregation were generally executed, critical vulnerabilities emerged during the collection, temporary storage, and final disposal phases. Overall regulatory adherence remained moderate because of suboptimal enforcement, economic constraints, and prevailing cultural norms influencing practitioner behavior. Medical waste management in independent dental practices constitutes a multifaceted challenge dictated by regulatory and organizational determinants. Mitigating these risks necessitates robust policy enforcement, comprehensive professional capacity building, and integrating environmental health metrics into primary care governance to ensure safe and sustainable healthcare delivery.