Public Health Interventions Delivered by Pharmacy Professionals in Low- and Middle-Income Countries in Africa: A Systematic Scoping Review
Abstract
:1. Introduction
2. Methods
2.1. Search Strategy and Information Sources
2.2. Electronic Search
2.3. Hand-Searching of Key Journals, Theses and Dissertations, and Relevant Organizations
2.4. Data Extraction
2.5. Data Charting
- the country setting (e.g., LMICs in Africa),
- the setting type (e.g., community pharmacy, hospital pharmacy, health center, hospital),
- the intervention type (e.g., advice, testing, monitoring),
- the health condition (e.g., diabetes, hypertension, Asthma, malaria),
- The aims of the study and the aims of the intervention,
- The type of study design (e.g., randomized controlled trial (RCT), quasi-experimental, single-arm before and after intervention, quantitative cross-sectional survey, qualitative study, mixed-method design,
- Outcomes and processes assessed,
- The sample size,
- Characteristics of the sample (e.g., gender, age, health status),
- Resource investment (e.g., training),
- Mode of delivery,
- The number of required interactions to deliver the intervention,
2.6. Collating, Summarizing, and Reporting the Findings
- Level A: Evidence from meta-analysis or systematic reviews of randomized controlled trials.
- Level B: Evidence from randomized controlled trials.
- Level C: Evidence from quasi-experimental or intervention studies
- Level D: Evidence from observational studies or quantitative surveys or well-designed qualitative studies
- Level E: Expert opinion, case reports.
3. Results
3.1. Study Selection
3.2. Study Characteristics
3.3. Scope of Public Health Interventions and Quality of Evidence
- Non-communicable diseases (NCDs) (n = 15),
- Infectious diseases (n = 12),
- Antimicrobial resistance (n = 5),
- Sexual and reproductive health (n = 11),
- Other health conditions (n = 5)
3.3.1. Noncommunicable Diseases (NCDs)
3.3.2. Infectious Disease
3.3.3. Antimicrobial Resistance
3.3.4. Sexual and Reproductive Health
3.3.5. Other Health Conditions
3.4. The Strength and Level of Evidence
4. Discussion
4.1. Strengths and Limitations of this Scoping Review
4.2. Implication
- Randomized and interventional studies that compare the effectiveness of the delivery public health services by pharmacy professionals.
- Studies exploring the experiences and challenges faced by pharmacy professionals in providing public health services and identifying strategies to overcome these barriers.
- Studies investigating the impact of policy and regulatory changes on the delivery of public health services by pharmacy professionals in LMICs.
- Studies evaluating the effectiveness of interprofessional collaboration between pharmacists and other health professionals in delivering public health services in LMICs.
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Themes | Included Studies and Aims of Interventions | Study Settings (n) | Intervention Component, Mode of Delivery and Training (n) | Study Designs (n) | Number of Settings |
---|---|---|---|---|---|
NCDs | 15 studies identified Interventions: Cardiovascular risk factors including diabetes, hypertension, obesity | Nigeria (7) Ethiopia (4) Ghana, South Africa, Sudan and Tanzania (1 each) Community pharmacies (12), and health centers or hospitals (3) | Risk identification and reduction screening for cardiovascular risk factors (7) Disease management: interventions included counselling or advice, education, medication management (8) In person service delivery (15) Use of mobile health technology (1) Staff training on service delivery (7) Length of training reported in 3 studies and were one or two days | Cross-sectional study design to gather and analyze data on service provision (10) Single-blind randomized controlled trial (1) Quasi-experimental design (1) Single group before and after intervention studies (3) | More than one setting or multi-center (11) More than 100 individuals (6) |
Infectious Diseases | 12 studies identified: Malaria (8) Diarrheal disease (6) Pneumonia (5) Tuberculosis (1) | Tanzania (3) Ghana (2) Ethiopia (2) Uganda (2) Nigeria, Kenya and Sudan (1 each) Community pharmacies or accredited drug dispensing outlets or drug shops or licensed chemical shops or drug stores/vendors | Interventions focused on testing and treatment of conditions Additional interventions: referral to others, counselling and education In person service delivery (12) Staff training on service delivery (6) Length of training reported in 5 studies, and were 3 days (2), 5 days (2) and 1 week (1) | Cross-sectional study design (8) Mixed-method design including survey and qualitative interview (1) Quasi-experimental design (2) Cluster-randomized trial (1) Randomized interventional study (1) | More than one setting or multi-center (12) Data collected from 100 or more participants (7) |
Sexual and reproductive health | 11 studies were identified: sexually transmitted infections (STIs) (5), and reproductive health (6) | Kenya (5) Ethiopia (2) Uganda, Ghana, and Sudan (1 each), and Nigeria and Kenya (1) Community pharmacies or licensed chemical seller or drug shops | Interventions focused on screening and treatment of STIs, and family planning Additional interventions: referral to others, counselling and education In person service delivery (11) Staff training on service delivery (7) Length of training reported in one study, and was 6 weeks | Cross-sectional study design (10) Quantitative (8) Qualitative design involving FGDs, in-depth interviews, KIIs (2) Controlled interventional design (1) | More than one setting or multi-center (11) Data collected from 100 or more participants (4) |
Antimicrobial resistance | 5 studies were identified aimed at evaluating antibiotic stewardship interventions | South Africa (3) Ethiopia (1) Nigeria (1) Community pharmacies (1) Hospital (4) | Interventions: reviewing and auditing antimicrobial therapy, protocol development, feedback, and in-service education In person service delivery (5) Additional written protocol and mobile phone messages (2) Staff training on service delivery (2) | Cross-sectional (1) Single group before and after intervention (4) | More than one setting or multi-center (5) Data collected from 100 or more participants (4) |
Other health conditions | 5 studies focused on back pain, dyspepsia, immunization, oral health, unused medicine or waste, minor ailment, and community health risk identification | Ethiopia (3) Nigeria (1) Sudan (1) community pharmacies | Vaccine distribution, providing information, conducting need assessments, counselling, diagnosing and treating conditions, and referral to physician In person service delivery (5) | cross-sectional design (5) | More than one setting or multi-center (4) Data collected from 100 or more participants (1) |
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Gebresillassie, B.M.; Howells, K.; Ashiru-Oredope, D. Public Health Interventions Delivered by Pharmacy Professionals in Low- and Middle-Income Countries in Africa: A Systematic Scoping Review. Pharmacy 2023, 11, 24. https://doi.org/10.3390/pharmacy11010024
Gebresillassie BM, Howells K, Ashiru-Oredope D. Public Health Interventions Delivered by Pharmacy Professionals in Low- and Middle-Income Countries in Africa: A Systematic Scoping Review. Pharmacy. 2023; 11(1):24. https://doi.org/10.3390/pharmacy11010024
Chicago/Turabian StyleGebresillassie, Begashaw Melaku, Kelly Howells, and Diane Ashiru-Oredope. 2023. "Public Health Interventions Delivered by Pharmacy Professionals in Low- and Middle-Income Countries in Africa: A Systematic Scoping Review" Pharmacy 11, no. 1: 24. https://doi.org/10.3390/pharmacy11010024