Delivery of pharmaceutical services and care at three primary healthcare clinics with different dispensing models in the Nelson Mandela Bay Health District
- Authors: Bobbins, Amy Claire
- Date: 2018
- Subjects: National health insurance -- South Africa , Community health services -- South Africa Pharmaceutical services -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/23580 , vital:30583
- Description: As South Africa moves into an era of National Health Insurance (NHI), the idea of primary health care (PHC) re-engineering is placed at the forefront; however, the role of the pharmacist in this process remains vague. Task-shifting of the dispensing process to pharmacist’s assistants and nurses in PHC clinics is a common phenomenon, but the implications of this on the provision of pharmaceutical services and care to patients is largely unstudied. Thus, this study aims to explore these pharmacist-based, pharmacist’s assistant-based and nurse-based dispensing models present in PHC clinics. A two-phase, mixed methods approach was utilised, comprising of a pharmaceutical services audit and semi-structured interviews. The interviews provided insight into the lived experiences of personnel and patients of pharmaceutical care provision. Results revealed that although basic pharmaceutical services may be available at clinics with each of the three dispensing models, the quality is of a varying standard due to challenges in infrastructure and maintenance and poor personnel support. Furthermore, the provision of quality pharmaceutical care is minimal with all three dispensing models, resulting in a missed opportunity to optimise patient health outcomes in patient-centred PHC.
- Full Text:
- Date Issued: 2018
Future role of community pharmacy in the national health insurance
- Authors: Aluko, Olubusola Aderonke
- Date: 2018
- Subjects: National health insurance -- South Africa , Health care reform -- South Africa Community health services -- South Africa Pharmacy -- Practice -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/21472 , vital:29525
- Description: Governments all over the world have shown interest in the healthcare system and various policies and measures have been adopted to ensure optimum health of the people. Inequity in health provision in South Africa is a great challenge. In South Africa, the healthcare system is currently characterised by distinctly different public and private sectors. The public sector serves approximately 84% of the population while the private sector services the smaller portion, 16% of the population. However, the expenditure in both the private and public sectors is almost the same, with approximately five times more being spent per capita in the private sector than in the public sector. The South African health care system is therefore unbalanced with respect to expenditure per capita resulting in inequitable access to, and quality of, health services. In particular, relative to the population it serves and the disease burden that it carries, the public sector is under-resourced. In order to address the inequities characteristic of the current two-tiered system, the South African Government is in the process of implementing a National Health Insurance (NHI). The NHI will provide a means of pooling all healthcare funding, thereby providing a means of cross subsidization within the public sector. Funding contributions will be linked to the ability of an individual to pay and benefits will be determined by an individual’s need for care. A core principle of NHI is to provide access to quality care. It has been suggested that within a NHI system private pharmacies may be contracted through service agreements to provide both chronic and acute medicines. However, there are currently no policies specifying the roles and functions of pharmacists in the NHI or in a re-engineered Primary Health Care system, although it has been suggested that for South Africa to have a successful healthcare system it requires the support and assistance of pharmacists. Research suggests that the majority of pharmacists do not believe that the NHI is a suitable means to address South Africa’s healthcare problems and many do not agree with the principles behind it. This study describes the perceptions and attitudes of community pharmacists and the lay public in Nelson Mandela Bay Metropole toward NHI and the potential role of community pharmacists within the NHI. A qualitative approach was used to provide an in-depth exploration of the attitudes and perceptions of community pharmacists and the lay public in Nelson Mandela Bay Metropole (NMBM). It is envisaged that this understanding will provide a basis for addressing pharmacists’ concerns and may contribute towards the further development of the role and the scope of practice of community pharmacists in the NHI. Semi-structured, in-depth interviews were conducted with both community pharmacists and with members of the public. The interviews were digitally recorded and then transcribed. The transcriptions were coded and analysed thematically. The analysis of the themes identified revealed that while community pharmacists and the public are aware of NHI they are uncertain as to how it is being implemented. However, both community pharmacists and patients see NHI as an advantage and display a positive attitude towards NHI.
- Full Text:
- Date Issued: 2018