During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers. The aim of this paper is to highlight the role of pharmacists in developing countries.The paper draws on the literature related to the socioeconomic and health status of countries population, along with background on the pharmacy profession in the country in the context of the current directions of health care.
This lack of recognition is due to the limited interaction of pharmacists with the public. Pharmacists in developing countries are concerned about their present professional role in the health care system. The main problem they are facing is the shortage of pharmacists in pharmacies. Moreover, their services are focused towards management more than towards customers. For these reasons, the pharmacist’s role as a health care professional is not familiar to the public.
The pharmacist as a health care provider
Pharmacy is the health profession that links the health sciences with the basic sciences; it is committed to ensuring the safe and effective use of medication . Pharmacists’ professional roles and responsibilities have evolved historically from a focus on medication compounding and dispensing to extended pharmaceutical care services
An increase in health demands, with a complex range of chronic medicines and poor adherence to prescribed medicines, has forced pharmacists to take a patient-centered approach . The paradigm shift for pharmacy practice took turn in 1990, when Hepler and Strand introduced the term “pharmaceutical care” . Over the last few decades, pharmacy organizations and academic training programmes around the world have promoted pharmaceutical care as a philosophy and standard of provision of care for patients . In essence, the pharmaceutical care concept has transformed the pharmacy profession to be more accountable in patient care, especially to ensure that a patient achieves positive outcomes from drug therapy .
In many parts of the world, pharmacists have played a significant role in provision of pharmaceutical care services. In addition, it is also widely believed that pharmacists can make a great contribution to the provision of the primary health care, especially in developing countries . Their role varies in different parts of the world: some deal with the preparation and supply of medicines, while some focus on sharing pharmaceutical expertise with doctors, nurses and patients .
The pharmacy profession in the international context
WHO has contributed effectively towards encouraging and defending the role of pharmacists worldwide.The International Pharmaceutical Federation (FIP) and WHO developed the concept of “The seven star pharmacist”, which stated that a well-rounded pharmacist should be a compassionate care giver, decision maker, active communicator, lifelong learner and good manager; and should possess good leadership qualities and the ability to be a teacher and researcher . According to WHO, future pharmacists must possess specific knowledge, attitudes, skills and behaviors in support of their roles .
Due to the increasing demand for pharmacists in public health, WHO recommends a ratio of one pharmacist per 2000 population in order for optimal health care to be delivered. Besides their pivotal role in public health, pharmacists can also act as advisors to physicians and nurses and contribute to policy decisions .
Pharmacy practice in developing countries
Pharmacy practice models in developing countries vary significantly from one country to another. Some of the major issues identified as barriers to effective pharmacy practice models in these countries include an acute shortage of qualified pharmacists and no implementation of dispensing separation practices – especially in countries where the pharmacist is not the sole dispenser and medical practitioners are allowed to dispense as well – and a lack of standard practice guidelines.
In developing countries, the urban population is more affluent . As a result, health professionals such as pharmacists prefer to work in cities rather than rural areas . The lack of human resources creates a significant difference between the health services available in the urban and rural areas. In many cases this is due to the shortage of pharmacists .
Other countries, such as India, have a comparatively high number of trained pharmacists, but their pharmacy training is focused more towards the industrial sector. This is due mainly to the demand from the industrial side and the focus of the national pharmacy curriculum in most universities, which covers mainly subjects pertaining to the production aspects of pharmaceuticals .
Pharmaceutical services in developing countries face some specific challenges unlike those faced by pharmacists in the developed world. In most developing countries, lack of appropriate and good-quality medicines is the most common problem encountered. Irrational use of medicine and weak regulatory enforcement of drug sales are also serious issues in developing countries. For example, findings from a survey conducted in a rural region of Ghana revealed that drug retailers in five pharmacy shops were found to have little or no training in pharmacy; the population bought drugs without prescriptions; the staff of these shops contributed to drug misuse by providing misinformation about drugs and selling drugs according to popular demand .