The global pharmacy workforce: a systematic review of the literature.

Nicola Hawthorne,Claire Anderson

doi:10.1186/1478-4491-7-48

Abstract

The importance of health workforce provision has gained significance and is now considered one of the most pressing issues worldwide, across all health professions. Against this background, the objectives of the work presented here were to systematically explore and identify contemporary issues surrounding expansion of the global pharmacy workforce in order to assist the International Pharmaceutical Federation working group on the workforce.International peer and non-peer-reviewed literature published between January 1998 and February 2008 was analysed. Articles were collated by performing searches of appropriate databases and reference lists of relevant articles; in addition, key informants were contacted. Information that met specific quality standards and pertained to the pharmacy workforce was extracted to matrices and assigned an evidence grade.Sixty-nine papers were identified for inclusion (48 peer reviewed and 21 non-peer-reviewed). Evaluation of evidence revealed the global pharmacy workforce to be composed of increasing numbers of females who were working fewer hours; this decreased their overall full-time equivalent contribution to the workforce, compared to male pharmacists. Distribution of pharmacists was uneven with respect to location (urban/rural, less-developed/more-developed countries) and work sector (private/public). Graduates showed a preference for completing pre-registration training near where they studied as an undergraduate; this was of considerable importance to rural areas. Increases in the number of pharmacy student enrolments and pharmacy schools occurred alongside an expansion in the number and roles of pharmacy technicians. Increased international awareness and support existed for the certification, registration and regulation of pharmacy technicians and accreditation of training courses. The most common factors adding to the demand for pharmacists were increased feminization, clinical governance measures, complexity of medication therapy and increased prescriptions.To maintain and expand the future pharmacy workforce, increases in recruitment and retention will be essential, as will decreases in attrition, where possible. However, scaling up the global pharmacy workforce is a complex, multifactorial responsibility that requires coordinated action. Further research by means of prospective and comparative methods, not only surveys, is needed into feminization; decreasing demand for postgraduate training; graduate trends; job satisfaction and the impact of pharmacy technicians; and how effective existing interventions are at expanding the pharmacy workforce. More coordinated monitoring and modelling of the pharmacy workforce worldwide (particularly in developing countries) is required.

Highlights

Shortages of pharmacists have been reported in specific countries since the early 1990s
Reports of shortages of the health workforce had surfaced in the 1970s but it was not until the following decade, and in particular the publishing of the World health report in 2006 [1], that health workforce issues gained sufficient momentum to merit widespread investigation and international action to bring about changes
The international shortage of health care professionals exists in different severities and has different root causes, depending on the particular health profession and the country of origin

Summary

Introduction

Shortages of pharmacists have been reported in specific countries since the early 1990s. Reports of shortages of the health workforce had surfaced in the 1970s but it was not until the following decade, and in particular the publishing of the World health report in 2006 [1], that health workforce issues gained sufficient momentum to merit widespread investigation and international action to bring about changes. That report was a major driving force for expansion of the international health workforce in order to meet the health-related Millennium Development Goals. The international shortage of health care professionals exists in different severities and has different root causes, depending on the particular health profession and the country of origin. The Global pharmacy workforce and migration report was the first of its kind to investigate specific workforce issues affecting the international pharmacy profession as a whole [3]

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Conclusion