Qatar's National Mental Health Survey-The World Mental Health Qatar: Sampling design, instrument adaptation, quality control, and fielding procedures.

OBJECTIVES: The World Mental Health Qatar (WMHQ) study, the first national general population mental health survey in Qatar, was conducted as part of the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. It was one of the few WMH survey conducted during the COVID-19 pandemic. This paper presents the methodological advances and challenges encountered while conducting the survey by telephone during the pandemic. METHODS: Disproportionate stratified sampling using a national-level cellular telephone frame selected a representative sample of Arabic-speaking adults. Participants were initially contacted via Short Message Service text, followed by telephone interviews. WMH training materials supported a comprehensive training program, and data quality was ensured through a quality control indicator system and extensive monitoring. RESULTS: Over 234 days, 5195 interviews in Arabic were completed, averaging 77 min each. In line with Qatar's population, the majority of participants were non-Qatari residents living in Qatar (72.2%). CONCLUSIONS: A distributed remote Computer Assisted Telephone Interviewing system facilitated centralized quality monitoring and data security. However, the pandemic intensified challenges such as remote management of interviewer productivity, low response rates, and rising survey costs. The findings will inform Qatar's mental health policymakers, and the strategies used to address these challenges offer valuable insights for researchers worldwide.

Feasibility of replacing face-to-face with telephone interviews for the World Mental Health Qatar survey during the COVID-19 pandemic.

OBJECTIVES: We investigated the feasibility of replacing face-to-face with telephone interviews conducted as part of the World Mental Health Qatar (WMHQ) survey and discuss the main methodological changes across the two pilots that were subsequently implemented in the full-scale WMHQ telephone survey. METHODS: We assessed the net mode effect by comparing the lifetime prevalence estimates of the main mental disorder classes (mood and anxiety disorders) and a number of disorders across the two survey pilots conducted prior to and post-pandemic. RESULTS: The main differences in terms of methodology for both pilots stemmed from differences in the survey mode, including questionnaire length, study recruitment method, and fielding team size and structure. These factors influenced response rates and costs. However, the lifetime prevalence estimates and other key indicators of survey results did not differ across modes. CONCLUSIONS: Our findings confirm the comparability of data collected via telephone and face-to-face modes, supporting the adoption of telephone surveys for future mental health studies, particularly in the context of pandemics. They also confirm the feasibility of changing or mixing modes depending on field conditions in future psychiatric epidemiological research.

The development and validation of a global advanced development framework for the pharmacy workforce: a four-stage multi-methods approach.

BACKGROUND: Studies have indicated that a generalisable and translatable global framework is a useful tool for supporting career progression and recognising advanced practice. AIM: To develop and validate a global advanced competency development framework as a tool to advance the pharmacy profession globally. METHOD: A four-stage multi-methods approach was adopted. In sequence, this comprised an assessment of initial content and a cultural validation of the advanced level framework. Following this, we conducted a transnational modified Delphi followed by an online survey sampling the global pharmacy leadership community. Finally, a series of case studies was constructed exemplifying the framework implementation. RESULTS: Initial validation resulted in a modified draft competency framework comprising 34 developmental competencies across six clusters. Each competency has three phases of advancement to support practitioner progression. The modified Delphi stage provided feedback on framework modifications related to cultural issues, including missing competencies and framework comprehensiveness. External engagement and case study stages provided further validity on the framework implementation and dissemination. CONCLUSION: The four-staged approach demonstrated transnational validation of a global advanced competency framework as a mapping and development tool for the pharmacy professions. Further study is needed to develop a global glossary of terminologies on advanced and specialist practice. Also, developing an accompanying professional recognition system and education and training programmes to support framework implementation is recommended.

An evidence-led review of the FIP global competency framework for early career pharmacists training and development.

BACKGROUND: The International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) for early career pharmacists is an evidence-driven guide for pharmacist professional development. First published in 2012, the FIP GbCFv1 contains a structured assembly of competencies for pharmacists in four broad areas: pharmaceutical public health; pharmaceutical care; organisation and management; and professional/personal. FIP is committed to support the advancement of pharmacy around the world, and in light with the expansion of the type of services that pharmacists may provide to their patients and the advances in technology and therapeutics, revising and updating the GbCF is imperative. OBJECTIVE: The aim of this project was to revise and update the first published iteration of the FIP GbCFv1 (2012) to ensure currency and continued relevance. METHODS: This is a qualitative study that employed four rounds E-Delphi method. A group of international experts (n = 29) was convened to revise the GbCFv1 through an iterative approach with repeated and synchronised rounds of analysis and revision focusing on the currency of the competency areas and associated behavioural statements. The revision was conducted between January to August 2020. RESULTS: The number of behavioural statements increased from 100 to 124 behavioural statements, with 23 competency domains, but remain structured within the competency clusters. Three new competencies were added to the GbCF (emergency response, digital literacy, and interprofessional collaboration) and one competency was renamed from self-management to leadership and self-regulation. CONCLUSIONS: The process undertaken to revise the GbCFv1 are described, resulting in a valid and transnationally relevant GbCFv2. In the GbCFv2, the number of competencies and associated behavioural statements increased due to important additions including emergency response, digital literacy, interprofessional collaboration and an expansion of leadership and self-regulation. This process provides an assurance of relevancy and currency for a 'fit for purpose' early career competency development framework for global implementation.

A comparative analysis of pharmaceutical workforce development needs across the commonwealth.

BACKGROUND: Increasing demographic healthcare challenges, such as increased life expectancy coupled with increased use of medicines for complex morbidities, point to the need for globally applicable transformative policies in health workforce development. The International Pharmaceutical Federation (FIP) has established a set of 21 Global Development Goals (FIP DGs) to strengthen pharmacy workforce and benchmark professional developmental needs. OBJECTIVE: This study aimed to identify policy directions and factors affecting pharmacy workforce development across the Commonwealth, and to examine country progress made towards implementing workforce oriented FIP DGs. METHODS: The study involved a literature review and a global survey of commonwealth countries professional leadership bodies. The literature database search included PubMed/Medline, CINAHL, Scopus and PsychINFO databases as well as the websites of the respective national pharmacy organisations of Commonwealth countries. A global survey was also conducted to assess country-level alignment with the workforce component of FIP DGs. RESULTS: Thirty-one articles representing 21 Commonwealth countries were included in the literature overview. The development needs identified were workforce shortages and inequitable distribution across practice areas and geographical regions, low workforce supply capacity, workforce feminisation, lack of professional recognition, limited training opportunities, low job satisfaction, high workload and attrition. The survey showed disparities in country-level progress and alignment with the FIP DGs. High-income countries in the survey sample reported alignment with most of the FIP DGs, while the low-income countries reported alignment with fewer DGs. More than two-thirds of the countries showed alignment with the FIP DGs related to academic capacity, early career training, quality assurance and advancing integrated services. About half reported alignment with the FIP DGs related to competency and leadership development, respectively, while only a third aligned with the equity and equality DG. CONCLUSION: This study identified realistic pharmacy workforce developmental needs across a range of Commonwealth countries. Addressing these needs through appropriate policy interventions will be essential for increasing the pharmacy workforce capacity and assuring the delivery of high-quality pharmaceutical care and medicines expertise in these countries.

Experience with pharmacy academic programmes and career aspirations of pharmacy students and young pharmacists-an international cross-sectional study.

OBJECTIVES: This study aims to assess pharmacy students and young pharmacists' motives to pursue pharmacy degrees, their overall experiences and satisfaction with their pharmacy academic programmes, and their career aspirations and future plans. METHODS: Between May-2019 and March-2020, a self-administered online questionnaire was distributed via the International Pharmaceutical Students Federation and the Young Pharmacists Group at the International Pharmaceutical Federation. The questionnaire targeted pharmacy students and young pharmacists worldwide. Data were analysed descriptively and inferentially. RESULTS: In total, 1,423 pharmacy students and young pharmacists participated in the study. Almost 70% (993) of respondents reported that pharmacy was their first choice subject for study. Intentions for studying pharmacy were driven by an interest in healthcare, wanting to help people as well as an interest in science. In general, more than 60% of the participants had a satisfactory education experience. However, dissatisfaction was more prevalent among current pharmacy students in comparison to young pharmacists. Out of 1,423 participants, 1,110 (78%) showed a continuing desire to practice pharmacy. Being female and resident of a middle-income country increased the likelihood of being more satisfied with the academic programme. Having pharmacy as the subject first-choice and being generally satisfied with the academic programmes were positively associated with participants' willingness to practice pharmacy. CONCLUSIONS: Our study revealed that the majority of this extensive sample had pharmacy as their profession of choice and wanted to continue to practice in the future. In addition most of the targeted population indicated satisfaction with their pharmacy academic programmes.

Strengthening Primary Healthcare through accelerated advancement of the global pharmacy workforce: a cross-sectional survey of 88 countries.

OBJECTIVE: Advancing the pharmacy workforce contributes to strengthening primary healthcare and accelerating progress towards universal health coverage. This study aimed to identify key enablers to support policy development for national pharmacy workforce advancement. DESIGN: A cross-sectional country-level questionnaire was distributed from July 2018 to March 2019. SETTING: National-level or country-level pharmacy workforce development policy. PARTICIPANTS: Professional leadership associations and national agencies of the International Pharmaceutical Federation (FIP). The FIP global database included 129 countries. MEASURES: The questionnaire was designed to collate data on the scope of advanced and specialist practice in respondent countries. Multiple correspondence analysis and subsequent cluster analysis were conducted to explore the associations and patterns of country-level attributes of systems in place for the pharmacy workforce advancement in order to develop a general transnational model for country-level advanced practice development. RESULTS: Eighty-eight countries (68.2% response rate) responded to the questionnaire. Factors that enhance and contribute to advanced practice policy development include the country's socioeconomic factors and the availability of national practice advancement concepts. The essential advancement concepts include the availability of framework and professional recognition systems, programmes assisting advanced practice development and workforce advancement and recognition opportunities. Cluster analysis identified three clusters of country respondents. First cluster included low-income and middle-income with poor pharmacy advancement implementation, second cluster included a higher socioeconomic status with weaker pharmacy workforce advancement implementation and third cluster included upper middle-income to high-income countries and high rates of pharmacy advancement implementation. CONCLUSION: The key factors identified in this study can be used to support a transnational approach to pharmacy workforce advancement. The three clusters identified highlighted that workforce advancement was not an exclusive trait of higher-income countries. Lessons from countries that have already adopted concepts of advancement in pharmacy practice could be adopted to other countries to accelerate the progress of advanced practice globally.

Consensus development methods: Considerations for national and global frameworks and policy development.

BACKGROUND: key decisions have to be made in healthcare systems and policies often under uncertain conditions or without complete objective evidence. Decisions made on the health system and policy levels affect national and global population, which requires transparency and accountability to ensure the best impact to population's health. Consensus development methods assist complex process of the decision making combining existing evidence and expert opinions. Variety of challenges affect the selection, application and use of the consensus development methods, which requires careful consideration to keep rigour, validity and transparency. OBJECTIVE: To identify and review studies which have used consensus development methods in order to develop national or international policy or framework in health field. METHODS: A literature review was conducted searching the databases PubMed, EMBASE and PsycINFO. Studies using a consensus development approach to develop tools or frameworks for health system and policy enhancement were eligible for the review. Key elements of consensus development process were extracted and reported using content analysis and narrative synthesis. RESULTS: The review included 26 studies in total either in national or international settings. Over 60% of studies extracted did not apply typical consensus development methods; however, stated as consensus meetings instead. Delphi technique was the most used method from the consensus development methods, which often combined with some face-to-face meeting features. CONCLUSIONS: This review summarised the use of consensus development methods in health system and policy development. The review identified a wide range of variations in the selection, use and application of the methods in studies. For better utilisation and application of the consensus development methods in the field, some standardisation of the methods and reporting would be warranted.

Advancing a global pharmacy support workforce through a global strategic platform.

The pharmacy support workforce (PSW) is the mid-level cadre of the global pharmacy profession, referring to pharmacy technicians, assistants and other cadres that assist in the delivery of pharmaceutical services in a variety of practice contexts. The PSW undertake technical tasks delegated under the supervision of a pharmacist or performed collaboratively. The PSW are not intended to replace pharmacists, but rather work side-by-side with the pharmacist to achieve a shared goal. However, extensive variation in the PSW exists globally, ranging from an educated, regulated, and highly effective workforce in some countries to unrecognized or non-existent in others. Vast differences in education requirements, specific roles, regulatory oversight, and need for pharmacist supervision, inhibit the development and advancement of a global PSW. As clinical care providers, pharmacists worldwide need for a competent support workforce. Without the confidence to delegate technical responsibilities to a well-trained and capable PSW, pharmacists will be unable to fully deliver advanced clinical roles. A clear vision for the role of the PSW in the expanding scope of pharmacy practice is needed. One organization working to unite global efforts in this area is the International Pharmaceutical Federation (FIP). The FIP Workforce Development Hub Pharmacy Technicians & Support Workforce Strategic Platform was established to address the pharmacy workforce shortage in low and middle-income countries. Further developments were made in 2019, with the creation of a representative global PSW advisory panel, to provide guidance towards the development of the global PSW. Provision of frameworks and strategic input to support quality in education, development of legislative frameworks, guidelines for registration and licensure, and advice on appropriate role advancement are critical to move the PSW forward. In order to produce substantial advancement of roles and recognition of the PSW and advancement of pharmacists as patient care providers, global collaborative work is needed.

Competency-Based Education: Developing an Advanced Competency Framework for Indonesian Pharmacists.

Introduction: Pharmacists need to be adaptable, flexible, and capable of advancing their practice to adapt to rapidly changing population health needs. We describe an educational approach to pharmacy workforce transformation in Indonesia through an advanced practice competency framework development using an "adopt and adapt" methodology. Methods: The competency framework development process comprised a translation phase, an adopt and adapt phase, validation through a nationwide mapping survey, and a completion phase through leadership consensus panels. We conducted a forward-backwards translation of a previously validated Advanced to Consultancy Level Framework (ACLF) to yield the Indonesian Advanced Development Framework (IADF) draft. The subsequent adoption and adaptation process was conducted through a series of consensus panels. We validated the IADF through a nationwide workforce survey. The final phase included leadership consensus panels with the professional leadership body in Indonesia. We analyzed the qualitative data thematically and the quantitative data using a Multiple Correspondence Analysis (MCA) technique. Results: We identified conceptual challenges in adopting and adapting the existing ACLF, which were addressed by providing a national glossary and concrete examples. A total of 6,212 pharmacists participated in the national workforce survey, of which 43% had <2 years of post-license (post-registration) experience. The MCA results showed that practitioner self-assessment to the IADF could discriminate their career development stages. The results also indicated a four-stage career model (including early years career training). Embedding this model in a structured national training program will enhance the professional workforce development through a more structured career journey. Conclusions: We describe the first validation of an advanced competency development framework for the pharmacy workforce in a non-Anglophone country, showing the possibility of transnational applicability of this framework. We argue that this methodology can be used in Low and Middle-income countries (LMICs) for the more rapid advancement of pharmaceutical care practice.

Conducting a state-of-the-art mental health survey in a traditional setting: Challenges and lessons from piloting the World Mental Health Survey in Qatar.

OBJECTIVES: A small country in the Arabian Peninsula, Qatar experienced rapid economic growth in the last 3 decades accompanied by major socio-demographic shifts towards a younger and more highly educated population. To date, no national epidemiological study has examined the prevalence, associated factors, or sequelae of mental disorders in Qatar's general population. METHODS: The World Mental Health Qatar (WMHQ) is a national mental health needs assessment survey and is the first carried out in collaboration with the World Mental Health Survey initiative to assess the prevalence and burden of psychiatric illnesses among the full Arabic speaking population (nationals and non-nationals) within the same country. RESULTS: Standard translation and harmonization procedures were used to develop the WMHQ instrument. A survey quality control system with standard performance indicators was developed to ensure interviewer adherence to standard practices. A pilot study was then carried out just prior to the COVID-19 pandemic. Endorsement from public health authorities and sequential revision of the interview schedule led to full survey completion (as opposed to partial completion) and good overall response rate. CONCLUSIONS: The WMHQ survey will provide timely and actionable information based on quality enhancement procedures put in place during the development and piloting of the study.

Prevalence and Potential Determinants of COVID-19 Vaccine Hesitancy and Resistance in Qatar: Results from a Nationally Representative Survey of Qatari Nationals and Migrants between December 2020 and January 2021.

Global COVID-19 pandemic containment necessitates understanding the risk of hesitance or resistance to vaccine uptake in different populations. The Middle East and North Africa currently lack vital representative vaccine hesitancy data. We conducted the first representative national phone survey among the adult population of Qatar, between December 2020 and January 2021, to estimate the prevalence and identify potential determinants of vaccine willingness: acceptance (strongly agree), resistance (strongly disagree), and hesitance (somewhat agree, neutral, somewhat disagree). Bivariate and multinomial logistic regression models estimated associations between willingness groups and fifteen variables. In the total sample, 42.7% (95% CI: 39.5-46.1) were accepting, 45.2% (95% CI: 41.9-48.4) hesitant, and 12.1% (95% CI: 10.1-14.4) resistant. Vaccine resistant compared with hesistant and accepting groups reported no endorsement source will increase vaccine confidence (58.9% vs. 5.6% vs. 0.2%, respectively). Female gender, Arab ethnicity, migrant status/type, and vaccine side-effects concerns were associated with hesitancy and resistance. COVID-19 related bereavement, infection, and quarantine status were not significantly associated with any willingness group. Absence of or lack of concern about contracting the virus was solely associated with resistance. COVID-19 vaccine resistance, hesitance, and side-effects concerns are high in Qatar's population compared with those globally. Urgent public health engagement should focus on women, Qataris (non-migrants), and those of Arab ethnicity.

National assessment of pharmaceutical workforce and education using the International Pharmaceutical Federation's global development goals: a case study of Qatar.

BACKGROUND: The sustainable development goals were launched by the United Nations in 2015. Its fifth goal was describing the achievement of universal health coverage by 2030. This goal reaffirms the importance of investing in the development and training of the global health workforce. In alliance with this, the International Pharmaceutical Federation (FIP) has published reports about pharmacy workforce planning in several countries. However, data about Qatar were not included in these reports. In 2017, FIP developed a transformational roadmap of pharmaceutical workforce and education. One systematic framework component of the roadmap is the Pharmaceutical Workforce Development Goals (DG[w]s) that were released in late 2016 and subsequently incorporated into the more comprehensive Global Development Goals1 in 2020, encompassing not only workforce development, but additionally practice and pharmaceutical science development. This study aimed to evaluate the current situation of pharmacy workforce and education in Qatar in relation to the original 13 Pharmaceutical Workforce Development Goals (DG[w]s). The objective was to identify the gaps in pharmacy workforce and education and to recommend evidence-led strategies to be included in both the Ministry of Public Health and the Qatar University College of Pharmacy workforce development plans. METHODS: Three rounds of conventional Delphi technique were conducted with expert panels of key decision-makers in pharmacy practice from the College of Pharmacy at Qatar University and the Ministry of Public Health, utilizing the FIP's self-assessment survey. Qualitative content analysis was used to analyze and prioritize the identified gaps from the collected data. DG[w] was considered "met" if all the provided indicators were achieved, "partially met" if at least one of the indicators were achieved, and "not met" if none of the indicators were achieved RESULTS: The lack of competency framework (DG[w]5), workforce data (DG[w]12), and workforce policy formation (DG[w]13) are three major gaps in the provision of pharmaceutical workforce and pharmacy education in Qatar, influencing other DG[w]s. These gaps need to be addressed by the formation of Qatar Pharmaceutical Association through which academic, practice, and policymaking sectors can work together in developing health workforce intelligence system. CONCLUSION: The results indicated that DG[w]s are interrelated and a gap in one goal can negatively influence others. Results and recommendations of this research will facilitate the implementation of strategic plans across leading pharmacy sectors to meet health needs in Qatar and achieve the third pillar of the Qatar National Vision 2030.

Using a global systematic framework tool to guide the advancement of the pharmacy workforce education and training on a national level.

BACKGROUND: Systematic education and training strategies play a critical role in preparing a competent pharmacy workforce to meet the evolving healthcare needs of nations. Reports have shown that investing in healthcare workers' education and training not only has a positive impact on employment rates and economic growth but also results in measurable improvement in health and population outcomes. The goal of this study was to evaluate the use of globally validated workforce goals as a guide to the planning and advancement of the Kuwait pharmacy workforce's education and training. METHODS: A mixed-approach qualitative study involving representatives of key stakeholders was conducted. Focus group interviews were carried out with pharmacists with patient and non-patient facing roles (N = 33). In addition, semi-structured interviews with the three main pharmacy Continuing Professional Development (CPD) providers in the country were conducted. Data were analysed using a framework analysis method. Interviews were transcribed verbatim and data were analysed and coded using MAXQDA-12. The International Pharmaceutical Federation Workforce Development Goals (FIP WDGs) were used as the framework for data analysis. RESULTS: Participants' responses highlighted three main priorities: the importance of initial and post-graduation needs-based education (WDG 2), the need for competency development and competency frameworks (WDG 5), and the crucial role of active policy and regulations that would enforce the profession development (WDG 9). Investing in competency development was seen the top priority for the pharmacy workforce in Kuwait. CONCLUSION: This study provided insights into areas in need of systematic development for pharmacy workforce in Kuwait including foundation training for early career pharmacists, competency development and competency frameworks, and policies and regulations that would enforce the profession development. In addition, the use of the FIP WDGs framework was found to offer a framing device to better understand and identify priorities and needs for pharmacy workforce development.

Competency development for pharmacy: Adopting and adapting the Global Competency Framework.

BACKGROUND: With current accelerated changes in the role of the pharmacists across different sectors, evidence-based developmental tools are needed to re-define the scope of practice for early career pharmacists (foundation level) and to support pharmacists' career development. This study aimed to develop a foundation competency framework for pharmacists in Kuwait using the International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) in an adopt and adapt approach. METHODS: A 4-phase adopt and adapt approach was followed to develop the Kuwait Foundation Competency Framework (KFCF). Phase one involved translating the FIP GbCF, into Arabic using parallel translation. Phase two utilises 2 consensus panels validation involving pharmacists from public and private sectors. Phase three involved a national survey to all registered pharmacists in Kuwait. The final phase involved focus groups with pharmacists and a consensus panel validation with key policy and decision makers in the pharmacy practice and education sectors in Kuwait. Qualitative data were thematically analysed, while quantitative data were analysed using IBM SPSS Statistics for Windows. RESULTS: The translation phase yielded a bilingual framework that could be utilised by pharmacists in Kuwait. The initial validation phase identified 70 behavioural statements (out of the GbCF's 100) as 'highly relevant' or 'relevant' to pharmacy practice in Kuwait. Findings from the national survey identified a list of behaviours that could be adapted in Kuwait context as well as competencies that were perceived as least relevant to Kuwait practice. The final validation phase generated a list of 98 behavioural statements to be included in the KFCF along with recommendations and an action plan to facilitate the adaptation of the framework. CONCLUSION: This study presents the first bilingual (Arabic/English) pharmacy foundation competency framework that builds on the FIP GbCF. The KFCF could be utilised as a developmental tool to support pharmacists' performance at foundation level.

Transforming the pharmaceutical workforce in the Eastern Mediterranean Region: a call for action.

Planning and development of the pharmaceutical workforce is fundamental to achieving universal health coverage and the United Nations Sustainable Development Goals by 2030. The International Pharmaceutical Federation (FIP) has recognized the importance of constructing mechanisms for transforming the global workforce. FIP has launched a developmental road map in order to support and facilitate global, regional and national transformations of pharmaceutical education and the workforce. Literature on the pharmaceutical workforce in the WHO Eastern Mediterranean Region is limited but what there is reports persistent workforce challenges. This necessitates stronger engagement across all countries of the Region to develop workable and sustainable strategic plans for workforce and educational development by adopting and adapting approaches to national transformation needs and the FIP roadmap. Countries have an opportunity to engage with FIP in collaborative programmes to implement the FIP roadmap locally, and provide proof of concept and a leadership model for other WHO regions.

Trends in advanced practice and specialisation in the global pharmacy workforce: a synthesis of country case studies.

OBJECTIVES: This study aims to gain a better understanding of the drivers and barriers to the development of advanced practice and specialised systems around the world. Through the synthesis of in-depth country case studies, this paper aims to identify current models of advanced practice and specialisation in pharmacy and illustrate trends, drivers and barriers in policy development. This is the first analysis of its kind to examine pharmacy specialisation and advanced practice in this depth from a global perspective. METHODS: A synthesis of country case studies was carried out. The country case study template was reviewed and approved by an expert working group drawn from a cross section of International Pharmaceutical Federations (FIP) experts and special-interest groups. FIP member organisations and country-level contacts from regulatory, professional and government agencies and universities were approached to contribute to the case study database. The data were collected between January and May 2015. Descriptive comparative analysis and qualitative thematic analysis were both used to analyse the data. KEY FINDINGS: Case study submissions were received from 17 countries. The findings demonstrate that the pace and depth of change in advanced practice and specialisation are occurring at different rates across countries and regions, although many countries appear to be moving towards recognising advanced and specialised practice of pharmacists and developing frameworks and/or formalised recognition systems. CONCLUSIONS: Country-specific examples are useful in identifying factors that may contribute to the rate at which developments in advanced practice and specialisation in pharmacy are taking place and enable progress in around the world.

A global survey on trends in advanced practice and specialisation in the pharmacy workforce.

OBJECTIVES: Despite the increasingly complex care and demanding health challenges shaping pharmacy, little work has been carried out to understand the global status of advanced and/or specialised pharmacy practice scopes and the models in which they exist. This study aims to describe the current global status of initiatives relating to advancement of pharmacy practice. METHODS: A global survey was conducted between January and May 2015 to collect country-level data from member organisations of the International Pharmaceutical Federation (FIP), and national-level contacts from regulatory, professional and government agencies or universities; data requests were sent to 109 countries. The collected data were triangulated (comparing multiple sources from single countries, e.g.), cleaned and analysed by descriptive and comparative statistics. KEY FINDINGS: Full data sets from 48 countries and territories were obtained. The findings demonstrate varying systems of advanced pharmacy practice and specialisation often linked to income level. The study found that there are variations within terminology and definitions, frameworks for specialisation and advanced practice, professional recognition mechanisms and benefits across countries. CONCLUSIONS: This survey of 48 countries and territories was the first of its kind to describe the range of specialisation and professional recognition systems for advanced pharmacy practice worldwide. Despite the variance, it is clear from this global study that professional advancement and the recognition of advancement in practice are developing around the world and this could be due to the increasingly complex nature of pharmaceutical care delivery and a consequent need to be able to endorse professional capabilities.

FIP's Commitment to Action on the WHO Astana Declaration: Transforming pharmacy for better health for all.

The attainment of better health for all cannot be achieved without effective primary health care. The WHO Declaration of Astana renewed global commitment to primary health care by all countries and states around the world. With pharmacy and the pharmacy workforce being integral to the delivery of quality primary health care, the International Pharmaceutical Federation (FIP) is leading pharmacy's commitment to the Astana Declaration. Through a series of regional conferences, starting with the Eastern Mediterranean region, FIP is working with its regional partners and members across the world to progress this imperative and consolidate the role of pharmacy in delivering the primary health care agenda. The first pharmacy Commitment to Primary Health Care was made in Amman, Jordan in April 2019, paving the way for transforming pharmacy for better primary health care everywhere. Now, it is time to move from commitment to action.