Redefining roles of community pharmacists in universal health coverage
Primary health care is no doubt the pivot of a sustainable health system, Providing the ‘programmatic engine’ for Universal Health Coverage (UHC), the health-related Sustainable Development Goals (SDGs), and health security.
Nevertheless, achieving UHC basically depends strongly on the availability and accessibility of adequate and competent healthcare workers with optimal skills mixed at facility, outreach, and community level, who can deliver quality, essential healthcare.
Unfortunately, the deficit in skilled professionals and the entire health workforce in Africa continues to be a massive setback on the pathway to achieving UHC in the continent.
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, …
According to the World Health Organisation (WHO), 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.
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.
We believe also that to achieve this, a Primary Health Care (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.
Hence, we believe also that 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, we believe that redefining the roles of community pharmacists by ensuring their active participation in the delivery of primary healthcare services will serve as a needed link 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.
Community pharmacists play a crucial role as they are mostly the first point of call for individuals trying to access PHC, as the pharmacies are multi-product, multi-service facilities that are essential to a health care system. Pharmacists’ knowledge and skill set, accessibility, and extended trade hours further reflect the capacity of the profession to contribute toward enhancing and complementing access and primary healthcare coverage under UHC.
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.
Community pharmacists play an essential role in the areas of medicines supply chain management, as they have critical roles in medicines 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.
They also help in the prevention and control of non-communicable diseases (NCDs), as WHO has predicted that by 2030, NCDs will become the leading cause of death in Africa, exceeding deaths caused by communicable, maternal, perinatal, and nutritional diseases combined. These pharmacists have critical roles to play in preventing and controlling NCDs at three levels.
They are pivotal in 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 countries, community pharmacists are an underutilised resource for patient care in low- and middle-income countries (LMICs).
There is a critical need for the introduction of skills that have been previously underutilised by this group of health professionals. Integrating pharmacists with the broader primary health-care system, greater strides in improving the training and early certification for providing these services at an undergraduate level would be beneficial.
Besides, gaps in the supply of and demand for health workers are concentrated in LMICs like those in Africa, 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.
Community pharmacists can leverage these gaps in the supply and demand for healthcare workers by strengthening their capacity to provide quality PHC services. UHC affords pharmacists the opportunity to evolve in their roles and become more engaged at community and system levels.
A change in attitude regarding the pharmacy profession is therefore essential for those practising it, for patients utilising the services, and for other health professionals collaborating in the future of shared patient care.