E-DRUG: Pharmacists in Africa
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[Crossposted from Afro-nets]
A recent report indicated that the US would be short of 120 000
pharmacists by 2020! That is just 14 years away - a very short time
to make a significant dent in the shortfall!
But what is a pharmacist? Someone with 3, 4, 6 or longer years of
training? Can we in Africa afford to train the Pharm D pharmacists
that are now the norm in the US?
In Africa we are already seriously short of skilled pharmacy
personnel. How bad is this shortage now and how much worse is it
going to become? As I see it, that will depend on:
1. The tasks that need to be performed,
2. The level of competence required in order to perform those tasks,
3. The allocation of responsibility for those tasks between pharmacy
technicians/ assistants, pharmacists and other trained health
personnel,
4. The capacity of the training institutions in each country and the
region.
5. The ability to recruit students who have the required entry level
competencies and the commitment to serve the health needs of their
country
6. The ability of each country to retain trained personnel within the
country/ health system
I am interested to find out which of these challenges pose a serious
problem in African countries, or whether there are other serious
challenges. I am also particularly keen to find out about any
initiatives that have taken place to address these challenges.
Although I am keen to see discussion taking place about these
issues, if anyone would like to send me their thoughts directly please
feel free to do so (b.futter@ru.ac.za)
cheers, Billy
Billy Futter
Associate Professor
Faculty of Pharmacy
Rhodes University, Grahamstown, South Africa
email B.Futter@ru.ac.za
phone 046 603 8494
fax 046 636 1205
E-DRUG: Pharmacists in Africa (2)
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Hi Billy (and e-drug listers)
I was interested in the questions posed and would like to make a general point.
This is a discussion that must be had because we in the First World operate under a different set of needs and values to the Third World. Well done Billy for bringing it forward.
When we talk about pharmacists in the developed First World we refer to people who have a degree from a university and have met the requirements for obtaining registration under the relevant legislation that then allows the registered pharmacist to meet the statutory obligations required by law to be done by such a person. For example - opening a retail shop from which medicines are sold and checking that the right label is on a pack of doctor prescribed medicine for the right patient. There are more requirements but these are not enshrined in legislation but rather in professional codes of conduct.
The need for a pharmacist is thus related to the legal obligations of such a person.
In my work with Third World Australia ( remote Aboriginal communities) I often wonder why we get so obsessed with the need for a registered pharmacist when what we really want is a person with the knowledge and ability to act in a way that improves the quality use of medicine.
We should not rule out the fact that there are many nurses, medical scientists and others with the basic understanding and knowledge to do the things that are really needed and may be more committed than a "registered pharmacist" with no previous experience in remote health.
In Africa - look at the legislation that governs the practice of pharmacy, single out the activities that by law require a pharmacist and then decide the qualifications needed to fill the balance of the requirements for improving quality.
Remember that a medicine is just a bottle of chemicals and until information is added and there are many people who can add the information that may not be registered pharmacists.
What do you think? Are we too hung up on what a pharmacist is in the developed world to deny the people of the Third World quality obtained by other than a registered pharmacist? What about the idea of specific training for the skills and knowledge needed rather than following the developed world tradition?
Don't let the shortage of pharmacists in America put you off finding the best person for the job at hand. There will be people wanting to do a "pharmacists job" without necessarily being registered.
Cheers
Rollo Manning
Darwin NT
Australia
rollom@iinet.net.au
E-DRUG: Pharmacists in Africa (3)
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I think Rollo Manning's definition of the professional role of a
pharmacist's is very narrow. It is more than reading a prescription and
fixing a level. In Kenya for example pharmacists have become an integral
part of healthcare provision both in the provision of the pharmaceutical
and clinical pharmacy services.
The pharmacist's role in the developed countries is widely different
than that of one in the developing countries. There are disparities in
technology and legislative frameworks that govern pharmacy practice and
differences in the scope of services given. The cope for hospital
practice in Australia and New Zealand for example may be quite advanced
compared to the developing countries.
But to go back to Billy's point, it is not a question of whether the
brand drain of pharmacist to the developed countries will take place.
This has already started and pharmacists especially in Africa and Asia
will find a way fitting in. You may not stop movement in the liberalized
labour market.
The question is, what is the third world especially Africa planning to
do at the policy and training level? What is the strategy to retain
pharmacists but at the same time produce international recognizable
pharmacists?
E-DRUG: Pharmacists in Africa (4)
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A recent report of Federal Ministry of Health, Sudan has revealed that
the number of pharmacists and pharmacy schools rapidly increased in
the recent years. According to the report, the number of registered
pharmacists increased from 1,500 in the early 1990s to more than 3,500
by the end of 2005 and the number of schools of pharmacy increased
from one at the begining of the last decade to 11 schools. The problem
in Sudamn is : pharmacists internal migration from public sector to
the private one.
I have recently published an article addressing issues of pharmacy
human resources in Sudan in the World Health & Population, below is
the abstract:
A Prescription for Improvement: A Short Survey to Identify Reasons
behind Public Sector Pharmacists' Migration
In Sudan, there is a mismatch between the numbers of pharmacists and
where they worked, and the demand for pharmacy services. The public
sector, where the majority of the population is served, suffered
heavily from the pharmacists' migration to the private sector. In
order to stem the "brain drain" of pharmacists, it is, however,
necessary to have accurate and evidence-based information regarding
the reasons that make the pharmacists emigrate to the private sector.
Yours sincerely
Gamal Khalafalla Mohamed Ali
Tel.+4479 40 25 69 42
College of Business,Law and Social Sciences
The Nottingham Trent University
Burton Street
Nottingham NG1 4BU
United Kingdom
gamalkh@hotmail.com