The pharmacy workforce in public primary healthcare centers: promoting access and information on medicines
Background: Only few studies have analyzed the pharmaceutical workforce in primary healthcare centers, and a global recommendation calls for better understanding of the trends that shape workforce development and capacity.
Objective: To analyze the distribution of the pharmaceutical workforce in primary healthcare centers in the national health system [Sistema Único de Saúde (SUS)] in Brazil.
Methods: The study was conducted using data from the National Survey on Access, Use and Promotion of Rational Use of Medicines in Brazil. Secondary data referring to the socioeconomic indicators of each municipality were obtained from national public databases. Data stratification in geographic regions was considered, and data on workers in the management of the municipal pharmaceutical services and medicines dispensing centers were analyzed. Crude and adjusted prevalence ratios were calculated by Poisson regression in the study investigating the factors associated with low and high-density pharmacists per 10,000 inhabitants.
Results: The results showed that most Brazilian municipalities have a rate of 1 or more pharmacist per 10,000 inhabitants in primary healthcare public facilities, with a higher concentration of pharmacists in small municipalities. Even in Brazilian municipalities with lower economic capacity, the conditions of access to medicines and pertinent information on medicines were directly related to the number of pharmacists available in these centers.
Conclusions: This study showed a high number of pharmacists in the public health system. The higher density of pharmacists in primary healthcare public facilities correlated to increased access to medicines information and better municipal social development.
Gregório J, Cavaco A, Lapão LV. A scenario-planning approach to human resources for health: the case of community pharmacists in Portugal. Hum Resour Health. 2014;12(58):1-13. https://doi.org/10.1186/1478-4491-12-58
World Health Organization. A universal truth: no health without a workforce: Forum Report, Third Global Forum on Human Resources for Health. Available at: https://www.who.int/workforcealliance/knowledge/resources/GHWA-a_universal_truth_report.pdf?ua=1 (accessed Oct 17, 2020).
International Pharmaceutical Federation. Pharmacy Workforce Intelligence: global trends report. The Hague: IPF; 2018. Available at: https://www.fip.org/file/2077 (accessed Oct 17, 2020).
Bates I, John C, Bruno A, Fu P, Aliabadi S. An analysis of the global pharmacy workforce capacity. Hum Resour Health. 2016;14(61):1-7. https://doi.org/10.1186/s12960-016-0158-z
International Pharmaceutical Federation. Global pharmacy workforce and migration report: a call for action. Available at: http://www.fip.org/files/fip/HR/FIP%20Global%20Pharmacy%20and%20Migration%20report%2007042006.PDF (accessed Oct 17, 2020).
Ekpenyong A, Udoh A, Kpokiri E, Bates I. An analysis of pharmacy workforce capacity in Nigeria. J Pharm Policy Pract. 2018;11(20):1-9. https://doi.org/10.1186/s40545-018-0147-9
Kennie-Kaulbach N, Farrell B, Ward N, Johnston S, Gubbels A, Eguale T, Dolovich L, Jorgenson D, Waite N, Winslade N. Pharmacist provision of primary health care: a modified Delphi validation of pharmacists’ competencies. BMC Fam Pract. 2012;13(27):1-9. https://doi.org/10.1186/1471-2296-13-27
Gray SF, Evans D. Developing the public health workforce: training and recognizing specialists in public health from backgrounds other than medicine: experience in the UK. Public Health Rev. 2018;39(14):1-9. https://doi.org/10.1186/s40985-018-0091-x
Groenewegen P, Heinemann S, Greß S, Schäfer W. Primary care practice composition in 34 countries. Health Policy. 2015;119(12):1576-1583. https://doi.org/10.1016/j.healthpol.2015.08.005
Smith MA. Primary Care teams and pharmacist staffing ratios: is there a magic number? Ann Pharmacother. 2018;52(3):290-294. https://doi.org/10.1177/1060028017735119
Carvalho MN, Costa EMOD, Sakai MH, Gil CRR, Leite SN. Expansion and diversification of the higher-level workforce in Basic Health Units in Brazil, 2008 - 2013. Saúde Debate. 2016;40(109):154-162. https://doi.org/10.1590/0103-1104201610912
Carvalho MN de, Gil CRR, Costa EMOD, Sakai MH, Leite SN. Need and dynamics of the workforce in Primary Health Care in Brazil. Cienc Saude Coletiva. 2018;23(1):295–302. http://dx.doi.org/10.1590/1413-81232018231.08702015
Carvalho MN, Álvares J, Costa KS, Guerra Junior AA, Acurcio FA, Costa EA, Guibu IA, Soeiro OM, Karnikowski MGO, Leite SN. Workforce in the pharmaceutical services of the primary health care of SUS, Brazil. Rev Saude Publica. 2017;51(Suppl 2):16s. https://doi.org/10.11606/s1518-8787.2017051007110
B Bates I, John C, Seegobin P, Bruno A. An analysis of the global pharmacy workforce capacity trends from 2006 to 2012. Hum Resour Health. 2018;16(3):1-9. https://doi.org/10.1186/s12960-018-0267-y
International Pharmaceutical Federation. Global Pharmacy: workforce report, 2012. Available at: http://www.fip.org/files/members/library/FIP_workforce_Report_2012.pdf (accessed Oct 17, 2020).
Walley J, Lawn JE, Tinker A, Francisco A, Chopra M, Rudan I, Bhutta ZA, Black RE. Primary health care: making Alma-Ata a reality. Lancet. 2008;372(9642):1001-1007. https://doi.org/10.1016/S0140-6736(08)61409-9
Shi L. The Impact of Primary Care: a focused review. Scientifica. 2012;2012:1-22. https://doi.org/10.6064/2012/432892
Castro MC, Massuda A, Almeida G, Menezes-Filho NA, Andrade MV, Noronha KVMS, Rocha R, Macinko J, Hone T, Tasca R, Giovanella L, Malik AM, Werneck H, Fachini LA, Atun R. Brazil’s unified health system: the first 30 years and prospects for the future. Lancet. 2019;394(10195):345-356. https://doi.org/10.1016/S0140-6736(19)31243-7
Leite SN, Manzini F, Veiga A, Lima MEO, Pereira MA, Araujo SQ, Santos RF, Bermudez JAZ. Science, Technology and Pharmaceutical Policy on the agenda: contributions from the society to the 16th National Conference on Health. Cienc Saude Coletiva. 2018; 23(12):4259-4268. https://doi.org/10.1590/1413-812320182312.29962018
Vieira FS. [TD 2500 – State challenges about inclussion of medicines in the national health service]. Available at: https://www.ipea.gov.br/portal/index.php?option=com_content&view=article&id=34970 (accessed Oct 17, 2020).
Serafin C. [Profile of the pharmacist in Brazil]. Available at: https://www.cff.org.br/userfiles/file/Perfil%20do%20farmac%c3%aautico%20no%20Brasil%20_web.pdf (accessed Oct 17, 2020).
Ministério da Saúde. Resolução no 338/2004. Available at: http://bvsms.saude.gov.br/bvs/saudelegis/cns/2004/res0338_06_05_2004.html (accessed Oct 17, 2020).
Ministério da Saúde. [Portaria no 2.077, Creates the National Survey about access, use and prmootion of the rational use of medicines in Brazil (PNAUM)]. Available at: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2012/prt2077_17_09_2012.html (accessed Oct 17, 2020).
Ministério da Saúde. [Component of primary care pharmaceutical services assessment: introduction, methods and instruments]. Available at: http://bvsms.saude.gov.br/bvs/publicacoes/componente_avaliacao_assistencia_pnaum_caderno2.pdf (accessed Oct 17, 2020).
lvares J, Alves MCGP, Escuder MML, Almeida AM, Izidoro JB, Guerra Junior AA, Costa KS, Costa EA, Guibu IA, Soeiro OM, Leite SN, Karnikowski MGO, Acurcio FA. National survey on access, use and promotion of rational use of medicines: methods. Rev Saude Publica. 2017;51(Suppl 2):4s. https://doi.org/10.11606/s1518-8787.2017051007027
International Pharmaceutical Federation. 2012 FIP Global Pharmacy: workforce report. Available from: http://www.fip.org/files/members/library/FIP_workforce_Report_2012.pdf (accessed Oct 17, 2020).
Almaghaslah D, Alsayari A, Asiri R, Albugami N. Pharmacy workforce in Saudi Arabia: challenges and opportunities: a cross-sectional study. Int J Health Plann Manage. 2018;34(1):e583-e593. http://doi.wiley.com/10.1002/hpm.2674
Instituto Brasileiro de Geografia e Estatística. [Municipal social metrics: analysis of the results of the 2010 demopgraphic census]. Available at: https://biblioteca.ibge.gov.br/pt/biblioteca-catalogo?view=detalhes&id=254598 (accessed Oct 17, 2020).
Programa das Nações Unidas para o Desenvolvimento. [Brazilian municipal human development index]. Available at: https://onedrive.live.com/?authkey=%21AGvg%2D0FawRuMMj4&cid=124653557C0404EC&id=124653557C0404EC%2123008&parId=124653557C0404EC%2122848&o=OneUp (accessed Oct 17, 2020).
Araújo PS, Costa EA, Guerra Junior AA, Acurcio FA, Guibu IA, Álvares J, Costa KS, Karnikowski MGO, Soeiro OM, Leite SN. Pharmaceutical care in Brazil’s primary health care. Rev Saude Publica. 2017;51(Suppl 2):6s. https://doi.org/10.11606/S1518-8787.2017051007109
Moore GD, Kosirog ER, Griend JPV, Freund JE, Saseen JJ. Expansion of clinical pharmacist positions through sustainable funding. Am J Health Syst Pharm. 2018;75(13):978-981. https://doi.org/10.2146/ajhp170285
Oliveira MA, Luiza VL, Tavares NUL, Mengue SS, Arrais PSD, Farias MR, Dal Pizzol TS, Ramos LR, Bertoldi AD. Access to medicines for chronic diseases in Brazil: a multidimensional approach. Rev Saude Publica. 2016;50(Suppl 2):6s. https://doi.org/10.1590/s1518-8787.2016050006161
Copyright (c) 2020 Pharmacy Practice and the Authors
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The authors hereby transfer, assign or otherwise convey to Pharmacy Practice (1) the right to grant permission to republish or reprint the stated material, in whole or in part, without a fee; (2) the right to print or epublish copies for free distribution or sale; and (3) the right to republish the stated material in any format (electronic or printed). In addition, the undersigned affirms that the article described above has not previously been published, in whole or part, is not subject to copyright or other rights except by the author(s), and has not been submitted for publication elsewhere, except as communicated in writing to Pharmacy Practice with this document.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-NC-ND) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Author Self-Archiving Policy
Pharmacy Practice permits and encourages authors to post and archive the final PDFs of their respective articles submitted to the journal on personal websites or institutional repositories after publication, while providing bibliographic details that credit its publication in this journal.