Needs assessment of global pharmaceutical development goals: an explanatory mixed-methods study of 21 countries.

OBJECTIVES: Investment in the development of the pharmacy workforce has been recognized as crucial for achieving universal health coverage. The 21 International Pharmaceutical Federation (FIP) Development Goals (DGs) have been used when conducting national needs assessments in several countries to provide evidence-based policy on workforce development. This study aimed to explore factors contributing to education and training in a FIP sample of mainly low- to middle-income countries (LMICs), and current national policy initiatives and priorities, mapped against the FIP DGs. METHODS: The study employed a mixed-methods approach, including an online survey questionnaire and interviews with representatives from 26 national professional organizations from 21 countries. A Multiple Correspondence Analysis (MCA), descriptive analysis, and thematic analysis were carried out to analyse the data. KEY FINDINGS: A total of 26 national professional organizations from 21 countries participated in this study. The quantitative MCA results indicated categorical correlations with variables related to the maintenance of licensed pharmacy practice and mechanisms for personal career development and advancement, such as the availability of competency development frameworks. Six themes emerged from the qualitative analysis of ongoing national programmes in the sampled countries: strengthening initial education and training, competency and career development programmes, initiatives related to pharmacists' role in patient safety, communicable diseases, and antimicrobial stewardship, pharmaceutical care and medicines access, strengthening research to improve pharmacists' impact, and outcomes and policy review and development. CONCLUSION: This study provided an evidence-based needs assessment exploring factors contributing to workforce development and identifying pharmaceutical development priorities mapped to the FIP DGs across a cohort of nations.

Factors influencing pharmacists and pharmaceutical scientists' membership in professional organisations: an international survey.

BACKGROUND: Professional organisations exist as international or national organisations, with each country establishing at least one national professional association. There remains a knowledge gap about factors that influence professional organisational involvement of pharmacists and pharmaceutical scientists. This study aims to explore the motivators and barriers of pharmacy professionals holding organisation membership from a global perspective. METHODS: An online questionnaire was developed and disseminated between May and July 2021. The survey was open to all pharmacists and pharmaceutical scientists. The survey consisted of four sections; demographic information, questions about professional organisations, about the International Pharmaceutical Federation (FIP) and its impact on the members. Data were analysed descriptively. RESULTS: A total of 1033 complete survey responses were received and included in the analysis. Of all respondents, 761 (73.7%) respondents were current members of a professional organisation and 272 (26.3%) were not members of any professional organisation. Overall, findings demonstrated networking, education, training and professional development opportunities as the main interests and anticipated activities, while the lack of clarity or need to join organisation, time, and financial constraints as the main barriers of pharmacy professionals holding membership. The majority of FIP members are satisfied with current FIP activities, and anticipate further networking opportunities, educational resources and grants made available to members. CONCLUSIONS: Understanding the perceptions and needs, as well as factors that influence engagement of pharmacists and pharmaceutical scientists is the key to enhancing membership. Professional organisations are highly encouraged to strengthen and target activities according to the identified motivators and barriers.

The development and validation of a global advanced development framework for the pharmacy workforce: a four-stage multi-methods approach.

BACKGROUND: Studies have indicated that a generalisable and translatable global framework is a useful tool for supporting career progression and recognising advanced practice. AIM: To develop and validate a global advanced competency development framework as a tool to advance the pharmacy profession globally. METHOD: A four-stage multi-methods approach was adopted. In sequence, this comprised an assessment of initial content and a cultural validation of the advanced level framework. Following this, we conducted a transnational modified Delphi followed by an online survey sampling the global pharmacy leadership community. Finally, a series of case studies was constructed exemplifying the framework implementation. RESULTS: Initial validation resulted in a modified draft competency framework comprising 34 developmental competencies across six clusters. Each competency has three phases of advancement to support practitioner progression. The modified Delphi stage provided feedback on framework modifications related to cultural issues, including missing competencies and framework comprehensiveness. External engagement and case study stages provided further validity on the framework implementation and dissemination. CONCLUSION: The four-staged approach demonstrated transnational validation of a global advanced competency framework as a mapping and development tool for the pharmacy professions. Further study is needed to develop a global glossary of terminologies on advanced and specialist practice. Also, developing an accompanying professional recognition system and education and training programmes to support framework implementation is recommended.

How can pharmacists contribute to anaemia management? A review of literature and exploratory study on pharmacists' role in anaemia.

Background: Iron deficiency anaemia (IDA) is the leading cause of anaemia globally, most frequently found in children and pregnant women. With their increasing role in the healthcare system, pharmacists may contribute to the management of anaemia. Through the International Pharmaceutical Federation (FIP) Multinational Needs Assessment Programme, the FIP explored the contribution of pharmacists in anaemia, specifically IDA, focusing on five countries: India, Indonesia, Malaysia, Philippines and Singapore. Objective: To explore information on pharmacists' roles in a variety of settings related to 1) IDA management; 2) education and training needed to support the roles; and 3) barriers and enablers to expanding or developing the roles. Methods: This study involved a literature review and a focus group discussion with twelve participants selected purposively and nominated by national professional leadership bodies across five countries. A literature search was conducted using PubMed Database. A focus group discussion explored pharmacists' roles, education and training needs, as well as barriers and enablers to support their roles in anaemia management, specifically in IDA. A codebook thematic analysis approach was conducted according to the study objectives. Results: Sixteen articles were included in the analysis. The pharmacists' roles in anaemia identified from literature ranged from patient management and monitoring, collaboration with other healthcare professionals and involvement in guideline development, in which the roles vary according to the workplace. Twelve participants attended the focus group discussion. Participants highlighted pharmacists' roles in screening and detection, medication therapeutic management, patient counselling and patient monitoring. Participants emphasised a need for guidelines or toolkits with subsequent training or workshops to support their competency development in anaemia. Monitoring the success of pharmacist delivered anaemia programmes was recommended to support advocating for active pharmacist roles. Conclusion: Pharmacists have a growing opportunity to contribute to achieving the global targets on anaemia through their involvement in screening and managing anaemia and increasing anaemia awareness among the patients and community.

How are groups of early career pharmacists and pharmaceutical scientists contributing to global health and policy development: A cross-sectional survey.

BACKGROUND: Early career pharmacists and pharmaceutical scientist groups (ECPGs) can make valuable contributions to addressing global health challenges and policy development. There is limited information describing their contribution to this topic. This study describes initiatives and activities related to global health and policy development led by ECPGs. METHODS: An online questionnaire was disseminated between July and October 2020 through the International Pharmaceutical Federation Young Pharmacists Group (FIP YPG) mailing list and its social media network. The survey consisted of questions about ECPGs' involvement in global health and policy development activities. In addition to groups or organisations, the FIP YPG also invited individual pharmacists and pharmaceutical scientists to explore their needs and views on the role of the ECPGs, and themselves as individuals in global health. Data were analysed descriptively. RESULTS: Thirty national ECPGs across six regions of the World Health Organisation (WHO) participated in the survey. Most of the initiatives led by ECPGs focused on health and wellbeing, quality of education and partnership. The most common activities were webinars, social events and partnerships with other organisations. In terms of global health challenges listed by the WHO, the most common initiatives led by ECPGs were related to medicines access and medicines safety. There was some involvement of early career pharmacists, pharmaceutical scientists, and ECPGs in the policy and regulation in their countries across various topics. CONCLUSION: To the best of the authors' knowledge, this is the first global study exploring initiatives conducted by ECPGs. This study informed initiatives that have been implemented across regions, which could be useful for other ECPGs to initiate in their country according to their needs and priorities. Fostering engagement and collaboration between ECPGs is encouraged to provide opportunities and share learning across ECPGs, which could accelerate progress towards tackling global health challenges.

A comparative analysis of pharmaceutical workforce development needs across the commonwealth.

BACKGROUND: Increasing demographic healthcare challenges, such as increased life expectancy coupled with increased use of medicines for complex morbidities, point to the need for globally applicable transformative policies in health workforce development. The International Pharmaceutical Federation (FIP) has established a set of 21 Global Development Goals (FIP DGs) to strengthen pharmacy workforce and benchmark professional developmental needs. OBJECTIVE: This study aimed to identify policy directions and factors affecting pharmacy workforce development across the Commonwealth, and to examine country progress made towards implementing workforce oriented FIP DGs. METHODS: The study involved a literature review and a global survey of commonwealth countries professional leadership bodies. The literature database search included PubMed/Medline, CINAHL, Scopus and PsychINFO databases as well as the websites of the respective national pharmacy organisations of Commonwealth countries. A global survey was also conducted to assess country-level alignment with the workforce component of FIP DGs. RESULTS: Thirty-one articles representing 21 Commonwealth countries were included in the literature overview. The development needs identified were workforce shortages and inequitable distribution across practice areas and geographical regions, low workforce supply capacity, workforce feminisation, lack of professional recognition, limited training opportunities, low job satisfaction, high workload and attrition. The survey showed disparities in country-level progress and alignment with the FIP DGs. High-income countries in the survey sample reported alignment with most of the FIP DGs, while the low-income countries reported alignment with fewer DGs. More than two-thirds of the countries showed alignment with the FIP DGs related to academic capacity, early career training, quality assurance and advancing integrated services. About half reported alignment with the FIP DGs related to competency and leadership development, respectively, while only a third aligned with the equity and equality DG. CONCLUSION: This study identified realistic pharmacy workforce developmental needs across a range of Commonwealth countries. Addressing these needs through appropriate policy interventions will be essential for increasing the pharmacy workforce capacity and assuring the delivery of high-quality pharmaceutical care and medicines expertise in these countries.

A national analysis of the pharmacy workforce in Indonesia.

BACKGROUND: Pharmacists play a fundamental role in healthcare systems and achieving Universal Health Coverage (UHC) through quality primary healthcare service provision. While the World Health Organization (WHO) forecasts a global shortage of health workforce by 2030, mainly affecting low- and middle-income nations (LMICs), limited published literature is found regarding pharmacy workforce capacity in LMICs, including Indonesia. This paper aims to analyse pharmacists' capacity in Indonesia to identify emerging workforce planning gaps for future workforce planning and policies in Indonesia. METHOD: Several data sources were accessed, including a database from the National Pharmacy Committee and the professional leadership body in Indonesia. Descriptive (frequencies, percentages, and mean), correlational and time-series analysis using curve estimation were conducted. Secondary data on the number of programmes, pharmacy students, pharmacy workforce (pharmacists and pharmacy technicians) per province were obtained from the Ministry websites and reports. RESULT: There were a total of 77 191 registered pharmacists in Indonesia in 2019. The pharmacists' pyramid showed a youth bulge as a general indication of market expansion in the education sector correlating to the pharmacy programme's number and size. There was a variation in pharmacy workforce density and access to pharmacy programmes across islands, which also were strongly correlated. Forecasting estimates that by 2030, women will represent around 86% of pharmacists in Indonesia. More female pharmacists were found working in the hospital and primary healthcare (providing direct services to patients) than male pharmacists. Younger pharmacists worked in the industrial sector, while older pharmacists worked in governmental and educational institutions. CONCLUSION: This study signposted workforce planning gaps for policy development in Indonesia, including a need to develop structured training to support early career pharmacists in their practice. There is also a need for better access to professional development programmes designed to support female pharmacists return to the regulated workforce following career breaks. National policy to promote equitable distribution and retention of pharmacists is recommended.

Strengthening Primary Healthcare through accelerated advancement of the global pharmacy workforce: a cross-sectional survey of 88 countries.

OBJECTIVE: Advancing the pharmacy workforce contributes to strengthening primary healthcare and accelerating progress towards universal health coverage. This study aimed to identify key enablers to support policy development for national pharmacy workforce advancement. DESIGN: A cross-sectional country-level questionnaire was distributed from July 2018 to March 2019. SETTING: National-level or country-level pharmacy workforce development policy. PARTICIPANTS: Professional leadership associations and national agencies of the International Pharmaceutical Federation (FIP). The FIP global database included 129 countries. MEASURES: The questionnaire was designed to collate data on the scope of advanced and specialist practice in respondent countries. Multiple correspondence analysis and subsequent cluster analysis were conducted to explore the associations and patterns of country-level attributes of systems in place for the pharmacy workforce advancement in order to develop a general transnational model for country-level advanced practice development. RESULTS: Eighty-eight countries (68.2% response rate) responded to the questionnaire. Factors that enhance and contribute to advanced practice policy development include the country's socioeconomic factors and the availability of national practice advancement concepts. The essential advancement concepts include the availability of framework and professional recognition systems, programmes assisting advanced practice development and workforce advancement and recognition opportunities. Cluster analysis identified three clusters of country respondents. First cluster included low-income and middle-income with poor pharmacy advancement implementation, second cluster included a higher socioeconomic status with weaker pharmacy workforce advancement implementation and third cluster included upper middle-income to high-income countries and high rates of pharmacy advancement implementation. CONCLUSION: The key factors identified in this study can be used to support a transnational approach to pharmacy workforce advancement. The three clusters identified highlighted that workforce advancement was not an exclusive trait of higher-income countries. Lessons from countries that have already adopted concepts of advancement in pharmacy practice could be adopted to other countries to accelerate the progress of advanced practice globally.

A global study on job and career satisfaction of early-career pharmacists and pharmaceutical scientists.

Background: Job and career satisfaction of early-career pharmacists and pharmaceutical scientists is imperative to ensure a motivated and effective workforce, and a secure future for pharmacy practice. In turn, this enables planning, deployment and long term implementation of global imperatives, through universal pharmacy coverage. Objectives: This study used data from a global survey to determine the level of job and career satisfaction and identify factors that are most significant in determining satisfaction in early-career professionals. Methods: A cross-sectional survey was distributed to members of the International Pharmaceutical Federation (FIP) Young Pharmacists Group (YPG) via email and social media platforms from November 2019 to May 2020. A previously validated questionnaire using 5-point Likert scales was used. Data were analysed by exploratory factor analysis, using principal component analysis, oblique rotation, and reliability testing of identified components, followed by a comparative statistical analysis. Results: A total of 1014 respondents from 92 countries participated in this study. Regions of domicile significantly affected job satisfaction (p = 0.004) and career satisfaction (p < 0.0001) scores. Pharmacists working in community pharmacies perceived lower job satisfaction measures compared to those who work in academic institutions (p < 0.0001) and industry sector (p = 0.012). There is a negative association between career expectations and job satisfaction and career satisfaction scores. The workplace climate is related to education and training opportunities, lower reported workloads, greater autonomy, and more remuneration. Conclusion: This was an international study of early-career pharmacists and pharmaceutical scientists. Enhancing factors associated with job and career satisfaction is essential to support early-career pharmacists and pharmaceutical scientists in obtaining fulfilment and esteem in their chosen careers. Developing and implementing a well-framed system that provides a conducive working environment, remuneration, and greater autonomy could improve job and career satisfaction. This study provides evidence to support investment in early-career training, stated in the FIP Development Goal 2.

Competency-Based Education: Developing an Advanced Competency Framework for Indonesian Pharmacists.

Introduction: Pharmacists need to be adaptable, flexible, and capable of advancing their practice to adapt to rapidly changing population health needs. We describe an educational approach to pharmacy workforce transformation in Indonesia through an advanced practice competency framework development using an "adopt and adapt" methodology. Methods: The competency framework development process comprised a translation phase, an adopt and adapt phase, validation through a nationwide mapping survey, and a completion phase through leadership consensus panels. We conducted a forward-backwards translation of a previously validated Advanced to Consultancy Level Framework (ACLF) to yield the Indonesian Advanced Development Framework (IADF) draft. The subsequent adoption and adaptation process was conducted through a series of consensus panels. We validated the IADF through a nationwide workforce survey. The final phase included leadership consensus panels with the professional leadership body in Indonesia. We analyzed the qualitative data thematically and the quantitative data using a Multiple Correspondence Analysis (MCA) technique. Results: We identified conceptual challenges in adopting and adapting the existing ACLF, which were addressed by providing a national glossary and concrete examples. A total of 6,212 pharmacists participated in the national workforce survey, of which 43% had <2 years of post-license (post-registration) experience. The MCA results showed that practitioner self-assessment to the IADF could discriminate their career development stages. The results also indicated a four-stage career model (including early years career training). Embedding this model in a structured national training program will enhance the professional workforce development through a more structured career journey. Conclusions: We describe the first validation of an advanced competency development framework for the pharmacy workforce in a non-Anglophone country, showing the possibility of transnational applicability of this framework. We argue that this methodology can be used in Low and Middle-income countries (LMICs) for the more rapid advancement of pharmaceutical care practice.

A country-level national needs assessment of the Indonesian pharmacy workforce.

BACKGROUND: Conducting a systematic country-level workforce needs-assessment is a way to develop coherent strategic and justifiable workforce planning. OBJECTIVE(S): This article describes a country-level needs-assessment process using a systematic approach (via the FIP Development Goals (FIP DGs) workforce element) as an analytical framework. The needs-assessment aimed to prioritise gaps toward transforming the pharmacy workforce as a prelude to practice and pharmaceutical services reform in Indonesia. METHODS: The needs assessment consisted of three stages: needs identification, needs analysis, and needs prioritisation. The needs (workforce development gaps) were defined as the discrepancies between the perceived workforce challenges and the existing national workforce development projects. Interviews or group discussions were conducted to gather the workforce challenges of individual pharmacists. A structured workshop was conducted to identify workforce challenges and existing organisations' projects, with main stakeholders contributing to pharmacists' development in Indonesia. Perceived challenges findings and identified national workforce projects were mapped to the FIP DGs workforce element. The needs prioritisation was conducted by comparing the proportional mapping to the FIP DGs workforce element. RESULTS: There were forty-three individual pharmacists and 7 principal stakeholder categories that provided information related to perceived workforce challenges; thirty national projects were identified from stakeholders. While this study identified perceived challenges with workforce "competency development" and "pharmacy workforce intelligence," there were no active ongoing national projects mapped to those goals. The framework mapping analysis showed there are workforce development gaps centred on "competency development" initiatives, "advanced and specialist development" initiatives, and strategic pharmacy workforce intelligence data gathering. Additionally, there were policy gaps with initiatives for strengthening "working with others" and a lack of clarity on infrastructure for early-career training strategies and workforce impact. CONCLUSIONS: This study prioritises the gaps in developing pharmacists in Indonesia. This process could be used in conducting needs assessment of pharmacy workforce development in other Low and Middle-Income Countries (LMICs).

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.

Exploring young pharmacists' and pharmaceutical scientists' needs and expectations within an international pharmacy organization: Findings from FIP's needs assessment survey.

BACKGROUND: Engaging youth in the activities of health organizations is imperative to achieve the Sustainable Development Goals (SDGs). The International Pharmaceutical Federation Young Pharmacists Group (FIP YPG) was formally launched in 2001 to increase the engagement of young pharmacists and pharmaceutical scientists. Additionally, FIP YPG was set up to foster their potential for leadership within the various Sections and Special Interest Groups of FIP in the areas of pharmacy practice, pharmaceutical sciences and pharmacy education. With the new ONE FIP strategy, achieving the goal of advancing pharmacy together as ONE organization, FIP and FIP YPG looked into the needs and expectations of its members to achieve synergy and amplify outcomes. OBJECTIVES: FIP YPG carried out a needs-assessment survey to explore the needs and expectations of its members in order to better align FIP's goals and its members' needs. METHODS: An online survey was conducted between 1 May 2019 and 2 June 2019 of the members of FIP YPG. Invitations to complete the questionnaire were sent out by email to all FIP YPG members. The questionnaire included participant demographics; satisfaction on current FIP YPG activities, participation in FIP YPG activities; preferred activities of FIP YPG; expectations from FIP YPG and presence of national/regional YPG in the members' respective geographies. RESULTS: The survey elicited a response rate of 37.25%. Sixty-seven percent of members were satisfied with current FIP YPG activities. The most preferred activity and the main reason for joining the organization was 'networking opportunities.' 'Newsletter' (as a reader) was the most common resource selected by participants (71%). Newsletters were also the preferred platform for communication (75.32%). 'International YPG conference' was found to be the focus of members' preference (59.49%). Nearly a majority FIP YPG members preferred webinars focused on 'Career development' (44.94%). The preferred type of project to be involved in were 'Inter-professional collaboration projects' (45.57%). 'Exploration of opportunities and incentives for implementing new professional services' was found to be the preferred topic for research survey (33.54%). CONCLUSION: FIP YPG members' needs were descriptively analyzed for the purpose of better alignment of the organization's goals with members' goals. Networking, collaborations, career and leadership development and effective communication, among other aspects, were found to be the main interests of the members surveyed. The survey findings have been employed in the development of strategic plans for FIP YPG members and how FIP YPG can be an effective launching platform for the future roles in FIP.