Different models of pharmaceutical services and care in primary healthcare clinics in the Eastern Cape, South Africa: challenges and opportunities for pharmacy practice

Background: Primary health care (PHC) re-engineering forms a crucial part of South Africa's National Health Insurance (NHI), with pharmaceutical services and care being crucial to treatment outcomes. However, owing to a shortage of pharmacists within PHC clinics, task-shifting of the dispensing process to pharmacist's assistants and nurses is common practice. The implications of this task-shifting process on the provision of pharmaceutical services and care remains largely unstudied. Aim: The study aimed to explore the pharmacist-based, pharmacist's assistant-based and nurse-based dispensing models within the PHC setting. Setting: The Nelson Mandela Bay Health District, South Africa. Methods: A mixed methods approach was utilised comprising of Phase 1: a pharmaceutical services audit to analyse pharmaceutical service provision and Phase 2: semi-structured interviews to describe the pharmaceutical care provision within each dispensing model thematically. Results: Pharmaceutical services partially fulfilled minimum standards within all models, however, challenges exist that limit the quality of these services. Phase 2 showed that the provision of pharmaceutical care within all models was restricted by context-related constraints, thus patient-centred activities to underpin pharmaceutical services were limited. Conclusion: Although pharmaceutical services may have been available for all models, compromised quality of these services impacted overall quality of care. Limited pharmaceutical care provision was evident within each dispensing model. The results raised concerns about the current utilisation of pharmacy personnel, including the pharmacist, within the PHC setting. Further opportunities exist, if constraints allow, for the pharmacist to contribute to better patient-centred care

Patient Satisfaction with the Quality of Care in a Primary Health Care Setting in Botswana

Primary health care involves a sustained partnership between patients and providers that addresses the majority of a population's health needs over time. Patients' perception of satisfaction is an aspect of healthcare quality that is being increasingly recognised for its importance. The objective of this study was to investigate the factors contributing to patients' satisfaction with and their rating of the quality of care in Extension II Clinic in Gaborone; Botswana. of them were displeased with this aspect. A total of 36.9 Method: This was a cross-sectional study in which 360 systematically selected participants completed five-point Likert scale self-administered questionnaires. Results: Overall; participants were quite satisfied (mean score = 3.75) with the services provided by the different service providers. The participants indicated that overall; the quality of care of the health care facility was good (mean score = 3.45). The pharmacy received the highest satisfaction level with a mean rating of 4.1. Thirty-eight per cent of the participants rated the services provided by the doctors as best despite giving the highest quality ratings with a mean of 3.9 to the pharmacy compared to mean ratings of 3.4 for the doctors. The participants' greatest displeasure was with the time spent at the facility; as 63.9 was most pleased with information given to them as a factor of importance. Conclusion: The participants were quite satisfied with the services provided as well as the quality of care provided by the different service providers of the health care facility. There is; however; a need for interventions in terms of time spent at the facility; which would promote good customer-focused service delivery

Patients' Perception of the Benefits of Pharmaceutical Care Services in the Management of Hypertension in a Tertiary Health Care Facility in Benin City

"Purpose: Measuring the perceptions of patients is essential in evaluating the success of therapy and needs of patients. The objective of this study was to investigate patients' perceptions of the benefits of regular participation in pharmaceutical care services in the management of hypertension. Method : In a cross sectional study; 285 systematically selected hypertensive patients attending consultant outpatient clinic in University of Benin Teaching Hospital; Benin City (UBTH) were interviewed on the benefits of pharma- ceutical care services they received from pharmacists; susceptibility to health-related problems and threat reduction associated with regularly meeting with the pharmacists; using a validated structured interview format with reliability coefficient in the range of 0.79 to 0.87. Results: The patients rated medications supply and medication cost infor- mation provision as beneficial but rated patient education/counseling as fairly beneficial. However; patient monitoring; provision of nonmedication information and other specific information such as side effects; exercises; weight and blood pressure control were rated as ""not beneficial"". The services provided by the pharmacists in preventing /reducing health-related problems were poorly rated. While the perceived benefits and thread reduction were not associated with age; sex and education of the patients or the type of medication taken; patients perceived a significantly lower chance of developing health-related problem when they met with the pharmacists as compared to when they did not (P0.001). Conclusion: Although the hypertensive patients studied perceived that pharmacists contribute to the reduction in hypertension-related problems; they do not currently benefit much from the level of services offered by the pharmacists. Therefore; pharmacists working in UBTH needs to develop and fully implement comprehensive pharmaceutical care and the Health Ministries should work in collaboration with the relevant professional bodies to ensure that there is effective pharmaceutical care services in all health care facilities."

Patients' response to waiting time in an out-patient pharmacy in Nigeria

PURPOSE : To identify the dispensing procedure at a pharmacy; investigate the possible operational problems that may lead to excessive patient waiting times as prescriptions are filled and to examine patient disposition to perceived delays at the pharmacy. METHODS : The study was carried out in a 574-bed university teaching hospital in Ile - Ife; Nigeria. The subjects were out-patients who gave their consent to participate in the study. Data were collected using the techniques of workflow analysis and time study in observing the dispensing process. A validated questionnaire was administered on the out-patients to measure their responses to waiting in the pharmacy as well as their level of satisfaction with pharmaceutical services rendered. RESULTS: The workflow analysis revealed considerable delay in the dispensing procedure as a result of extended process components. The total waiting time for a dispensing process averaged 17.09 min; and 89.5 percent of this was due to delay components. Specifically; the major delay components included patient queues for billing prescription sheets and subsequent payment to the cashier. Operational problems identified included patients' indirect access to dispensing pharmacist and the tortuous procedure for prescription billing and payments. Generally; patients were not satisfied with undue delay caused by the dispensing procedure at the pharmacy. CONCLUSION: Most of the patient waiting time in the hospital studied can be accounted for by delay components of the dispensing procedure. Attempts should therefore be made to reduce the time on these components of the dispensing process so that more time could be devoted to counseling while reducing the total time spent by the patient in having their prescriptions sheets filled

Tiding the Road to decentralisation in Mulago Hospital Complex as seen in the Pharmacy Department

Decentralisation being a Toddler of Mulago Hospital et Complex; it has to be nurtured with a lot of care in order to make it reach its target apex. for that matter the staff of the Pharmacy Department have tried their level best to see to it that though not 100; but to a greater extent; this target point is relaised

Drug collectors at Chonde Health Centre

A survey of patients not really sick but who come to the hospital to collect drugs and to avoid work

Minister of health opens a three-day national prescriber workshopby editor

The workshop was to discuss plans on how to improve pharmaceutical services to ensure the supply of essential drugs to health facilities

A three-day drug policy seminar held in Blantyre; Malawiby editor

The aim of the workshop was to sensitise key decision makers from the public and private sectors on the implications of implementing the Pharmacy; Medicines and Poisons Act (1988) and the development of a clear drug policy to acheive better efficiency of the pharmaceutical supply system

How effective are drug supplies to Malawi's rural population

With Malawi's adoption of the Expanded Programme on Immunization (EPI); the supply of vaccines to many rural areas seems to be well controlled and coordinated. In contrast; there are problems with the supply of drugs to many of the rural health facilities. Reasons for this are discussed and solutions proposed

Malawi district pharmacy survey report

A study of how well Pharmacy Assistants have been doing since being posted out to District Hospitals in 1982

CIDA drugs distribution audit

Objectives were to provide CIDA with details of the Central Medical Stores distribution system down to the Rural Health Centres and any problems experienced

A report on a pharmacy out-patient questionnaire at Kamuzu Central Hospital; Lilongwe

Data was collected with the object of identifying and quantifying problems in provision of dispensing services to non-paying out-patients at Kamuzu Central Hospital [KCH]

Malawi Drug Action Programme; prescriber training: plan of action 1991-1993

This WHO supported mission was to facilitate development of the planning of prescriber training by assisting the Government of Malawi in the preparation of a detailed plan of action and budget; and review prescriber training material currently available and advise on the need for any additional material

Malawi drug action programme: information; education and communication; plan of action 1991-1995

The objective of the programme is to increase public awareness of the correct use and storage of medicines; correct misperceptions of the efficacy of different dosage forms and therapies; improve communication between patients and prescribers; and reduce wastage of medicines due to irrational use and non-compliance. The present plan proposes a combination of printed pictoral materials; newspaper and magazine features; traditional theatre performances; and radio broadcasts among others