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      Development of pharmacy competency framework for the changing demands of Thailand’s pharmaceutical and health services

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          Abstract

          Background:

          In Thailand, pharmacists are responsible for all activities to ensure access to medicines throughout pharmaceutical supply chain. Competency framework (CF) is an important guidance for professional development and workforce planning.

          Objective:

          This study aimed to explore needs for pharmacy services in pharmaceutical supply chain and competencies of pharmacists to serve those needs. It was the first step for developing evidence-based pharmacy CF within the context of Thailand in 2026.

          Methods:

          A qualitative method using in-depth interviews to gain rich data from practitioners and leaders in all area of practices. 99 key informants from 56 workplaces in Thailand were interviewed during January and March 2016. Data was transcribed verbatim, and thematic analysis was used. Competencies were extracted, followed by several rounds of group discussion among team members to develop an initial framework. The competencies and CF were presented, and recommendations were gained from professional leaders for refining the findings.

          Results:

          The key informants agreed that pharmacist’s works and responsibilities have gradually been drifted to support changes in healthcare and pharmaceutical systems. The upcoming pharmaceutical services call for higher standards of practice, larger number of personnel, and skillful pharmacists who have strong foundation in pharmaceutical knowledge as well as an ability to integrate knowledge into practices. Two sets of CFs were established. The general CF comprises five core domains: product focus, patient focus, healthcare system focus, community focus, and personal focus for self-improvement. These general competencies allow practitioners to perform basic professional tasks, including providing information, dispensing, and compounding. The service-specific competency is the integration of general competencies tailored into specific area of practice.

          Conclusions:

          Regarding the professional goal to evolve pharmacists from generalists to specialists for providing higher quality of professional services, the pharmacists are required to demonstrate general competencies and service-specific competencies. The findings serve as the need-based evidence for developing a national CF for pharmacists in Thailand.

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          Most cited references63

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          Health systems development in Thailand: a solid platform for successful implementation of universal health coverage.

          Thailand's health development since the 1970s has been focused on investment in the health delivery infrastructure at the district level and below and on training the health workforce. Deliberate policies increased domestic training capacities for all cadres of health personnel and distributed them to rural and underserved areas. Since 1975, targeted insurance schemes for different population groups have improved financial access to health care until universal health coverage was implemented in 2002. Despite its low gross national income per capita in Thailand, a bold decision was made to use general taxation to finance the Universal Health Coverage Scheme without relying on contributions from members. Empirical evidence shows substantial reduction in levels of out-of-pocket payments, the incidence of catastrophic health spending, and in medical impoverishment. The scheme has also greatly reduced provincial gaps in child mortality. Certain interventions such as antiretroviral therapy and renal replacement therapy have saved the lives of adults. Well designed strategic purchasing contributed to efficiency, cost containment, and equity. Remaining challenges include preparing for an ageing society, primary prevention of non-communicable diseases, law enforcement to prevent road traffic mortality, and effective coverage of diabetes and tuberculosis control.
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            An analysis of the global pharmacy workforce capacity

            Background The World Health Organization (WHO) estimates that there is a global healthcare workforce shortage of 7.2 million, which is predicted to grow to 12.9 million by 2035. Globally, people are living longer with multiple co-morbidities and require increased access and use of medicines. Pharmacists are a key component of the healthcare workforce, and in many countries, pharmacists are the most accessible healthcare profession. This paper identifies key issues and current trends affecting the global pharmacy workforce, in particular workforce distribution, country economic status, capacity, and workforce gender balance. Methods National professional pharmacy leadership bodies, together with other contacts for professional bodies, regulatory bodies, and universities, were approached to provide country-level data on pharmacy workforce. A descriptive and comparative analysis was conducted to assess each country’s pharmacy workforce. Results A total of 89 countries and territories responded to the survey. To standardise the capacity measure, an analysis of the population density of pharmacists (per 10 000 population) was performed. The sample mean was 6 pharmacists per 10 000 population (n = 80). There is considerable variation between the surveyed countries/territories ranging from 0.02 (Somalia) to 25.07 (Malta) pharmacists per 10 000 population. African nations have significantly fewer pharmacists per capita. Pharmacist density correlates with gross national income (GNI) and health expenditure. The majority of pharmacists are employed in community settings, followed by hospital, industry-related, academia, and regulation. There is a greater proportion of females in the pharmacy workforce globally, with some WHO regions showing female representation of more than 65 % with an increasing trend trajectory. Conclusions Pharmacy workforce capacity varies considerably between countries and regions and generally correlates with population- and country-level economic indicators. Those countries and territories with lower economic indicators tend to have fewer pharmacists and pharmacy technicians; this has implications for inequalities regarding access to medicines and medicine expertise.
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              Primary health care policy and vision for community pharmacy and pharmacists in Indonesia

              The practice of community pharmacy in low and middle-income countries, including in Indonesia, is often described as in the state of infancy with several intractable barriers that have been substantially and continuously hampering the practice. Such description might be valid in highlighting how pharmacy is practiced and the conditions within and beyond community pharmacy organizations. Therefore, it is not surprising that the concept of integrating community pharmacy into the primary care system may not be considered in the contemporary discourse despite the fact that community pharmacy has been operating within communities for years. However, in the case of Indonesia, we argue that changes in the health care system within the past decade particularly with the introduction of the universal health coverage (UHC) in 2014, may have significantly amplified the role of pharmacists. There is good evidence which highlights the contribution of pharmacist as a substantial health care element in primary care practice. The initiative for employing pharmacist, identified in this article as primary care pharmacist, in the setting of community health center [puskesmas] and the introduction of affiliated or contracted community pharmacy under the UHC have enabled pharmacist to work together with other primary care providers. Moreover, government agenda under the “Smart Use of Medicines” program [Gema Cermat] recognizes pharmacists as the agent of change for improving the rational use of medicines in the community. Community pharmacy is developing, albeit slowly, and is able to grasp a novel position to deliver pharmacy-related primary care services to the general public through new services, for example drug monitoring and home care. Nevertheless, integrating community pharmacy into primary care is relatively a new notion in the Indonesian setting, and is a challenging process given the presence of barriers in the macro, meso- and micro-level of practice.
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                Author and article information

                Contributors
                Journal
                Pharm Pract (Granada)
                Pharm Pract (Granada)
                Pharmacy Practice
                Centro de Investigaciones y Publicaciones Farmaceuticas
                1885-642X
                1886-3655
                Oct-Dec 2020
                04 December 2020
                : 18
                : 4
                : 2141
                Affiliations
                PhD. Assistant professor. Faculty of Pharmacy, Chiang Mai University . Chiang Mai (Thailand). puckwipa.suwan@ 123456elearning.cmu.ac.th
                PhD. Assistant professor. Faculty of Pharmacy, Chiang Mai University . Chiang Mai (Thailand). siritree.s@ 123456cmu.ac.th
                PhD. Assistant professor. Faculty of Pharmacy, Chiang Mai University . Chiang Mai (Thailand). suntara.e@ 123456elearning.cmu.ac.th
                PhD. Associate professor. Faculty of Pharmaceutical Sciences, Ubon Ratchathani University . Ubon Ratchathani (Thailand). teeraporn.s@ 123456ubu.ac.th
                PhD. Associate professor. Faculty of Pharmacy, Khon Kaen University . Khon Kaen (Thailand). nustat@ 123456kku.ac.th
                PhD. Assistant professor. Faculty of Pharmaceutical Sciences, Prince of Songkla University . Songkhla (Thailand). khunjira.u@ 123456gmail.com
                PhD. Assistant professor. Faculty of Pharmaceutical Sciences, Chulalongkorn University . Bangkok (Thailand). rungpetch.c@ 123456pharm.chula.ac.th
                Author information
                https://orcid.org/0000-0002-5797-6915
                https://orcid.org/0000-0001-5501-8003
                https://orcid.org/0000-0002-0876-6575
                https://orcid.org/0000-0002-6887-8181
                https://orcid.org/0000-0002-5474-4991
                https://orcid.org/0000-0003-1540-7324
                https://orcid.org/0000-0002-5579-9273
                Article
                pharmpract-18-2141
                10.18549/PharmPract.2020.4.2141
                7732214
                33343773
                9d2c64d2-00e8-429d-82ae-d3d73f2998d8
                Copyright: © Pharmacy Practice and the Authors

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 August 2020
                : 22 November 2020
                Funding
                Funded by: Pharmacy Council of Thailand
                Funded by: National Science Technology and Innovation Policy Office
                Categories
                Original Research

                education, pharmacy,curriculum,academic success,pharmaceutical services,pharmacy,pharmacies,pharmacists,evidence-based pharmacy practice,workforce,health services accessibility,qualitative research,thailand

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