Aspects of the demographic profile and standard of pharmaceutical services in South Africa
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The objects of the South African Pharmacy Council in terms of the Pharmacy Act, 1974 (5311974) as amended are, inter alia, "to uphold and safeguard the rights of the general public to universally acceptable standards of pharmacy practice in both the private and the public sector" as well as "to establish, develop, maintain and control universally acceptable standards of practice of the various categories of persons required to be registered.. ." One of the major difficulties health care providers worldwide are faced with is how to maintain a proper balance between the trio goals of health care, namely adequate access, high quality and acceptable costs (Li, 2003:192-193). Relatively little is known about such problems as do exist for patients regarding access to pharmaceutical services (Doucette et al., 1999:1268). Two main objectives were identified for this study, namely to investigate the demographic profile of community and institutional pharmacies registered with the South African Pharmacy Council; and to determine the standard of pharmaceutical services provided by these pharmacies. Inspection results of community and institutional pharmacies were obtained from the South African Pharmacy Council and extracted for the time period 1 January 2004 to 31 May 2005. To determine the demographic and geographic profile of these pharmacies, data of the Register of Pharmacies of the South African Pharmacy Council for August 2003, 2004 and 2005 were merged with the Census data of South Africa of 2001. It was found that the total number of pharmacies in both the public and private sectors increased with 2.1% (n=68) from August 2003 to August 2005. Public and private pharmacies that provided services directly to patients increased with 6.3% (n=33) and 1.3% (n=35) from August 2003 to 2005. It was found that the Gauteng province was the best provided with registered pharmacies in South Africa, as only 0.06% (n=5 783) of the population did not have any registered pharmacy available on municipality level. It was also revealed that the majority of inspections were carried out in Gauteng, whilst this province accounts for only 19.7% of the total population of South Africa. During the study period a total of 1178 community pharmacy inspections were carried out in 1103 community pharmacies (one or more inspections per pharmacy) representing 43% (n=2 550) of the total number of community pharmacies registered with the South African Pharmacy Council during May 2005. Nationally community pharmacies achieved a score of 92.27 (+ 6.65 per cent) for compliance with Good Pharmacy Practice guidelines. The lowest compliance score (73.34 + 27.49 per cent) was obtained for the availability of written standard operating procedures and the highest was for the promotion of public health (99.02 + 6.30 per cent). No practical significant differences (dc0.8) were found between the overall compliance scores obtained by community pharmacies of the different provinces. The highest compliance score was obtained by community pharmacies in the Free State (93.09 + 4.90 per cent), followed by Western Cape, Eastern Cape, Kwazulu Natal, Limpopo, Northern Cape, Gauteng, Mpumalanga and the North West. A total of 343 institutional pharmacy inspections (one or more inspections per pharmacy) were carried out in public and state subsidised institutions (n=245), private institutions (n=90) and mine hospitals (n=5). These pharmacies represented 46% of the total number of institutional pharmacies registered with the South African Pharmacy Council during May 2005. Nationally all institutional pharmacies (both private and public) achieved a score of 92.49 + 8.33 per cent for compliance with Good Pharmacy Practice guidelines for all above-mentioned aspects. Nationally public and state subsidised institutional pharmacies obtained a lower compliance score (91.02 + 9.08 per cent) than private institutional pharmacies (96.39 + 3.91 per cent). Lastly, a grading system was developed that was based on the results obtained through this study, in order to quantify the standard of pharmaceutical services provided by pharmacies in South Africa.
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