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THE FUTURE OF PHARMACY
INTERNATIONAL PHARMACY JOURNAL
aroun d t h e wo r l d . 5 8 The co unt r y h a s m a d e sig n i fi c a nt p r o g - r e s s in a d d r e s s i n g p o v e r t y by ini t i a t i n g gr a nt s su c h a s chi l d sup p o r t , 5 5 whi c h w a s a im e d t o r e a c h o v e r 8 mill i o n c hi l d r e n n a t i o n w i d e e a c h m o nt h . Howe v e r t hi s gr a nt t o da t e d o e s n ot r e a c h e v e r y c hi l d in t h e p o o r e s t h o u s e h o l d s , a s on e of t h e r e - q u i r e m e nt s t o obt a i n t h e gr a nt is chi l d b ir t h d o c u m e nt a t i o n , whi c h co nt i n u e s t o r e m a i n a ma j o r ch a l l e n g e a s a n e s t i m a t e d PGCJSUITBSFVOSFHJTUFSFEFBDIZFBSJO4PVUI"GSJDB5 4 , 5 9
Assis t a nt D ir e c t o r G e n e r a l fo r WHO’s Famil y, Wo m e n ’ s a n d Chil dr e n ’ s Healt h Clus t e r, D r Flav i a B u s t r e o , a d v o c a t e s t h a t m a t e r n a l a n d inf a nt m o r t a l i t y co u l d b e p r e v e nt e d if m ot h e r s co u l d a c c e s s a b a s i c s e t of m e d i c i n e s a n d h e a l t h sup p l i e s , h e n c e t h e in c l u s i o n of cr u c i a l r e p r o d u c t i v e a n d m a t e r n a l h e a l t h co m m o d i t i e s a n d inf a nt h e a l t h int e r v e nt i o n s o n na t i o n a l e s s e nt i a l m e d i c i n e s li s t s mu s t b e p r i o r i t i s e d un d e r t h e h e a l t h p o li c y of a ll na t i o n s . 6 0 In t hi s p e r s p e c t i v e , ini t i a - t i v e s su c h a s ‘ St a n d Up fo r Afr i c a n Mothe r s ’, a n int e r n a t i o n a l aw a r e n e s s a n d f un d r a i s i n g c a m p a i g n whi c h will r un f r o m 2 0 1 2 t o 2 0 15 , gr e a t l y a c c e nt s t h e n e c e s s i t y t o a d d r e s s t h e p r e d i c a m e nt f a c e d by Afr i c a n m ot h e r s in ge t t i n g t h e b a s i c m e d i c a l c a r e t h e y n e e d dur i n g p r e g n a n c y a n d chi l d b i r t h . Thro u g h t h e m o b i l i s a t i o n of gl o b a l c it i z e n s t h e c a m p a i g n is a im e d o n t h e p r o m o t i o n a n d t r a i n i n g of 15 , 0 0 0 mi d w i v e s by 2 0 15 in or d e r t o de c r e a s e m a t e r n a l d e a t h s o n t h e Afr i c a n DPOUJOFOUCZ 6 1 Exis t i n g c h a l l e n g e s in gl o b a l h e a l t h , e sp e c i a l l y in c a s e of MDG 4 a n d 5 in de v e l o p i n g co u nt r i e s su c h a s S o u t h Afr i c a , p r o v i d e s im m e n s e o p p o r t u n i t i e s fo r p h a r m a c i s t s n ot o nl y in co nt r i b u t i n g t o w a r d s t r a d i t i o n a l r o l e s b ut a l s o in ini t i a t i n g n e w ro l e s t h a t r e s u l t in co m m u n i t y e n g a g e m e nt a n d h e a l t h p r o m o t i o n . 6 2 , 6 3
AUTHORS’ INFORMATION
Faith Kuzeeko, Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa Amanda Siruma, Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa Diana Hornby, Community Engagement office, Rhodes University, Grahamstown, South Africa Sunitha Srinivas, Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
Rhodes University, Grahamstown, Eastern Cape, South Africa, g08k2216@campus.ru.ac.za, g07s0371@campus.ru.ac.za
t o v isit t h e s e f a c ili t i e s dur in g pr e g n a n c y a n d fo r chil db ir t h IBTMFEUPPGQSFHOBOUXPNFOJO4SJ-BOLBSFDFJWJOHGPVS o r mo r e pr e n a t a l v isit s a n d gi v in g bir t h at a he a lt h f a c ili t y. 5 2
In c a s e of inf a nt m o r t a l i t y is s u e s , Ethi o p i a , Malaw i a n d Su d a n a d o p t e d a co m m u n i t y - b a s e d m a n a g e m e nt of s e v e r e a c u t e un d e r - n u t r i t i o n a p p r o a c h , whi c h w a s b ot h co s t - e f f e c - t i v e a n d su c c e s s f u l . The pr o g r a m p r o v e d t o b e co s t - e f f e c t i v e a s t h e a p p r o a c h m a d e us e of a pr e c i s e t a r g e t i n g of r e s o u r c e s t o w a r d s s e v e r e l y un d e r - n o u r i s h e d c hi l d r e n , a n d wo r k e d in uni s o n wit h ot h e r co n v e nt i o n a l c hi l d sur v i v a l int e r v e nt i o n s su c h a s V it a m i n A sup p l e m e nt a t i o n . 5 3 , 5 4 The co m m u n i t y - CBTFEQSPHSBNBDIJFWFESFDPWFSZSBUFTPGBOESFEVDFE JOGBOUNPSUBMJUZSBUFTUPCFUXFFOBOE$PWFS- BHFSBUFTSFBDIFEPGBMMDIJMESFOBOEPGUIFTFWFSFMZ u n d e r - n o u r i s h e d c hi l d r e n . 5 3
*O/JHFSBQQSPYJNBUFMZPGUIFQPQVMBUJPOMJWFTNPSFUIBO fi v e k il o m e t r e s f r o m a he a l t h f a c i l i t y. To in c r e a s e t h e ch a n c e s of inf a nt sur v i v a l , t h e go v e r n m e nt b e g a n im p l e m e nt i n g a s t r a t e g y t o fin a n c e t h e co n s t r u c t i o n of 2 , 0 0 0 co m m u n i t y h e a l t h p o s t s . Each he a l t h p o s t s e r v e d 5 , 0 0 0 p e o p l e in r ur a l a r e a s . Tra in e d co m m u n i t y h e a l t h wo r k e r s t o da t e of f e r a min i m u m p a c k a g e a n d p r e v e nt i v e int e r v e nt i o n s at t h e s e p o s t s . This ini t i a t i v e is ch a n g i n g t h e li v e s of o v e r 1 . 8 mill i o n c hi l d r e n in Nige r, wh o d o n ot ha v e r e g u l a r a c c e s s t o h e a l t h ce nt r e s . 5 3
S o m e co u nt r i e s h a v e a d o p t e d t h e co m m u n i t y c a s e m a n a g e - m e nt of chi l d h o o d illn e s s e s , a s t r a t e g y wit h t h e p ot e nt i a l t o a c c e l e r a t e im p r o v e m e nt t o w a r d s at t a i n i n g MDG 4 . This pr o g r a m is a co m m u n i t y - b a s e d p r o v i s i o n of cur a t i v e t r e a t - m e nt s fo r di a r r h o e a , p n e u m o n i a , m a l a r i a a n d /o r n e o n a t a l inf e c t i o n s t o chi l d r e n by co m m u n i t y h e a l t h wo r k e r s . 5 4 This pr o g r a m h a s t h e p ot e nt i a l t o in c r e a s e t h e num b e r of c a r e p r o v i d e r s at t h e co m m u n i t y l e v e l , whi c h p r o m o t e s t a s k shif t i n g t o t h e m o r e a c c e s s i b l e co m m u n i t y h e a l t h wo r k e r, e sp e c i a l l y in lo w - r e s o u r c e a r e a s . Fur t h e r m o r e t h e p r o v i s i o n of he a l t h c a r e at t h e co m m u n i t y l e v e l is lik e l y t o r e a c h m o r e p e o p l e , e sp e c i a l l y t h o s e wh o a r e m o s t in ne e d , t h u s im p r o v - i n g e qu i t y. In or d e r t o r e a c h it s t a r g e t , S o u t h Afr i c a n e e d s t o s c a l e up it s co v e r a g e of e s s e nt i a l s e r v i c e s , p a r t i c u l a r l y t o t h e chi l d r e n wh o a r e d e n i e d t h e i r r ig ht s t o h e a l t h . To acc o m p l i s h t hi s will in c l u d e e x p a n d i n g t h e d e li v e r y of p r o v e n int e r v e nt i o n s a n d o v e r c o m e b e h a v i o u r a l a n d e n v i r o n m e nt a l o b s t a c l e s t o s e r v i c e d e li v e r y. To dat e , t h e r e h a v e b e e n ini t i a - t i v e s a n d p a r t n e r s h i p s t h a t we r e fo r m e d t o imp r o v e d e v e l o p - m e nt t h a t ha v e n ot o nl y in c r e a s e d in num b e r s b ut ha v e a l s o e x p a n d e d in co v e r a g e , b ut wit h o u t b e t t e r co h e r e n c e t h e s e ef f o r t s t e n d t o f a ll sh o r t of r e a c h i n g t h e i r t a r g e t s . 5 5 , 5 6
The way forward The emp o w e r m e nt of wo m e n is at t h e ce nt r e of MDG 4 a n d 5 a n d is e s s e nt i a l fo r o v e r c o m i n g ge n d e r di s c r i m i n a t i o n . 5 7 Abs e n c e of fe m a l e e du c a t i o n a n d lo w fe m a l e lit e r a c y r a t e s n e g a t i v e l y af f e c t wo m e n ’ s h e a l t h by r e s t r i c t i n g t h e i r k n o w l - e d g e a b o u t nut r i t i o n , b ir t h sp a c i n g a n d co nt r a c e p t i o n w h i c h is s t r o n g l y a s s o c i a t e d wit h hig h r a t e s of ma t e r n a l m o r t a l i t y