By Dr. Filza Tahir.
The aim of this article is to highlight the role of pharmacists in developing countries, particularly in Pakistan. Pharmacists are health care professionals, involved in preparation compounding and dispensing of medicine to the patient who practice in pharmacy, the field of health sciences focusing on safe and effective medication use. The role of the pharmacist has shifted from the classical “lick, stick, and pour” dispensary role (that is, “lick & stick the labels, count & pour the pills”), to being an integrated member of the health care team directly involved in patient care.
The World Health Organization (WHO) has defined health as the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Within the context of this definition, health care providers play a major role in striving for health in a population. Although the pharmacy profession is recognized for its importance in many developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers.
Pharmacy practice models in developing countries vary significantly from one country to another. Some of the major issues identified as barriers to effective pharmacy practice models in these countries include an acute shortage of qualified pharmacists and no implementation of dispensing separation practices – especially in countries like Pakistan where the pharmacist is not the sole dispenser and medical practitioners are allowed to dispense as well – and a lack of standard practice guideline In developing countries, the urban population is more affluent. As a result, health professionals such as pharmacists prefer to work in cities rather than rural areas. In many cases this is due to the shortage of pharmacists.
Although the pharmacy profession in Pakistan is continuously evolving, the health care system of Pakistan has yet to recognize the pharmacist’s role. This lack of recognition is due to the limited interaction of pharmacists with the public. Pharmacists in Pakistan are concerned about their present professional role in the health care system. The main problem they are facing is the shortage of pharmacists in pharmacies. Moreover, their services are focused towards management more than towards customers. For these reasons, the pharmacist’s role as a health care professional is not familiar to the public.
In 2002, the Doctor of Pharmacy (Pharm.D) began to be offered as a five-year professional degree programme in Pakistan, focused mainly towards the clinical aspects of the pharmacy profession. During recent years, in most of the public-sector hospitals, small numbers of pharmacists were appointed; their role was limited to drug delivery, procurement and inventory control. There was a lack of pharmacy services in the hospitals and community pharmacies because of the isolation and lack of recognition of pharmacists as health care professionals. This is due to their lack of interaction with pharmacists, as most of the pharmacy exists without an attached hospital where pharmacy students can acquire basic clinical knowledge. The lack of trained personnel and the resulting lack of contact of pharmacists with the public are also among the main contributing factors towards the lack of recognition of the pharmacy profession institutions in Pakistan.
Along with lack of human resources, the profession seriously lacks government interest in Pakistan. The health care system without pharmacists is unable to cope effectively with most medicine-related issues.
The Pakistan is facing a very precarious economic situation and there is a need of innovative health reforms. Till now, health policies have not been given enough time for proper implementation in the country because of political instability, legal reform is needed to achieve the health objectives of the nation to contribute towards attainment of the global Millennium Development Goals (MDG) and to achieve acceptance of the pharmacy profession as an integral part of a well-structured health care system.
Writer is Doctor of Pharmacy based in Islamabad and writes on health issues in Pakistan.