Evaluation of the profile and standard of community pharmacy practice in Lesotho

Abstract

The profession of pharmacy is growing fast and like in many countries, Lesotho has seen more growth in community pharmacy practice. The increased number of community pharmacies should be matched with necessary regulations, policies and human resources. Lesotho faces the provision of pharmaceutical services being in the hands of mostly non-pharmacy personnel and obsolete statutes regulating the pharmaceutical sector. A lack of up-to-date laws governing the ownership and licensing of community pharmacies, as well as the practice itself endangers Basotho lives as unqualified people might operate community pharmacies. The lack of laws poses questions about the standard of pharmaceutical services provided. The research project assessed the extent to which community pharmacies in Lesotho comply with the good pharmacy practice (GPP) guidelines of the World Health Organisation (WHO), as well as South Africa as a neighbouring country. The study evaluated the standard of premises, facilities and equipment of community pharmacies in Lesotho and lastly investigated the profile, nature and extent of pharmaceutical services provided by community pharmacies in Lesotho. A descriptive, quantitative, cross-sectional study design was utilised, using survey forms and structured questionnaires as data collection tools. The study consisted of two phases, namely the literature and empirical phase. A comprehensive literature review achieved the literature objectives. The empirical objectives were investigated through the following: • Phase I: An assessment of the standard of pharmaceutical services provided by community pharmacies and compliance with GPP guidelines using a structured survey form. A structured survey form was used to assess the standard of pharmaceutical services and compliance with GPP guidelines in 36 community pharmacies in Lesotho. • Phase II: Explore the profile, nature and extent of pharmaceutical services provided by community pharmacies in Lesotho through face-to-face interviews according to structured questionnaires with community pharmacists and other stakeholders.

The face-to-face interviews using structured questionnaires were conducted in the 36 community pharmacies (the same 36 community pharmacies selected for phase 1) with the staff member in charge of the pharmacy and 13 community pharmacy stakeholders. The results of the study will be made available to decision-makers to be used as a reference regarding the current status of community pharmacy practice and may be used as a tool to improve the practice in general. The research profiled community pharmacies in Lesotho and evaluated compliance with GPP standards successfully. In conclusion, community pharmacy practice in Lesotho has grown as evidenced by an increase in pharmacy human resources and the number of community pharmacies within the country. Pharmacy personnel increased from 60, including both pharmacists and pharmacy technicians, to 130 pharmacists and 80 pharmacy technicians in 2018 according to the Lesotho Medical, Dental and Pharmacy Council (LMDPC). Community pharmacies increased from 46 in 2010 to 60 in 2016 and 80 by 2019. Community pharmacies in Lesotho did not comply with standards, as prescribed by the WHO and South Africa. This non-compliance includes registering pharmacy staff with the LMDPC, handling (storage and dispensing) of controlled medicines, community pharmacies’ premises, and equipment standards (for example availability of washing area, fire extinguisher and cold chain monitoring). Community pharmacy practice in Lesotho still faces regulation through outdated laws and therefore; the need for updating of such laws. There is also a need for continued inspections to ensure adherence and maintenance of standards of practice.