Prescribing better health: utilising pharmacists in Ghana

Community pharmacies in developing countries have great untapped potential for improving people’s health through prevention and treatment.  People in remote regions of Ghana often do not attend health clinics. They buy drugs from peddlars who have no medical training.  A trained pharmacist can advise on how to treat common conditions and provide the right drugs in areas where health clinic services are limited. 

The University of London'sSchool of Pharmacy reviewed existing the literature toidentify ways that pharmacies could be better used as part of the public healthsystem in Ghana. Patients often see a doctor at a health clinic who does notspeak the local language.  In comparison,chemist shops are open for long hours, offer quick and cheap treatment and thechemists – who have no formal training - are friendly local people who are partof the community.  Pharmacies appear tobe a valuable and underused resource for improving the nation’s health.

The following findingsemerged from the review:

• Most pharmacists work in or near the cities. 837of the country’s 964 pharmacies are based in the capital city Accra or inthe Ashanti Region. Many people living in rural areas do not have accessto a pharmacy.
• Many pharmacies do not have professional staffand the role of pharmacist is frequently taken on by someone with noformal training.
• When pharmacists are not available people buytheir drugs from peddlers or licensed chemical sellers.  Chemical sellers’ main objective is tomake money, not to provide the most cost-effective treatment for thepatient.
• The people often lack an understanding of thecauses of their illnesses; many people did not know the role mosquitoesplay in causing malaria.

Since 1992, people in Ghanahave had to pay for their own drugs and other treatments. This has negativelyimpacted upon the health of poor sections of society.  Many poor people do not visit a doctorbecause of the cost of the consultation. Some people do not follow theircorrect prescribed dosages because they want to make the drugs last longer. Inthese situations, the role of the pharmacist is crucial.  The review recommends the following:

• Current reforms in the Ghanaian health system shouldexpand pharmacy services so they are available to more people. Pharmacists’fees could be lowered in remote areas to encourage them to set up businessin underserved parts of the country.
• Pharmacies should be included as a part of the national health service. National health programmescould use pharmacies to help educate communities on particular healthissues.
• Every pharmacy should have a qualified pharmacistto give people correct advice, for example, on treating malaria ordiarrhoea. They could also advise poorer patients on the mostcost-effective way of tackling a health problem.
• Pharmacy assistants should be given training to giveadvice to patients when the pharmacist is not present.
• Services must be sensitive to local attitudes andneeds. They should remain informal and approachable.