Medicine shortages are a complex global challenge affecting all countries. This includes South Africa where ongoing medicine shortages are a concern among public sector hospitals as South Africa strives for universal access to healthcare. The objectives of this research were to highlight challenges in the current pharmaceutical procurement process for public sector hospitals. Subsequently, suggest potential ways forward based on the findings as the authorities in South Africa seek to improve the procurement process. Qualitative in-depth interviews were conducted with 10 pharmacy managers in public sector hospitals in the Gauteng Province, South Africa. A thematic content analysis was performed, with transcripts coded by two of the authors. Coding was discussed until consensus was reached. Categories were developed and grouped into themes. The ‘Procurement process’ emerged from the data as the overarching theme, rooted in three main themes: (i) The buy-out process that was used to procure medicines from suppliers other than the contracted ones; (ii) Suppliers not performing thereby contributing to medicine shortages in the hospitals; and (iii) Challenges such as the inaccuracy of the electronic inventory management system used in the hospitals. Effective management of contracts of suppliers by the Provincial Department of Health is crucial to ensure accessibility and availability of essential medicines to all citizens of South Africa. Ongoing monitoring and support for the future use of computerised inventory management systems is important to reduce medicine shortages, and this is being followed up.

/pdf/medicine-shortages-and-challenges-with-the-procurement-1x7kfw40h9.pdf

Medicine shortages and challenges with the procurement process among public sector hospitals in South Africa; findings and implications

Antibiotics are the most commonly prescribed medicines in global healthcare practice today. Their effectiveness is crucial and often life-saving in humanity’s battle against pathogens and infectious diseases. Antibiotic/antimicrobial stewardship strategies and programmes have become vital to the preservation of effective antibiotics and the optimisation of their use. The South African Society of Clinical Pharmacy (SASOCP) has written this guideline to outline the importance, role and purpose of pharmacists in such stewardship programmes, both in the public, as well as the private hospital sectors in South Africa. It also provides an overview of various approaches to antibiotic preservation, behavioural change, stewardship measures, and monitoring strategies.

/pdf/sasocp-position-statement-on-the-pharmacist-s-role-in-3ln2qiv3rs.pdf

SASOCP position statement on the pharmacist’s role in antibiotic stewardship 2018

In low- and middle-income countries (LMICs), over 12 million people die yearly from chronic diseases and this number is expected to increase if concerted actions are not taken. The purpose of this paper is to highlight the roles and impact of community pharmacists in chronic disease management support and the need for policymakers in LMICs to reposition community pharmacists appropriately for this extended role. Recent findings have shown that community pharmacists are the most accessible healthcare providers to the members of the community. Published evidence have demonstrated that community pharmacists' interventions in chronic diseases significantly improve economic, clinical, and humanistic outcomes. However, they are not officially recognized as primary healthcare providers in LMICs. Therefore, there is need for policy reforms that will encourage strategic use of the clinical skills of community pharmacists as part of the primary healthcare team in LMICs.

Community pharmacists on the frontline in the chronic disease management: The need for primary healthcare policy reforms in low and middle income countries

Global engagement between schools and colleges of pharmacy in the United States and Africa is increasing. For a balanced and fruitful engagement, sensitivity towards the cultural and clinical needs of the people and professionals of the African region is critical. In this paper, we have divided the discussion into Southern, East, Central, and West Africa. General information about Africa, with unique aspects for individual subregions and countries, will be introduced. Stereotypes and misconceptions about the region and the people will also be discussed, along with recommendations for culturally sensitive engagement for pharmacy and other health care practitioners when hosting members from, or visiting this region. The paper is a resource for schools and colleges of pharmacy who are currently engaged or considering future outreach opportunities in Africa.

/pdf/cultural-sensitivity-and-global-pharmacy-engagement-in-4l0l7vpb8l.pdf

Cultural Sensitivity and Global Pharmacy Engagement in Africa

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.

/pdf/different-models-of-pharmaceutical-services-and-care-in-3b6662zhws.pdf

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

INTRODUCTION South Africa is a large (about 1.2 million km2), upper middle income country located at the southern tip of the African continent. The 2014 midyear estimate of the total population was just over 54 million, of whom 80.2% self-identified as Black Africans.1 South Africa underwent a fundamental political transition to democracy in 1994, with the demise of the racially segregated apartheid system. In the years since then, there has been an ongoing process of reform in all areas, including in relation to the organization and delivery of health care. The organization, financing, and delivery of pharmaceutical services have also been subject to significant changes in this period. This paper describes the background and current position of pharmacy in South Africa, with particular reference to reforms that are still underway and those that are anticipated. In many ways, and in particular with regard to the delivery of hospital pharmacy services, pharmacy reform can still be regarded as a work in progress. The paper is arranged according to the “building blocks” outlined in the World Health Organization’s Health Systems Framework.2

/pdf/health-care-and-pharmacy-practice-in-south-africa-17vhb8qxu4.pdf

Health Care and Pharmacy Practice in South Africa.

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Health Care and Pharmacy Practice in South Africa.