66 67

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Figure 5.8.3. Registered pharmacist assistants (Pas), 2006-2010

Source: SAPC Register, 2010 [8]

New pharmacy technician and pharmacy technical assistant cadres

The pharmaceutical needs of the country increase considerably in the past decade, particularly with the rollout of ARVs, and the need for a more highly qualified pharmacy support cadre that is able to work at primary health care clinics under the indirect su- pervision of a pharmacist. In response to this, the SAPC decided to phase out the current pharmacy support personnel (pharma- cist assistants) and introduce two new mid-level workers, pharmacy technicians and pharmacy technical assistants. These new cadres will be trained full time in higher education and training institutions for one and two years, respectively, and then perform a six-month internship [11]. Precise details of which institutions will provide the training is being negotiated with the Department of Education and Training, the SAPC, and individual universities.

Workforce development

The changing health needs of the country and a health system in flux provide challenges and opportunities for the pharmacy workforce. It is essential to ensure not only production of sufficient numbers but also that the pharmacy workforce have appropriate competencies to contribute optimally as members of the health care team.

Undergraduate education and training

A new pharmacy qualification was recently approved by the South African Qualification Authority to take into account changes in health delivery and pharmacists roles. The new curriculum will be introduced in schools of pharmacy in 2013 and will train generalist pharmacists to work in diverse settings. Innovative ways of training pharmacy undergradates are responding to requirements for pharmacists that are confident in working inter-professionally and at all levels of the health service, from primary and community-based care to highly specialised tertiary hospitals, as well as in industry and academia. New strategies introduced include problem-based and experiential learning methods and opportunities to work in underprivileged communities and at community clinics, as well

as hospital settings [12]. Electronic teaching and learning strategies are also in development [13]. The success of these initiatives in producing pharmacy graduates with appropriate attributes and skills for the needs of the country s health system will need to be evaluated.

New roles for pharmacists

Implementing the district health system in South Africa has resulted in an increased emphasis on primary level services, including the establishment of new posts for district and facility-based pharmacists and pharmacy support workers. Further work on skill mix and staffing norms for primary level services is required to ensure optimal use of the pharmacy workforce to deliver primary level pharmaceutical services.

Community pharmacies in South Africa, in line with those in developed countries, have expanded services from dispensing and OTC prescribing to a range of preventive services, such as blood pressure monitoring, immunisations and family planning counseling. The recent introduction of a fees structure for pharmacists providing these services paves the way for pharmacists to be remunerated for these new roles [14].

Other strategies currently underway to develop the pharmacy workforce and address gaps in health care provision include the proposed introduction of authorised pharmacist prescribers and specialities in industrial pharmacy, clinical pharmacy, and pharmaceutical services in public health [15, 16]. How all these new roles will integrate into the PHC re-engineering strategy and NHI reforms underway is unknown at the moment but they provide opportunities for the pharmacy profession to contribute to the creation of a reformed health system in South Africa [6, 7].

5.8.4. Outcomes

Pharmacy Human Resources in South Africa 2011 published by the SAPC provides a situational assessment of the current South African pharmacy workforce and outlines challenges and future strategies for pharmacy workforce development in the country.

The number of pharmacists working in the public sector has improved significantly over past few years-improving equity-and appears to be due to improvements in remuneration, progress in creating career paths, and improved working conditions.

A fee structure was recently approved for pharmacists working in community pharmacies to provide a range of preventive health services, paving the way for pharmacists to contribute to primary health care.

The number of pharmacist assistants has increased steadily to just over 9,000 since a new pharmacist assistant programme was launched in 2000. Training for two new mid-level pharmacy support workers, pharmacy technicians and pharmacy technical assistants, with greater scopes of practice, is expected

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10000

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

2006 2007 2008 2009 2010

720

1588

1883

2088

1150

2405

11063

2507

2821

202

1330

1499

3393

327

2967

1524

447

3619

3481

Basic Pharmacist s Assistants Learner Basic Pharmacist s Assistants

Learner Post-Basic Pharmacist s AssistantsPost-Basic Pharmacist s Assistants

N um

be r o

f r eg

is te

re d

Pa s

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to commence in 2015 to meet pharmacy workforce needs, particularly for the ARV rollout and a re-engineered PHC system.

Increasing production of pharmacy graduates remains a challenge in the current higher education environment and is an area that the SAPC and pharmacists in academia are giving urgent attention.

Acknowledgements

Use of data from Pharmacy Human Resources in South Africa 2011, SA Pharmacy Council, 2012. Input from Round Table Discussion, 16 March 2012, School of Public Health, University of the Western Cape attended by Prof Nadine Butler, Mr Gary Black, Mr Douglas Defty, Ms Denise Frieslaar, Dr Tana Wuliji, and Ms Hazel Bradley.

References

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3. Department of Health. National Drug Policy for South Africa. Pretoria: Department of Health; 1996.

4. Department of Health. The White Paper for the Transformation of the Health System in South Africa. Pretoria: Government Gazette No: 17910; 1997.

5. Harrison D. An overview of health and health care in South Africa 1994- 2010: Priorities, progress and prospects for new gains. Muldersdrift: Henry J. Kaiser Family Foundation; 2009.

6. Department of Health. Re-engineering Primary Health Care in South Africa. In: Discussion Document, editor. Pretoria: National Department of Health; 2010.

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9. National Department of Health. HRH Strategy for the Health Sector: 2012/13 2016/17. Pretoria: National Department of Health; 2011.

10. South African Pharmacy Council. The New Approach to the Training of Pharmacist s Assistants in South Africa. Pretoria: South African Pharmacy Council; 2003 [updated 12 December 2006; cited 12 December 2006].

11. South African Pharmacy Council. Scope of practice, supervision of pharmacy support personnel and qualifications. Board Notice 123 of 2011. Government Gazette No 34428; 2011.

12. Bheekie A, Obikeze K, Bapoo R, Ebrahim N. Service learning in pharmacy: opportunities for student learning and service delivery. African Journal of Pharmacy and Pharmacology. 2011;5(23):2546-57.

13. Suleman F. Relooking pharmacy training: what are the new approaches. South African Pharmaceutical Journal. 2012;79(1):40-2.

14. South African Pharmacy Council. Rules relating to the services for which a pharmacist may levy a fee and guidelines for levying such a fee or fees, Board Notice 193 of 2010. Government Gazette 33898; 2010.

15. South African Pharmacy Council. Specialities for pharmacists. Pharmaciae. 2011;19(1):22.

16. South African Pharmacy Council. Scope of practice and qualification for authorised pharmacist prescriber. Board Notice 122 of 2011. Government Gazette No 34428; 2011.

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