Private-sector retail drug outlets are often the first point of contact for common health ailments, including tuberculosis (TB). The objective of this systematic review was to better understand the extent to which the World Health Organization’s (WHO) recommendation on engaging retail drug outlets has been translated into programmatic policy, strategy, and intervention in low- and middle-income countries. The study found that of national strategic plans for TB control from 14 countries with varying TB burdens and a strong private sector, only 2 had explicit statements on the need to engage their national pharmacy professional association. The success rate of referrals from retail drug outlets who visited an approved health facility for TB screening ranged from 48% in Vietnam to 86% in Myanmar. Coverage of retail drug outlets ranged from less than 5 to 9% of the universe of retail drug outlets. For WHO’s End TB Strategy to be successful, scaling up retail drug outlets to increase national coverage, at least in countries with a thriving private sector, will be instrumental in accelerating the early detection and referral of the 3 million missing TB cases. The proposed public-private mix pharmacy model is applicable not only for TB control but also to tackle the antimicrobial resistance crisis in these countries.

Half of the Ugandan population obtains medicines from the public sector. Yet, we found only 3/5 of 455 inspected public health facilities meet Good Pharmacy Practice (GPP) standards. Facilities using SPARS (the Supervision, Performance Assessment, and Recognition Strategy) tended to perform better than unsupervised facilities, substantiating the value of supporting supervision interventions in GPP areas that need strengthening. Non-compliant indicators can be improved through practices and behavioral changes; some require infrastructure investments. We conclude that regular National Drug Authority inspections of public sector pharmacies in conjunction with interventions to improve GPP adherence can revolutionize patient care in Uganda.

Pharmacists' roles are evolving from that of compounders and dispensers of medicines to that of experts on medicines within multidisciplinary health care teams. In the developing country context, the pharmacy is often the most accessible or even the sole point of access to health care advice and services. Because of their knowledge of medicines and clinical therapeutics, pharmacists are suitably placed for task shifting in health care and could be further trained to undertake functions such as clinical management and laboratory diagnostics. Indeed, pharmacists have been shown to be willing, competent, and cost-effective providers of what the professional literature calls "pharmaceutical care interventions"; however, internationally, there is an underuse of pharmacists for patient care and public health efforts. A coordinated and multifaceted effort to advance workforce planning, training and education is needed in order to prepare an adequate number of well-trained pharmacists for such roles. Acknowledging that health care needs can vary across geography and culture, an international group of key stakeholders in pharmacy education and global health has reached unanimous agreement that pharmacy education must be quality-driven and directed towards societal health care needs, the services required to meet those needs, the competences necessary to provide these services and the education needed to ensure those competences. Using that framework, this commentary describes the Pharmacy Education Taskforce of the World Health Organization, United Nations Educational, Scientific and Cultural Organization and the International Pharmaceutical Federation Global Pharmacy and the Education Action Plan 2008–2010, including the foundation, domains, objectives and outcome measures, and includes several examples of current activities within this scope.

To achieve a high quality global infrastructure for pharmacy, the educational system should be mapped to the required competencies of pharmacists to provide the relevant pharmaceutical services for meeting the health needs in any given country context. While no one national model may be appropriate for all systems, there are significant global health and labor and market drivers which suggest that a competency-based approach is sensible and sustainable for workforce development.

The objective of this survey was to develop an indicator-based tool for systematic assessment and reporting of good pharmacy practice (GPP). The tool comprises a) a set of indicators, b) an indicator and survey manual, c) a data collection sheet, and d) Microsoft Excel based data collection and analysis tool. We developed a set of 34 pharmacy practice (PP) indicators using an iterative process to test their functionality in various pharmacy practice settings in Ethiopia, Uganda and Zimbabwe. The indicator-based survey assessed five components of PP: system, storage, services, dispensing and rational drug use. The new GPP indicator-based assessment tool proved to be an easily applicable tool for uniform assessments of pharmacy practices and identification of problem areas. It allows for both intra- and inter-country comparison and for self-assessment. However, the indicators need to be further developed to test their applicability in developed countries.

This article assessed private sector accredited drug dispensing outlets in Morogoro and pharmacies in Dar es Salaam, Tanzania, to determine (1) the level of knowledge about tuberculosis (TB) among dispensers in Tanzania's retail pharmaceutical sector; (2) practices related to identification of patients with suspected TB; (3) the availability of educational materials and training; and (4) the availability of first- and second-line anti-tuberculosis treatment in retail drug outlets. Private retail drug outlets are convenient; most are open at least 12 h per day, 7 days/week. Although 95% of dispensers identified persistent cough as a symptom of TB, only 1% had received TB-related training in the previous 3 years; 8% of outlets stocked first-line anti-tuberculosis medicines, which are legally prohibited from being sold at retail outlets. The majority of respondents reported seeing clients with TB-like symptoms, and of these 95% reported frequently referring clients to nearby health facilities. Private retail pharmaceutical outlets can potentially contribute to TB case detection and treatment; however, a coordinated effort is needed to train dispensers and implement appropriate referral procedures.

The Problem: In developing countries, the most accessible source of treatment for common conditions is often an informal drug shop, where drug sellers are untrained and operations are unmonitored.

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