|dc.description.abstract||Despite the deteriorated state of health care in South Africa, the government remains
committed to realising the right of every citizen to access health care, including good, quality
and essential drugs. In recognising the availability of pharmaceutical facilities as a major
component of access to health care, and the previous imbalances in the distribution of
pharmaceutical structures and services, laws pertaining to the licensing and ownership of
pharmacies were amended and promulgated in 2003 to address the distribution problem. In
addition, regulations relating to a transparent priCing system on medicines and related
sUbstances were introduced in 2004. These, coupled with factors influencing the choice of a
pharmacy location, and the deficiencies in human resourges exercising an impact on both
pharmacy and other health care personnel, have influenced the distribution and availability
of pharmaceutical structures in South Africa from the year 2003 to 2008.
The main objective of this study was to investigate the availability and distribution of
pharmaceutical structures registered with the South African Pharmacy Council, in South
Africa, as of 2003 until 2008.
Data on the total number and geographical distribution of registered pharmaceutical
structures in South Africa were obtained from the South African Pharmacy Council's register
of pharmacies of August 2003, 2004, 2005, 2006, 2007 and 2008. The registered
pharmaceutical structures were categorised according to their nature of services to the
patient into "direct service" and "indirect service" (support) pharmacies. Availability was
taken to refer to the actual presence of the pharmaceutical structures in relation to the
demand for the services and measured quantitatively using population: provider ratios. The
'population' for indirect service pharmacies was taken as the direct service pharmacies and,
the 'population' for direct seNice pharmacies was taken as the estimated population of the
different geographical regions.
The results revealed a 12% increase in the total number of registered pharmaceutical
structures between the study years, to a total of 4227 pharmaceu'tical structures in 2008.
Gauteng was identified as the province with the highest number of registered pharmaceutical
structures, while the Northern Cape province contained the lowest number of registered
pharmaceutical structures throughout the entire study period. The percentage of
municipalities without any registered pharmaceutical structures decreased from 23% in 2003
to 19% in 2008.
The indirect seNice pharmacies constituted 14% of the total number of registered
pharmaceutical structures in South Africa. Most of these structures were situated in the
province of Gauteng throughout the study period. National availability of these structures
only improved for the manufacturing pharmacies.
The registered direct seNice pharmacies increased by 13.2% to total 3642 pharmacies in
2008. Approximately 20% of the municipalities in the country (respectively 5.5% of the
population) did not contain any registered direct seNice pharmacy in 2008. Most of these
municipalities were situated in the KwaZulu-Natal province. The province of Gauteng
contained the highest proportion (32%) of the direct seNice pharmaceutical structures. The
decrease in the pharmacy per population ratio of the structures from 1: 14 547 people in
2003 to 1: 13 615 people in 2008 indicated an improvement in the availability of the
structures. However, the improved availability did not take effect within each province as the
Northern Cape, Mpumalanga and Gauteng provinces experienced an increase in the
pharmacy per population ratio.
The availability of registered pharmaceutical structures in South Africa improved between
2003 and 2008. However, the distribution of these structures remains geographically uneven
and inequitable to the population of the country.||