Transforming pharmaceutical education: A needs-based global analysis for policy development.

Background: A needs-based approach is desirable for the transformation of pharmaceutical education, and to link pharmaceutical education with the health needs of populations and national priorities. There are varying levels of data in the literature on the status of pharmaceutical education in all six World Health Organization (WHO) regions, especially in the context of needs identification and evidence-based policy interventions. The framework for this study was the FIP Development Goals. Objectives: The aim of the study was to develop evidence-based policies through a needs-based approach for pharmaceutical education transformation nationally, regionally and globally by addressing the following objectives: 1. Identify global and regional needs in pharmaceutical education, through a regional SWOT analysis and prioritization of FIP development goals; 2. Develop valid and credible regional roadmaps for pharmaceutical education advancement according to the identified prioritized goals and 3. Develop a global call to action as a policy intervention for advancing pharmaceutical education. Methods: This study was conducted between 2020 and 2021 using a mixed methods approach. Surveys of higher education institutions and a series of qualitative interviews were conducted with national professional leadership organizations, with further regional workshops having 284 participants recruited from the International Pharmaceutical Federation (FIP) membership base, spanning all six WHO regions. Results: Eleven out of 21 FIP DGs were identified as priorities for regional roadmaps and FIP DG 1 (Academic capacity) was identified as a priority in four regions. All regions had distinctive results with an area of commonality between them. There were common weaknesses in the adoption of competency-based education and inter-professional education. Conclusions: It is critical for every country and region to develop needs- and evidence-based policies for the transformation of pharmaceutical education, for which FIP DGs provide a systematic framework.

Assessment of drug use in primary health centers in Lagos State, Nigeria.

Introduction: rational drug use prevents wastage of resources, loss of confidence in healthcare system and drug-related morbidity and mortality. This study aims to assess drug use in Primary Health Centers (PHCs) in Lagos State, Nigeria using the World Health Organization in collaboration with the International Network of Rational Use of Drugs core drug use indicators. Methods: the study was conducted between February to October 2021 as a comparative observational survey of selected PHCs. It included a retrospective and prospective cross-sectional design for prescribing and patient care indicators assessing 2640 prescriptions and clients respectively. Data were analyzed and presented as frequency with percentage or mean with standard deviation, as applicable. The performances of the types of PHCs were compared using two-sample t-test. A 2-tailed p-value < 0.05 was considered statistically significant. Results: average number of drugs per prescription, drugs prescribed by the generic name, percentage of encounters with prescribed antibiotics and injections were 3.6 ± 0.9%, 76.5 ± 18.5%, 63.3 ± 19.1% and 21.1 ± 24.1% respectively with no significance difference between the comprehensive and basic PHCs. For all the facilities, the average consultation and dispensing times were 10.5 ± 6.0 minutes, 244.9 ± 179.2 seconds respectively. In this study, the percentage of patients' knowledge of the correct dosage was 72.4 ± 38.3%. There is statistically significant difference in availability of key drugs in stock between the comprehensive and basic PHCs (p-value 0.0001). Conclusion: irrational drug use practices exist in comprehensive and basic PHCs. There is a need to implement interventions aimed at strengthening good prescribing and patient-care practices across the PHCs in Lagos State.

Estimating healthcare resource needs for COVID-19 patients in Nigeria.

INTRODUCTION: continuous assessment of healthcare resources during the COVID-19 pandemic will help in proper planning and to prevent an overwhelming of the Nigerian healthcare system. In this study, we aim to predict the effect of COVID-19 on hospital resources in Nigeria. METHODS: we adopted a previously published discrete-time, individual-level, health-state transition model of symptomatic COVID-19 patients to the Nigerian healthcare system and COVID-19 epidemiology in Nigeria by September 2020. We simulated different combined scenarios of epidemic trajectories and acute care capacity. Primary outcomes included the expected cumulative number of cases, days until depletion resources and the number of deaths associated with resource constraints. Outcomes were predicted over a 60-day time horizon. RESULTS: in our best-case epidemic trajectory, which implies successful implementation of public health measures to control COVID-19 spread, assuming all three resource scenarios, hospital resources would not be expended within the 60-days time horizon. In our worst-case epidemic trajectory, assuming conservative resource scenario, only ventilated ICU beds would be depleted after 39 days and 16 patients were projected to die while waiting for ventilated ICU bed. Acute care resources were only sufficient in the three epidemic trajectory scenarios when combined with a substantial increase in healthcare resources. CONCLUSION: substantial increase in hospital resources is required to manage the COVID-19 pandemic in Nigeria, even as the infection growth rate declines. Given Nigeria's limited health resources, it is imperative to focus on maintaining aggressive public health measures as well as increasing hospital resources to reduce COVID-19 transmission further.

Effect of the Affordable Medicines Facility for malaria (AMFm) on the availability of antimalarials in Nigeria.

Background: Malaria is one of the most important causes of mortality worldwide. Use of the most effective treatments remains inadequate for those in need and there is concern over the emergence of resistance. Rapid, accurate and accessible detection of malaria parasites plays a role in promoting more rational use of increasingly costly drugs in many endemic areas. Rapid diagnostic tests (RDTs) offer the potential to provide accurate diagnosis to all at-risk populations for the first time, reaching those unable to access good quality microscopy services. In 2010, the Global Fund launched the Affordable Medicines Facility for malaria (AMFm) designed to increase access and use of good quality artemisinin-based combination therapies (ACTs) for malaria treatment. AMFm involves manufacturer price negotiations, subsidies and other interventions. The aim of this study was to document the availability of ACTs and RDTs provided under the National Malaria Elimination Programme via the AMFm financing strategy. Materials and Methods: Investigators were systematically selected and trained on the data collection tool from the World Health Organization/Health Action International (WHO/HAI) Workbook. Data was collected from public and private facilities in 12 states in the six geopolitical zones of Nigeria in April and May 2014. Returned survey forms were checked, entered and verified. Data analysis was carried out using the embedded analysis toolkit in the WHO/HAI Workbook after double-entry and auto-checking of data. Data was analysed for the public and private sectors. Results: Seven AMFm products are available in the country, and include AL (IPCA), Artemef (Cipla), Coartem AMFm (Novartis), Combisunate (Ajanta), Lumartem (Cipla) as well as Arsuamoon (Guilin) and Coarsucam (Sanofi-Winthrop). The results reveal that antimalarials are largely concentrated in the private sector (private pharmacies and PPMVs). About 86% of the surveyed facilities had at least one AMFm AL product whereas only 18% had any AMFm AA product. Results show that the availability of the various AMFm AL products varies across the country. Lumartem by Cipla has the highest national availability with 26.4%, closely followed by AL (IPCA) with 25.7%. Twenty seven (%) of the facilities had an RDT in stock. Conclusion: The results obtained in this survey show that continuous monitoring of the antimalarial drug landscape is required to track progress in the fight against malaria in the country.