Community pharmacists in universal health coverage

Community pharmacies are private sector healthcare facilities, under the direct oversight of registered pharmacists, and offer a wide range of primary healthcare (PHC) services in addition to the traditional dispensing of prescribed medications. Often, community pharmacists are the most accessible healthcare professionals close to where people live, work, and play.

As we know, PHC is the most sustainable health system, providing the working engine for Universal Health Coverage (UHC), the health-related Sustainable Development Goals (SDGs), and health security.

 “Facilitating community pharmacists’ access to relevant digital technologies will significantly improve their contribution to PHC.”

Therefore, achieving UHC will basically depend on the availability and accessibility of adequate and competent healthcare workers with ideal skills mixed at facility, outreach, and community levels, who can deliver quality, essential healthcare.

Sadly, the deficit in skilled professionals and the entire health workforce in Africa continue to be a major setback on the pathway to achieving UHC on the continent.

The World Health Organisation (WHO) notes UHC means that all individuals and communities receive the health services they need without suffering financial hardship.

It includes the full range of essential quality health services from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.

The implications of not getting the roles of community pharmacists right in universal health coverage for policymakers abound. Community pharmacists are underutilised PHC service providers, as their concentration in urban centres remains a significant challenge for UHC. Policy action is required to incentivise the establishment of community pharmacies in rural communities.

Facilitating community pharmacists’ access to relevant digital technologies will significantly improve their contribution to PHC.

Also, integrating community pharmacists in the PHC architecture will significantly improve access to care and overall health outcomes in Nigeria.

According to the International Journal for Health Policy and Management, for the public, community pharmacies are private-sector facilities providing spatial proximity and easy accessibility to quality PHC services to people in their communities. With inadequate capacities in public sector facilities, people should have an option to access certain PHC services in their community pharmacies. It notes that if community pharmacies are integrated with the public sector service providers, patients will enjoy improved continuity of care with easy referrals along both vertical and horizontal channels of care.

We believe that for UHC to be truly effective and universal, a shift is needed from health systems designed around diseases and institutions to health systems designed for people with people in mind. Also, to achieve this, a PHC approach that focuses on organising and strengthening health systems so that people can access services for their health and well-being based on their needs and preferences, at the earliest, and in their everyday environments is needed.

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Hence, with the ease of access community pharmacists have to patients, the profession is well-positioned to play a critical role in the provision of PHC for the attainment of UHC.

Therefore, redefining the roles of community pharmacists by ensuring their active participation in the delivery of PHC services will serve as a needed bridge in the sustained global push towards providing increased access to essential medicines in developing communities and improving health coverage, especially in a country like Nigeria.

As the first point of call for individuals seeking access to PHC, community pharmacies are multi-product, multi-service facilities that are essential to a health care system. Pharmacists’ knowledge and skill set, accessibility, and extended work hours further reflect the capacity of the profession to contribute toward enhancing access and complementing primary healthcare coverage under UHC.

It is of note that increasing the involvement of community pharmacists at the PHC level would consequently benefit other public health sector establishments by relieving the workload and pressure on staff at these facilities, especially for patients that have been stabilised for treatment of chronic non-communicable diseases.

In the areas of medicine supply chain management, community pharmacists play an essential role. As they have critical roles in medicine supply chain management from selection, procurement, and distribution to quality assurance, dispensing, and monitoring. They play an important role in preventing frequent stock-outs and loss of stock and health technology assessment.

The WHO has predicted that by 2030, non-communicable diseases (NCDs) will become the leading cause of death in Africa, exceeding deaths by communicable, maternal, perinatal, and nutritional diseases combined. These pharmacists have critical roles to play in preventing and controlling NCDs at different levels—health promotion, as they are well-positioned to identify health conditions prominent in the community and initiate health promotion campaigns.

Health promotion interventions are driven by pharmacists, in addition to other health professionals, to raise awareness levels about the adverse effects of medicines and disease outbreaks.

In contrast to many high-income nations, community pharmacists are an underutilised resource for patient care in low- and middle-income countries (LMICs).

Besides, gaps in the supply of and demand for health workers are concentrated in LMICs. The WHO estimates that to meet the health workforce requirements of the SDGs and UHC targets, over 18 million additional health workers are needed by 2030.

We know community pharmacists can exploit these gaps in the supply and demand for healthcare workers by strengthening their capacity to provide quality PHC services.