Essential medicines and health products

Human Resources for the Pharmaceutical Sector

The World Health Report

The World Health Report 2006, Working together for health, estimates that 57 countries worldwide are experiencing a crisis in human resources for health, though the particular importance of an adequate pharmaceutical workforce is often overlooked. The development, production, distribution and appropriate utilization of medicines, as well as the supportive functions of regulation, operational research, and training, all require the involvement of competent pharmaceutical professionals. And the successful execution of these activities is essential to a strong health system. The dire shortage of pharmaceutical personnel, therefore, has deep implications for population health.

While it is clear that the pharmaceutical workforce has a vital role to play, there is often little to no information available on this element of the health system in developing countries. This lack of comprehensive data often translates into weak or insufficient national human resources policies; causing national plans and budgets to inadequately invest in the training, deployment and continuous development of a competent pharmaceutical workforce. The first step in developing successful strategies, which aim to build the capacity of human resources in the pharmaceutical sector, is to engage in methodologically sound assessment upon which evidence-based policies can be built.

MPC is working with the Human Resources for Health Department of WHO (HRH), WHO Regional Offices for Africa and for the Eastern Mediterranean and FIP (International Pharmaceutical Federation) to fill this gap in evidence. A survey on human resources for the pharmaceutical sector was carried out in four African countries: Ghana, Nigeria, Sudan, and United Republic of Tanzania. The survey collected responses from Ministries of Health, regulatory bodies, universities, manufacturers, and pharmaceutical personnel in selected facilities, on the following questions:

  • How many workers currently provide pharmaceutical services in both the private and public sector?
  • What is the distribution of pharmaceutical personnel in the country, both geographically and among sectors (public, private, teaching etc.)?
  • Do the work conditions differ between the public and private sectors?
  • Does job satisfaction vary for pharmacists according to whether s/he works in the public or private sector?
  • How many pharmacists have left the country in previous year or think of leaving the country?

After data collection and analysis, the four countries produced a report on the results, which was presented to all key stakeholders in their respective governments, including ministries of health, pharmacy councils and academic institutions. After a broad-based consultation process on how to translate the findings into action, each participant country produced its own Strategic Framework for Human Resources in the Pharmaceutical Sector.

Case study: Ghana

The 2009 assessment identified a total of 1,637 actively practicing pharmacists (1/14,400 population), 918 actively practising pharmacy technicians (1/25,600), and 1,642 medicine counter assistants (1/14,300). The public and private sectors were found to employ 26 and 74 percent of pharmacists, respectively. The pharmaceutical manufacturing industry only employs 3 percent of the pharmacist workforce. However, this sector is expanding with the establishment of new manufacturing sites and the growth of existing companies. 45 percent of the 103 facilities surveyed had one or more vacancies for pharmaceutical personnel at the time of the assessment, including: 82 percent of public sector facilities, 13 percent of private sector facilities, 12 percent of retail pharmacies, and 38 percent of pharmaceutical manufacturers. There were a total of 529 vacant posts in the surveyed facilities—an alarming number when one considers that the sample represents less than 6 percent of all sites providing pharmaceutical services in Ghana. The shortage of pharmaceutical personnel and their distribution is more severe in rural areas. This has led to inequitable service provision. Pharmaceutical cadres were found to be concentrated in urban regions with the ratio of personnel per 10,000 citizens in each region ranging from 0.13 to 3.05 for pharmacists and from 0.21 to 0.85 for pharmacy technicians. To ensure that only quality products are made available in the right quantities at the right time to the population, functional and well-resourced pharmaceutical supply and regulatory systems are required, supported by an adequate number of trained personnel.

In the area of training, there were three universities offering a Bachelor of Pharmacy degree with a combined intake of 240 in 2009, one pharmacy technician training school (diploma) enrolling 70 students, and 10 Medicines Counter Assistant programs with 800 participants total. Currently there is no formalized training for the over 10,000 licensed chemical sellers, who make up around 85% of premises providing pharmaceutical services in the country.

The findings of the 2009 Assessment of Pharmaceutical Human Resources provided an evidence base upon which to develop a strategy with key stakeholders that could be integrated into broader human resources for health planning. The methodological illumination of such issues as significant pharmaceutical workforce shortages, inequitable distribution, skill mix imbalances, and limited training capacity, enabled the development of a Pharmaceutical Human Resources Strategic Framework.

The purpose of the framework is to inform the strategic development of pharmaceutical human resources in Ghana, guiding policy development and planning. In particular, it will serve as a reference document for the development of a costed pharmaceutical human resources plan for 2011 – 2016 for the Ministry of Health and Ghana Health Service.