scholarly journals Primary health care policy and vision for community pharmacy and pharmacists in Lebanon

2020 ◽  
Vol 18 (2) ◽  
pp. 2003 ◽  
Author(s):  
Souheil Hallit ◽  
Carla Abou Selwan ◽  
Pascale Salameh
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Strategic Plan ◽  
Pharmacy Education ◽  
World Health ◽  
Care Providers ◽  
Primary Health ◽  
Pharmacy Profession

Within a crippling economic context and a rapidly evolving healthcare system, pharmacists in Lebanon are striving to promote their role in primary care. Community pharmacists, although held in high esteem by the population, are not recognised as primary health care providers by concerned authorities. They are perceived as medication sellers. The role of the pharmacist in primary health care networks, established by the Ministry of Public Health (MOPH) to serve most vulnerable populations, is limited to medication delivery. The practice of the pharmacy profession in Lebanon has been regulated in 1950 by the Lebanese Pharmacists Association [Order of Pharmacists of Lebanon] (OPL). In 2016, the OPL published its mission, vision, and objectives, aiming to protect the pharmacists’ rights by enforcing rules and procedures, raise the profession’s level through continuous education, and ensure patients’ appropriate access to medications and pharmacist’s counseling for safe medication use. Since then, based on the identified challenges, the OPL has suggested several programs, inspired by the World Health Organization and the International Pharmaceutical Federation guidelines, as part of a strategic plan to develop the pharmacy profession and support patient safety. These programs included the application of principles of good governance, the provision of paid services, developing pharmacists’ core and advanced competencies, generation of accreditation standards for both community pharmacy and pharmacy education, suggesting new laws and decrees, continuing education consolidation and professional development. There was an emphasis on all decisions to be evidence assessment-based. However, OPL faces a major internal political challenge: its governing body, which is reelected every three years, holds absolute powers in changing strategies for the three-year mandate, without program continuation beyond each mandate. Within this context, we recommend the implementation of a strategic plan to integrate pharmacy in primary health centers, promoting the public health aspect of the profession and taking into account of critical health issues and the changing demographics and epidemiological transition of the Lebanese population. Unless the proposed blueprint in this paper is adopted, the profession is unfortunately condemned to disappear in the current political, economic and health-related Lebanese context.

scholarly journals Primary health care policy and vision for community pharmacy and pharmacists in Australia

2020 ◽  
Vol 18 (2) ◽  
pp. 1967 ◽  
Author(s):  
Sarah Dineen-Griffin ◽  
Shalom I. Benrimoj ◽  
Victoria Garcia-Cardenas
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Community Pharmacists ◽  
Residential Aged Care ◽  
Multidisciplinary Teams ◽  
Care Providers ◽  
Australian Government ◽  
Primary Health

There is evidence that the Australian Government is embracing a more integrated approach to health, with implementation of initiatives like primary health networks (PHNs) and the Government’s Health Care Homes program. However, integration of community pharmacy into primary health care faces challenges, including the lack of realistic integration in PHNs, and in service and remuneration models from government. Ideally, coordinated multidisciplinary teams working collaboratively in the community setting are needed, where expanding skills are embraced rather than resisted. It appears that community pharmacy is not sufficiently represented at a local level. Current service remuneration models encourage a volume approach. While more complex services and clinical roles, with associated remuneration structures (such as, accredited pharmacists, pharmacists embedded in general practice and residential aged care facilities) promote follow up, collaboration and integration into primary health care, they potentially marginalize community pharmacies. Community pharmacists’ roles have evolved and are being recognized as the medication management experts of the health care team at a less complex level with the delivery of MedChecks, clinical interventions and medication adherence services. More recently, vaccination services have greatly expanded through community pharmacy. Policy documents from professional bodies highlight the need to extend pharmacy services and enhance integration within primary care. The Pharmaceutical Society of Australia’s Pharmacists in 2023 report envisages pharmacists practising to full scope, driving greater efficiencies in the health system. The Pharmacy Guild of Australia’s future vision identifies community pharmacy as health hubs facilitating the provision of cost-effective and integrated health care services to patients. In 2019, the Australian Government announced the development of a Primary Health Care 10-Year Plan which will guide resource allocation for primary health care in Australia. At the same time, the Government has committed to conclude negotiations on the 7th Community Pharmacy Agreement (7CPA) with a focus on allowing pharmacists to practice to full scope and pledges to strengthen the role of primary care by better supporting pharmacists as primary health care providers. The 7CPA and the Government’s 10-year plan will largely shape the practice and viability of community pharmacy. It is essential that both provide a philosophical direction and prioritize integration, remuneration and resources which recognize the professional contribution and competencies of community pharmacy and community pharmacists, the financial implications of service roles and the retention of medicines-supply roles.

scholarly journals  Scaling-up filariasis lymphoedema management into the Primary Health Care System in Kerala State, Southern India - an example of equity in healthcare.

2021 ◽  
Author(s):  
Suma Krishnasastry ◽  
Charles D. Mackenzie ◽  
Rajeev Sadanandan
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Lymphatic Filariasis ◽  
Health Care System ◽  
World Health ◽  
Parasitic Infections ◽  
Primary Health Care System ◽  
Care Providers ◽  
Primary Health ◽  
Care System

Abstract Background: Lymphatic filariasis remains one the world’s most debilitating parasitic infections and is a major contributor to poor health in many endemic countries. The provision of continuing care for all those affected by this infection and its consequences is an important component of the United Nations’ Sustainable Development Goals. The World Health Organization’s recommendation for achieving this goal is for countries to integration their lymphedema care into the primary health care system. Methods:To fulfil the WHO recommendation for providing care for all those affected with lymphoedema caused by lymphatic filariasis, selected health care providers from each of the endemic districts in Kerala participated in intensive training sessions endorsed by the State’s medical administration. The six training sessions included appropriate self-care information and the development of individual plans for each participating institution to provide instruction and care for their lymphoedema patients. The learning achieved by attendees was assessed during the training sessions by pre- and post-training testing. The number of lymphoedema patients receiving care and instruction from the post-training activities of each participating institution was assessed from local records, six months after the conclusion of the training sessions.Results:One hundred and eighty-four medical personnel (91 doctors and 93 staff nurses) from 82 medical institutions were trained which quickly led to the establishment of active lymphoedema clinics providing the essential package of care (EPC) for lymphoedema patients at all the participating institutions. Six months after the training sessions the number of previously unidentified lymphoedema patients registered and receiving care at these clinics ranged from 296 to almost 400 per clinic, with a total of 3477 new patients receiving training in the EPC during this period.Conclusions:Generalist health personnel, when appropriately trained, can provide quality lymphoedema care in public health settings, and that patients, when provided services close to their home, are willing to access these services. This approach is a feasible strategy for integrating long term care for LF patients into a national health system, and is a clear example of moving towards equity in health care for the medically underserved, and thus successfully addresses a major goal of the global program to eliminate lymphatic filariasis (GPELF).

Policy Development in Disaster Preparedness and Management: Lessons Learned from the January 2001 Earthquake in Gujarat, India

2003 ◽  
Vol 18 (4) ◽  
pp. 372-384 ◽  
Author(s):  
Rannveig Bremer
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Disaster Preparedness ◽  
Policy Development ◽  
Disaster Relief ◽  
World Health ◽  
Disaster Victims ◽  
Primary Health ◽  
The World

AbstractIntroduction:During the last decades, several humanitarian emergencies have occurred, with an increasing number of humanitarian organizations taking part in providing assistance. However, need assessments, medical intelligence, and coordination of the aid often are sparse, resulting in the provision of ineffective and expensive assistance. When an earthquake with the strength of 7.7 on the Richter scale struck the state of Gujarat, India, during the early morning on 26 January 2001, nearly 20,000 persons were killed, nearly 170,000 were injured, and 600,000 were rendered homeless. This study identifies how assigned indicators to measure the level of health care may improve disaster preparedness and management, thus, reducing human suffering.Methods:During a two-week mission in the disaster area, the disaster relief provided to the disaster-affected population of Gujarat was evaluated. Vulnerability due to climate, geography, culture, religion, gender, politics, and economy, as each affected the outcome, was studied. By assigning indicators to the eight ELEMENTS of the Primary Health Care System as advocated by the World Health Organization (WHO), the level of public health and healthcare services were estimated, an evaluation of the impact of the disaster was conducted, and possible methods for improving disaster management are suggested. Representatives of the major relief organizations involved were interviewed on their relief policies. Strategies to improve disaster relief, such as policy development in the different aspects of public health/primary health care, were sought.Results:Evaluation of the pre-event status of the affected society revealed a complex situation in a vulnerable society with substantial deficiencies in the existing health system that added to the severity of the disaster. Most of the civilian hospitals had collapsed, and army field hospitals provided medical care to most of the patients under primitive conditions using tents. When the foreign field hospitals arrived 5 to 7 days after the earthquake, most of the casualties requiring surgical intervention already had been operated on. Relief provided to the disaster victims had reduced quality for the following reasons: (1) proper public health indicators had not yet been developed; (2) efficient coordination was lacking; (3) insufficient, overestimated, or partly irrelevant relief was provided; (4) relief was delayed because of bureaucracy; and (5) policies on the delivery of disaster relief had not been developed.Conclusion:To optimize the effectiveness of limited resources, disaster preparedness and the provision of feasible and necessary aid is of utmost importance. An appropriate, rapid, crisis intervention could be achieved by continual surveillance of the world's situation by a Relief Coordination Center. A panel of experts could evaluate and coordinate the international disaster responses and make use of stored emergency material and emergency teams. A successful disaster response will depend on accurate and relevant medical intelligence and socio-geographical mapping in advance of, during, and after the event(s) causing the disaster. More effective and feasible equipment coordinated with the relief provided by the rest of the world is necessary. If policies and agreements are developed as part of disaster preparedness, on international, bilateral, and national levels, disaster relief may be more relevant, less chaotic, and easier to estimate, thus, bringing improved relief to the disaster victims.

scholarly journals Primary health care policy and vision for community pharmacy and pharmacists in Spain

2020 ◽  
Vol 18 (2) ◽  
pp. 1999 ◽  
Author(s):  
Miguel A. Gastelurrutia ◽  
Maria J. Faus ◽  
Fernando Martinez-Martinez
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Community Pharmacy ◽  
The State ◽  
Community Pharmacies ◽  
State Health ◽  
Primary Health

From a political and governance perspective Spain is a decentralized country with 17 states [comunidades autónomas] resulting in a governmental structure similar to a federal state. The various state regional health services organizational and management structures are focused on caring for acute illnesses and are dominated by hospitals and technology. In a review by the Interstate Council, a body for intercommunication and cooperation between the state health care services and national government, there is a move to improve health care through an integrative approach between specialized care and primary care at the state level. Community pharmacy does not appear to have a major role in this review. Primary health care is becoming more important and leading the change to improve the roles of the health care teams. Primary care pharmacists as the rest of public health professionals are employed by the respective states and are considered public servants. Total health care expenditure is 9.0% of its GDP with the public health sector accounting for the 71% and the private sector 29% of this expenditure. Community pharmacy contracts with each state health administration for the supply and dispensing of medicines and a very limited number of services. There are approximately 22,000 community pharmacies and 52,000 community pharmacists for a population of 47 million people. All community pharmacies are privately owned with only pharmacists owning a single pharmacy. Pharmacy chain stores are not legally permitted. Community pharmacy practice is based on dispensing of medications and dealing with consumer minor symptoms and requests for nonprescription medications although extensive philosophical deep debates on the conceptual and practical development of new clinical services have resulted in national consensually agreed classifications, definitions and protocolized services. There are a few remunerated services in Spain and these are funded at state, provincial or municipal level. There are no health services approved or funded at a national level. Although the profession promulgates a patient orientated community pharmacy it appears to be reluctant to advocate for a change in the remuneration model. The profession as a whole should reflect on the role of community pharmacy and advocate for a change to practice that is patient orientated alongside the maintenance of its stance on being a medication supplier. The future strategic position of community pharmacy in Spain as a primary health care partner with government would then be enhanced.

scholarly journals Quality of Life of Primary Healthcare Centres Physicians in BURAIDAH City 2020, a Study Using WHOQOL-BREF Questionnaire

2021 ◽  
pp. 10-18
Author(s):  
Mohamad Fahad Alreshoudi ◽  
Chandra Sekhar Kalevaru
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
World Health ◽  
Care Providers ◽  
Life Score ◽  
Primary Health ◽  
Psychological Domain

Background: Life of doctors puts them at a high level of challenges and stress which can affect their quality of life. Therefore, the objective of the study was to evaluate the Quality Of Life of Primary health care providers by applying a brief version of the World Health Organization questionnaire for assessing Quality of Life (WHOQOL-BREF). To find the factors which affect the QOL of PHC physicians and know the aspects where it was affecting the health and performance of the Doctors. Methods: A cross-sectional study was conducted among 186 physicians working in primary health care centers in BURAIDAH city under Ministry Of Health. WHOQOL BREF validated questionnaire was used in both English and Arabic versions. Data was entered and cleaned in SPSS 21.0 version and necessary statistical tests were applied. Results: In the present study, about 29.6% were females and 70.4% were males. About 66.6% of the study population were in 30-49 years age group and half (48.4%) of them were general practitioners. Mean QOL score in psychological domain (domain 2) was 63.66. In the other three domains of physical health, social relationships and environmental domain (domain 1, 3 & 4) was scoring more than 65. There was a statistically significant association observed between age and physical ,psychological health domains. This association was also seen between marital status and psychological, social domains. Conclusions: Based on the results, on the whole, the majority of primary health care doctors had a moderate quality of life score to a high quality of life score ranging from 63.66-68.06. Still, there is a scope of improvement in domain 2 (psychological domain). 

scholarly journals Responses to the Pandemic COVID-19 in Primary Health Care in Oman: Muscat Experience

2021 ◽  
Vol 36 (1) ◽  
pp. e216-e216
Author(s):  
Thamra Al Ghafri ◽  
Fatma Al Ajmi ◽  
Lamya Al Balushi ◽  
Padma Mohan Kurup ◽  
Aysha Al Ghamari ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Technology Use ◽  
Scale Up ◽  
Building Blocks ◽  
World Health ◽  
Public Health Response ◽  
Primary Health ◽  
The World

Objectives: As coronavirus disease (COVID-19) was pervading different parts of the world, little has been published regarding responses undertaken within primary health care (PHC) facilities in Arabian Gulf countries. This paper describes such responses from January to mid-April 2020 in PHC, including public health measures in Muscat, Oman. Methods: This is a descriptive study showing the trends of the confirmed positive cases of COVID-19 and the undertaken responses to the evolving epidemiological scenario. These responses were described utilizing the World Health Organizations’ building blocks for health care systems: Leadership and governance, Health workforce, Service delivery, Medical products and technologies, and health information management. Results: In mid-April 2020, cases of COVID-19 increased to 685 (particularly among non-nationals). As the cases were surging, the PHC responded by executing all guidelines and policies from the national medical and public health response committees and integrating innovative approaches. These included adapting comprehensive and multi-sectoral strategies, partnering with private establishments, and strengthening technology use (in tracking, testing, managing the cases, and data management). Conclusions: Facilities in the Muscat governorate, with the support from national teams, seemed to continuously scale-up their preparedness and responses to meet the epidemiological expectations in the management of COVID-19.

Client characteristics and satisfaction with the quality of primary health-care services in Calabar, Nigeria

2020 ◽  
Vol 3 ◽  
pp. 1-8
Author(s):  
H. C. Okeke ◽  
P. Bassey ◽  
O. A. Oduwole ◽  
A. Adindu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Client Satisfaction ◽  
Demographic Characteristics ◽  
Care Providers ◽  
Client Characteristics ◽  
Study Objective ◽  
Primary Health

Different mix of clients visit primary health care (PHC) facilities, and the quality of services is critical even in rural communities. The study objective was to determine the relationship between socio-demographic characteristics and client satisfaction with the quality of PHC services in Calabar Municipality, Cross River State, Nigeria. Specifically to describe aspects of the health facilities that affect client satisfaction; determine the health-care providers’ attitude that influences client satisfaction; and determine the socio-demographic characteristics that influence client satisfaction with PHC services. A cross-sectional survey was adopted. Ten PHCs and 500 clients utilizing services in PHC centers in Calabar Municipality were randomly selected. Clients overall satisfaction with PHC services was high (80.8%). Divorced clients were less (75.0%) satisfied than the singles and the married counterparts (81%), respectively. Clients that were more literate as well as those with higher income were less satisfied, 68.0% and 50.0%, respectively, compared to the less educated and lower-income clients, 92.0% and 85.0% respectively. These differences in satisfaction were statistically significant (P = 0.001). Hence, it was shown that client characteristics such as income and literacy level show a significant negative relationship with the clients satisfaction with the quality of PHC services in Calabar Municipality.

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