Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Human Resources for Health
Published in: Human Resources for Health 1/2015

Open Access 01-12-2015 | Research

Emerging roles and competencies of district and sub-district pharmacists: a case study from Cape Town

Authors: Hazel Bradley, Uta Lehmann, Nadine Butler

Published in: Human Resources for Health | Issue 1/2015

Login to get access

Abstract

Background

District and sub-district pharmacist positions were created during health sector reform in South Africa. High prevalence of HIV/AIDS, tuberculosis and increasing chronic non-communicable diseases have drawn attention to their pivotal roles in improving accessibility and appropriate use of medicines at the primary level. This research describes new roles and related competencies of district and sub-district pharmacists in Cape Town.

Methods

Between 2008 and 2011, the author (HB) conducted participatory action research in Cape Town Metro District, an urban district in the Western Cape Province of South Africa, partnering with pharmacists and managers of the two government primary health care (PHC) providers. The two providers function independently delivering complementary PHC services across the entire geographic area, with one provider employing district pharmacists and the other sub-district pharmacists. After an initiation phase, the research evolved into a series of iterative cycles of action and reflection, each providing increasing understanding of district and sub-district pharmacists’ roles and competencies. Data was generated through workshops, semi-structured interviews and focus groups with pharmacists and managers which were recorded and transcribed. Thematic analysis was carried out iteratively during the 4-year engagement and triangulated with document reviews and published literature.

Results

Five main roles for district and sub-district pharmacists were identified: district/sub-district management; planning, co-ordination and monitoring of pharmaceuticals; information and advice; quality assurance and clinical governance; and research (district pharmacists)/dispensing at clinics (sub-district pharmacists). Although the roles looked similar, there were important differences, reflecting the differing governance and leadership models and services of each provider. Five competency clusters were identified: professional pharmacy practice; health system and public health; management; leadership; and personal, interpersonal and cognitive competencies. Whilst professional pharmacy competencies were important, generic management and leadership competencies were considered critical for pharmacists working in these positions.

Conclusions

Similar roles and competencies for district and sub-district pharmacists were identified in the two PHC providers in Cape Town, although contextual factors influenced precise specifications. These insights are important for pharmacists and managers from other districts and sub-districts in South Africa and inform health workforce planning and capacity development initiatives in countries with similar health systems.
Literature
1.
2.
Sanders D, Chopra M, Lehmann U, Heywood A. Meeting the challenge of health for all through public health education; some responses from the University of the Western Cape. South African Med. J. 2001;91(10):823–829.
3.
Chatora R, Tumusiime P. Module 1: health sector reform and district health systems. Dist. Heal. Manag. Team Train. Modul. World Health Organisation: Brazzaville; 2004.
4.
Day C, Barron P, Massyn N, Padarath A, English R. District health barometer. Health Systems Trust: Durban; 2011.
5.
6.
Jameson JP, Kasilo O, Froese EH. The profession of pharmacy in Zimbabwe. Ann Pharmacother. 1991;25:302–5.
7.
8.
9.
10.
WHO. The role of the pharmacist in the health care system: quality pharmaceutical services - benefits for governments and the public. Rep. a WHO Meet. Tokyo: World health Organisation; 1993.
11.
Gray A, Smith JA. Changing to district-based pharmaceutical services: mountain or molehill? South African Pharm J. 1997;64:376–7.
12.
Gray A. Performing an in-depth situation analysis of the drug management system in a health district. Health Systems Trust: Durban; 1999.
13.
14.
Groenewald B. Portfolio report 2006: District health system (South African Association of Hospital and Institutional Pharmacists). South African Pharm J. 2006;73:22. 23 & 30.
15.
National Prescribing Centre. Competencies for pharmacists working in primary care [Internet]. Liverpool: National Prescribing Centre; 2000.
16.
Fernandes R, Webb D, Mooney C, Sharott P, Davies G. A new professional framework for developing future chief pharmacists. Pharm J. 2008;281:329–33.
17.
Haynes R, Byleveld S, Bhana R. District management study: a national summary report. Health Systems Trust: Durban; 2008.
18.
Bradshaw D, Nannan N, Laubscher R, Groennewald P, Joubert J, Nojilana B, et al. South African national burden of disease study 2000. Estimates of provincial mortality: summary report. Parow: Medical Research Council; 2006. www.​mrc.​ac.​za/​bod/​estimate.​pdf
19.
Department of Health. Re-engineering primary health care in South Africa. Pretoria: National Department of Health; 2010.
20.
21.
Lehmann U. Strengthening human resources for primary health care. In: Barron P, Roma-Reardon J, editors. South African Heal. Rev. Durban: Health Systems Trust; 2008.
22.
Pick WM, Khanyisa N, Cornwall JT, Masuku M. Human resources for health: a national strategy. Pretoria: Department of Health; 2001.
23.
24.
25.
26.
Gilson L, Hanson K, Sheikh K, Agyepong IA, Ssengooba F, Bennett S. Building the field of health policy and systems research: social science matters. PLoS Med. 2011;8, e1001079.CrossRefPubMedPubMedCentral
27.
28.
Whiddett S, Hollyforde S. A practical guide to competencies: how to enhance individual and organisational performance. London: Chartered Institute of Personnel Development; 2003.
29.
Herr K, Anderson G. The action research dissertation: a guide for students and faculty. Thousand Oaks: Sage; 2005.CrossRef
30.
Winter R. Action-research and the nature of social inquiry: professional innovation and educational work. Aldershot: Gower Publishing Company Ltd; 1987.
31.
Davis J. Rethinking the architecture: an action researcher’s resolution to writing and presenting their thesis. Action Res. 2007;5:181–98.CrossRef
32.
Green J, Thorogood N. Qualitative methods for health research. In: Silverman D, editor. Introd. Qual. methods. London: Sage; 2005.
33.
Gilson L. Health policy and systems research: a methodology reader. Geneva: WHO; 2012.
34.
Meyer J. Action research. In: Pope C, Mays N, editors. Qual. Res. Heal. Care. 3rd edition. Oxford: Blackwell Publishing; 2006. p. 121–31.CrossRef
35.
McNiff J, Whitehead J. Doing and writing action research. London: Sage; 2010.
36.
Lincoln YS, Guba EG. Naturalistic inquiry. Newbury Park, CA: Sage Publications, Inc; 1985.
37.
Galer JB, Vriesendorp S, Ellis A. Managers who lead: a handbook for improving health services. Cambridge Manag. Sci. Heal. 2005.
38.
39.
Chatora R, Tumusiime P. Module 2: management, leadership and partnership for district health. Dist. Heal. Manag. Team Train. Modul. Brazzaville: WHO; 2004.
40.
Egger D, Travis P, Dovlo D, Hawken L. Management strengthening in low-income countries. Mak. Heal. Syst. Work Work. Pap. No 1. Geneva: World Health Organisation; 2005.
41.
42.
Bateman C. Health leadership training academy tackles worst first. South African Med J. 2013;103:707–8.CrossRef
43.
Sheikh K, Gilson L, Agyepong IA, Hanson K, Ssengooba F, Bennett S. Building the field of health policy and systems research: framing the questions. PLoS Med. 2011;8, e1001073.CrossRefPubMedPubMedCentral
44.
Royal Pharmaceutical Society of Great Britain. Leadership competency framework for pharmacy professionals. London: NHS Institute for Innovation and Improvement and Academy of Medical Colleges; 2011.
45.
Kerrigan JE, Luke JS. Management training strategies for developing countries. Lynne Rienner: Colorado; 1987.
46.
Metadata
Title
Emerging roles and competencies of district and sub-district pharmacists: a case study from Cape Town
Authors
Hazel Bradley
Uta Lehmann
Nadine Butler
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2015
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-015-0081-8

Other articles of this Issue 1/2015

Human Resources for Health 1/2015 Go to the issue

Research

Projections of specialist physicians in Mexico: a key element in planning human resources for health

Research

What motivates doctors to leave the UK NHS for a “life in the sun” in New Zealand; and, once there, why don’t they stay?

Research

Enhancing public health practice through a capacity-building educational programme: an evaluation

Research

A scoping review of the association between rural medical education and rural practice location

Research

Global health leadership training in resource-limited settings: a collaborative approach by academic institutions and local health care programs in Uganda

Research

Health workers’ experiences, barriers, preferences and motivating factors in using mHealth forms in Ethiopia