Geospatial analysis of distribution of community pharmacies and other health care facilities providing minor ailments services in Malaysia

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Abstract

Background

Minor ailments are defined as common, self-limiting, or uncomplicated conditions that may be diagnosed and managed without a medical intervention. Previous studies reported that pharmacists were able to help patients self-manage minor ailments that led to a reduction of health care burden in other facilities. Nevertheless, public access to community pharmacy and other health care facilities offering services for minor ailments has not yet been explored in Malaysia. Hence, this study aims to determine population access to the above-mentioned services.

Method

According to the reported practice address in 2018, the spatial distribution of health care facilities was mapped and explored using the GIS mapping techniques. The density of health care facilities was analyzed using thematic maps with hot spot analysis. Population to facility ratio was calculated using the projection of the population growth based on 2010 census data, which was the latest available in the year of analysis.

Results

The study included geographical mapping of 7051 general practitioner clinics (GPC), 3084 community pharmacies (CP), 139 public general hospitals (GHs) and 990 public primary health clinics (PHC). The health care facilities were found to be highly dense in urban areas than in the rural ones. There were six districts that had no CP, 2 had no GPC, and 11 did not have both. The overall ratio of GPC, CP, GH, and PHC to the population was 1:4228, 1:10,200, 1:223,619 and 1:31,397, respectively. Should the coverage for minor ailment services in public health care clinics be extended to community pharmacies, the ratio of facilities to population for each district would be better with 1:4000–8000.

Conclusions

The distribution of health care facilities for minor ailment management in Malaysia is relatively good. However, if the scheme for minor ailments were available to community pharmacies, then the patients’ access to minor ailments services would be further improved.

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Most cited references 29

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Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries

Margaret Kruk, Anna Gage, Naima T Joseph … (2018)

Summary Background Universal health coverage has been proposed as a strategy to improve health in low-income and middle-income countries (LMICs). However, this is contingent on the provision of good-quality health care. We estimate the excess mortality for conditions targeted in the Sustainable Development Goals (SDG) that are amenable to health care and the portion of this excess mortality due to poor-quality care in 137 LMICs, in which excess mortality refers to deaths that could have been averted in settings with strong health systems. Methods Using data from the 2016 Global Burden of Disease study, we calculated mortality amenable to personal health care for 61 SDG conditions by comparing case fatality between each LMIC with corresponding numbers from 23 high-income reference countries with strong health systems. We used data on health-care utilisation from population surveys to separately estimate the portion of amenable mortality attributable to non-utilisation of health care versus that attributable to receipt of poor-quality care. Findings 15·6 million excess deaths from 61 conditions occurred in LMICs in 2016. After excluding deaths that could be prevented through public health measures, 8·6 million excess deaths were amenable to health care of which 5·0 million were estimated to be due to receipt of poor-quality care and 3·6 million were due to non-utilisation of health care. Poor quality of health care was a major driver of excess mortality across conditions, from cardiovascular disease and injuries to neonatal and communicable disorders. Interpretation Universal health coverage for SDG conditions could avert 8·6 million deaths per year but only if expansion of service coverage is accompanied by investments into high-quality health systems. Funding Bill & Melinda Gates Foundation.

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Poverty and access to health care in developing countries.

Celia G. Walker, A Garg, Gerry Bloom … (2007)

People in poor countries tend to have less access to health services than those in better-off countries, and within countries, the poor have less access to health services. This article documents disparities in access to health services in low- and middle-income countries (LMICs), using a framework incorporating quality, geographic accessibility, availability, financial accessibility, and acceptability of services. Whereas the poor in LMICs are consistently at a disadvantage in each of the dimensions of access and their determinants, this need not be the case. Many different approaches are shown to improve access to the poor, using targeted or universal approaches, engaging government, nongovernmental, or commercial organizations, and pursuing a wide variety of strategies to finance and organize services. Key ingredients of success include concerted efforts to reach the poor, engaging communities and disadvantaged people, encouraging local adaptation, and careful monitoring of effects on the poor. Yet governments in LMICs rarely focus on the poor in their policies or the implementation or monitoring of health service strategies. There are also new innovations in financing, delivery, and regulation of health services that hold promise for improving access to the poor, such as the use of health equity funds, conditional cash transfers, and coproduction and regulation of health services. The challenge remains to find ways to ensure that vulnerable populations have a say in how strategies are developed, implemented, and accounted for in ways that demonstrate improvements in access by the poor.

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The availability of pharmacies in the United States: 2007–2015

Dima Mazen Qato, Shannon N. Zenk, Jocelyn R. Wilder … (2017)

Importance Despite their increasingly important role in health care delivery, little is known about the availability, and characteristics, of community pharmacies in the United States. Objectives (1) To examine trends in the availability of community pharmacies and pharmacy characteristics (24-hour, drive-up, home delivery, e-prescribing, and multilingual staffing) associated with access to prescription medications in the U.S. between 2007 and 2015; and (2) to determine whether and how these patterns varied by pharmacy type (retail chains, independents, mass retailers, food stores, government and clinic-based) and across counties. Methods Retrospective analysis using annual data from the National Council for Prescription Drug Programs. Pharmacy locations were mapped and linked to the several publically-available data to derive information on county-level population demographics, including annual estimates of total population, percent of population that is non-English speaking, percent with an ambulatory disability and percent aged ≥65 years. The key outcomes were availability of pharmacies (total number and per-capita) and pharmacy characteristics overall, by pharmacy type, and across counties. Results The number of community pharmacies increased by 6.3% from 63,752 (2007) to 67,753 (2015). Retail chain and independent pharmacies persistently accounted for 40% and 35% of all pharmacies, respectively, while the remainder were comprised of mass retailer (12%), food store, (10%), clinic-based (3%) or government (<1%) pharmacies. With the exception of e-prescribing, there was no substantial change in pharmacy characteristics over time. While the number of pharmacies per 10,000 people (2.11) did not change between 2007 and 2015 at the national-level, it varied substantially across counties ranging from 0 to 13.6 per-capita in 2015. We also found that the majority of pharmacies do not offer accommodations that facilitate access to prescription medications, including home-delivery, with considerable variation by pharmacy type and across counties. For example, the provision of home-delivery services ranged from less than <1% of mass retailers to 67% of independent stores and was not associated with county demographics, including ambulatory disability population and percent of the population aged ≥65 years. Conclusions Despite modest growth of pharmacies in the U.S., the availability of pharmacies, and pharmacy characteristics associated with access to prescription medications, vary substantially across local areas. Policy efforts aimed at improving access to prescription medications should ensure the availability of pharmacies and their accommodations align with local population needs.

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Author and article information

Contributors

Ernieda Hatah:

ORCID: http://orcid.org/0000-0002-6300-2965

ernieda@ukm.edu.my

Journal

Journal ID (nlm-ta): J Pharm Policy Pract

Journal ID (iso-abbrev): J Pharm Policy Pract

Title: Journal of Pharmaceutical Policy and Practice

Publisher: BioMed Central (London )

ISSN (Electronic): 2052-3211

Publication date (Electronic): 24 February 2021

Publication date PMC-release: 24 February 2021

Publication date Collection: 2021

Volume: 14

Electronic Location Identifier: 24

Affiliations

[1 ]GRID grid.412113.4, ISNI 0000 0004 1937 1557, Faculty of Pharmacy, , Universiti Kebangsaan Malaysia, ; Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia

[2 ]GRID grid.461061.4, ISNI 0000 0004 1764 6449, Clinical Research Centre, , Hospital Sultan Abdul Halim, ; Sungai Petani, 08000 Kedah Malaysia

[3 ]GRID grid.412113.4, ISNI 0000 0004 1937 1557, Earth Observation Centre, Institute of Climate Change, , Universiti Kebangsaan Malaysia, ; Bandar Baru Bangi, 43650 Selangor Malaysia

[4 ]GRID grid.412113.4, ISNI 0000 0004 1937 1557, Department of Civil Engineering, Faculty of Engineering & Built Management, , Universiti Kebangsaan Malaysia, ; Bandar Baru Bangi, 43650 Selangor Malaysia

Author information

Ernieda Hatah http://orcid.org/0000-0002-6300-2965

Article

Publisher ID: 308

DOI: 10.1186/s40545-021-00308-9

PMC ID: 7903721

PubMed ID: 33627199

SO-VID: 9c7fea69-0bfd-4371-9de5-b2636c99e44c

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 15 September 2020

Date accepted : 15 February 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100011693, Pusat Pengurusan Penyelidikan dan Instrumentasi;

Award ID: GGP-2017-058

Award Recipient : Ernieda Hatah

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Geospatial analysis of distribution of community pharmacies and other health care facilities providing minor ailments services in Malaysia

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Most cited references 29

Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries

Poverty and access to health care in developing countries.

The availability of pharmacies in the United States: 2007–2015

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Cited by 8

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