Quality Of Primary Health Care Research Articles

Способы оплаты первичной медико-санитарной помощи, специализированной (в том числе, высокотехнологичной) медицинской помощи в системе ОМС: логика наиболее актуальных изменений тарифной политики 2023 года.

The article discusses new methodological approaches to the methods of paying for medical care in the compulsory medical insurance system for 2023, including those approved by recently issued regulatory legal acts, as well as joint recommendations of the Ministry of Health of Russia and the Federal Compulsory Medical Insurance Fund (FOMS). The article analyzes the main reasons for changes in the tariff policy and their expected consequences in terms of increasing the motivation of medical organizations. It is noted that there is a need to revise the remuneration systems of employees of medical organizations (primarily state and municipal) in order to more closely link incentive payments with performance indicators used in determining the amount of payment for medical care, which is intended to become an important motivation tool for improving the availability and quality of primary health care and, as a consequence, reducing the need for specialized medical care. An overview of innovations in the payment of high-tech medical care is given.

Embedding quality in primary healthcare

Embedding quality in primary healthcare

Intrinsic and extrinsic motivational factors of frontline health workers in Ghana

Background: Human resources are vital for delivering health services, and health systems cannot function effectively without enough skilled, motivated, and well-supported health workers. Even though several studies have addressed job satisfaction among healthcare professionals in different parts of the world, there is limited research examining intrinsic and extrinsic motivational factors involved in job satisfaction, particularly in low-and-middle-income countries. Methods: This was a facility-based quantitative cross-sectional study conducted in 34 primary health care facilities, across three out of the 26 districts in the Eastern Region of Ghana, between February and March 2018, analyzing job satisfaction and underlying factors. Randomly selected public health workers (n=287) from health facilities were included in the study. The two-factor theory was adopted as the measurement model for this study. Results: The odds of staff that had received management training in the past 12 months being intrinsically satisfied was 3.73 (95% CI:2.03,6.86) times higher than staff with no management training (p<0.001). Compared to staff working in hospitals, Community-based Health Planning and Services (CHPS) staff showed lower levels of satisfaction on factors relating to intrinsic motivation. Technical staff had higher odds of being intrinsically and extrinsically satisfied compared to non-technical staff. Conclusions: Public healthcare workers working at primary health facilities in Ghana, at higher levels of service delivery, showed higher satisfaction compared to lower-level staff, both in terms of intrinsic and extrinsic factors underlying satisfaction. Thus, to enhance healthcare services, health facilities’ administrators should take measures to improve the working conditions of staff at all levels of service delivery, since the hierarchy of service delivery in the health system makes the contributory role of all staff critical in improving the quality of primary healthcare.

Understanding virtual primary healthcare with Indigenous populations: a rapid evidence review

BackgroundVirtual care has become an increasingly useful tool for the virtual delivery of care across the globe. With the unexpected emergence of COVID-19 and ongoing public health restrictions, it has become evident that the delivery of high-quality telemedicine is critical to ensuring the health and wellbeing of Indigenous peoples, especially those living in rural and remote communities.MethodsWe conducted a rapid evidence review from August to December 2021 to understand how high quality Indigenous primary healthcare is defined in virtual modalities. After completing data extraction and quality appraisal, a total of 20 articles were selected for inclusion. The following question was used to guide the rapid review: How is high quality Indigenous primary healthcare defined in virtual modalities?ResultsWe discuss key limitations to the delivery of virtual care, including the increasing cost of technology, lack of accessibility, challenges with digital literacy, and language barriers. This review further yielded four main themes that highlight Indigenous virtual primary healthcare quality: (1) limitations and barriers of virtual primary healthcare, (2) Indigenous-centred virtual primary healthcare, (3) virtual Indigenous relationality, (4) collaborative approaches to ensuring holistic virtual care. Discussion: For virtual care to be Indigenous-centred, Indigenous leadership and users need to be partners in the development, implementation and evaluation of the intervention, service or program. In terms of virtual models of care, time must be allocated to educate Indigenous partners on digital literacy, virtual care infrastructure, benefits and limitations. Relationality and culture must be prioritized as well as digital health equity.ConclusionThese findings highlight important considerations for strengthening virtual primary healthcare approaches to meet the needs of Indigenous peoples worldwide.

Determinants of Patient-Perceived Primary Healthcare Quality in Lithuania.

Patient-centered care is considered to be one of the essential pillars of a modern healthcare system. Thus, quality assessment based on patients' perceptions, views and experiences in their journey through the healthcare system is recognized as one of the key principles for quality improvement initiatives. Measuring patient satisfaction can be confounded by expectations and prior experiences, which can be at least partly overcome by evaluating patient-perceived healthcare quality (PPHQ). Understanding the principal constituents of PPHQ may aid healthcare professionals and decision makers in the healthcare management process and help in creating instruments to meaningfully measure patient feedback. Herein, we aimed to analyze the primary determinants of PPHQ and their interactions, with a focus on patient experiences and healthcare accessibility, using the example of Lithuanian primary healthcare. For this purpose, we conducted a cross-sectional representative telephone survey that included a total of 1033 respondents (48% male) who had encountered primary healthcare during last 3 years. Survey questions consisted of sociodemographic characteristics, patient perceptions of healthcare service provision, patient experiences, self-reported health status and overall PPHQ ranked with a 5-point Likert scale as the primary outcome. The classification-regression tree (CRT) technique was used to analyze the relationship between different explanatory variables and PPHQ, as well as their relative importance and interactions. The majority of respondents (89%) evaluated PPHQ as acceptable or good. CRT analysis identified staff behavior, organizational accessibility and financial accessibility as the most important factors affecting PPHQ. Importantly, the latter factors surpassed the effect of other known PPHQ determinants, such as sociodemographic characteristics or health status. Further analysis has revealed that the relative importance of staff behavior, including understanding, attention and empathy, increased when more problems with organizational accessibility were encountered. In conclusion, our study suggests that PPHQ in primary healthcare may primarily be determined by organizational and financial accessibility and staff behavior, which may also act as an important mediating factor.

Job Satisfaction Model of Primary Health Care Midwives Based on Indonesian Workforce Research in the Health Sector

Promotive, preventive, curative, and rehabilitative efforts that are comprehensive, integrated, and sustainable are employed to enhance the health state of the global population. Within this context, however, the quality of primary health care depends on job satisfaction, which leads to the happiness of human resources in the health sector. Therefore, this study aimed to analyze and formulate a job satisfaction model among primary health care midwives in Indonesia. This study was an advanced secondary data analysis of a cross-sectional study conducted in 2017 by the National Institute of Health Research and Development, Ministry of Health of the Republic of Indonesia. A total of 87,341 midwives from all 9,669 primary health cares in Indonesia participated in this study. Data were collected by distributing the Minnesota Satisfaction Questionnaire, elaborating on the satisfaction level and relevant contributing factors. The prefilled Likert scale questionnaire was analyzed using logistic regression. The findings suggested a model indicating that motivation, work area (region), history of salary delay, and training received were important for their job satisfaction, whereas the motivation aspect contributed the most. Therefore, the local and central governments must consider these factors in the human resource policymaking process.

When primary healthcare meets queerstory: community-based system dynamics influencing regional/rural LGBTQ + people’s access to quality primary healthcare in Australia

BackgroundLesbian, gay, bisexual, transgender, Queer, and people of any other minority sexuality or gender identity (LGBTQ + or “Queer”) are often marginalised from accessing quality primary healthcare (PHC) in their local community. This is largely due to Queerphobic, cis-heteronormative/sexist systems pathologising Queer life and identities. The study aims were to: (1) identify key priorities for increasing Queer people’s access to quality PHC as told by Queer people themselves, (2) identify the feedback loops that reduce or support Queer people’s access to quality PHC in non-metropolitan, regional/rural communities, and (3) identify potential action areas to improve system structures to increase Queer people’s access to quality PHC.MethodsGroup Model Building (GMB) workshops were held with a small group (n = 8) of LGBTQ + people in regional Victoria with lived experience of using PHC services. This participatory approach permits exploration and visual mapping of local structures causing behaviour patterns of community concern over time – in this case, Queer people’s ability to access quality PHC in the Geelong-Barwon region. This is the first study that specially applies GMB in Queer PHC in the non-metropolitan regional/rural context.ResultsKey community identified PHC priorities were: (a) providers’ level of Queer Literacy, (b) the responsibility of Queer Advocacy (at individual, systemic, and collective levels), (c) support from safe Queer Spaces, (d) strength from a Queer Presence, and (e) power from Intersectional Queer Life. These priorities interconnected, creating system-level feedback loops reinforcing barriers and enablers to Queer people’s access to quality PHC in the Geelong-Barwon region; with potential action areas identified.ConclusionsImproving Queer people’s access to quality PHC in the Geelong-Barwon region requires embedding principles of Queer Literacy, Queer Advocacy, Queer Space, Queer Presence, and Intersectional Queer Life within practices and service systems. The study findings were distilled into a novel, preliminary set of Queer Equity Principles. These need to be taken back to regional Queer communities for further co-design and planning for translation across PHC practices and systems, with potential applicability in other areas of the healthcare spectrum.

Accreditation of Quality in Primary Health Care in Chile: Perception of the Teams from Accredited Family Healthcare Centers.

This study aimed to investigate the perception of the health teams belonging to the Family Healthcare Centers (CESFAMs) that are accredited, regarding the process of implementation and the achievement of accreditation. A qualitative approach was applied, with contributions from grounded theory, through the technique of individual in-depth interviews and focus groups. The interviews were carried out in nine accredited CESFAMs. For the presentation, organization and analysis of the data, Atlas.ti V9 software was used. From the results, derived from the open phase of the analysis, obtained from the opinions of the participants, a total of 26 categories emerged relating to the facilitating and hindering factors of the process. From the axial phase, it was possible to establish central categories that were related to quality management policies, the structure of Primary Health Care (PHC), participation and co-construction, and leadership and change management. In conclusion, the discourse of the teams reveals the need to have necessary conditions for the accreditation process, which are mainly related to training, characteristics of the types of leadership and teamwork in harmony with the process. Finally, the study reveals a gap in the community participation in this process, which suggests continuing this line of research.

Primary care team and its association with quality of care for people with multimorbidity: a systematic review

BackgroundMultimorbidity is posing an enormous burden to health systems, especially for primary healthcare system. While primary care teams (PCTs) are believed to have potentials to improve quality of primary health care (PHC), less is known about their impact on the quality of care for people with multimorbidity. We assessed the characteristics of PCTs and their impact on the quality of care for people with multimorbidity and the mechanisms. MethodsWe searched PubMed, MEDLINE, EMBASE, ProQuest for published studies from January 2000 to October 2021 for studies in English. Following through PRISMA guidelines, two reviewers independently abstracted data and reconciled by consensus with a third reviewer. Titles, abstracts, and full texts were evaluated to identify relevant studies. Studies were categorized by types of interventions, the impact of interventions on outcome measures, and mechanisms of interventions. ResultsSeventeen studies (13 RCT, 3 cohort studies, and 1 non-randomized trial) were identified. PCTs were summarized into three types—upward PCTs, downward PCTs and traditional PCTs according to the skill mix. The upward PCTs included primary care workers and specialists from upper-level hospitals, downward PCTs involving primary care workers and lay health workers, and traditional PCTs involving physicians and care managers. PCTs improved patients’ mental and psychological health outcomes greatly, and also improved patients’ perceptions towards care including satisfaction with care, sense of improvement, and patient-centeredness. PCTs also improved the process of care and changed providers’ behaviors. However, PCTs showed mixed effects on clinical outcome measures.ConclusionsPCTs have improved mental and psychological health outcomes, the process of care, patients’ care experiences, and satisfaction towards care for patients with multimorbidity. The effect of PCTs on clinical outcomes and changes in patient behaviors need to be further explored.

Associations between Primary Healthcare Experiences and Glycemic Control Status in Patients with Diabetes: Results from the Greater Bay Area Study, China.

Primary healthcare (PHC) plays an important role in diabetes management; community health centers (CHCs) serve as the main providers of PHC. However, few studies have discussed the association between the service quality of PHC and the effects of diabetes management. In this study, we explored the associations between experiences of PHC in CHCs and glycemic control status in patients with diabetes mellitus. This study was conducted in six CHCs in the Greater Bay Area of China. In total, 418 patients with diabetes mellitus (44% males and 56% females) were recruited between August and October 2019. We evaluated their PHC experiences using the Primary Care Assessment Tool (PCAT) developed by Johns Hopkins and assessed their glycemic control status by measuring their fasting plasma glucose levels. Binary logistic regression analyses were conducted to assess the associations between the patients' PHC experiences and glycemic control status, adjusting for covariates. The patients with good glycemic control had significantly higher total and dimensional PCAT scores compared with those with poor glycemic control (p < 0.05). Higher PCAT scores were significantly associated with a greater adjusted odds ratios (aORs) of good glycemic control for total and dimensional PCAT scores. For example, compared to those with poor glycemic control, the aORs for those with good glycemic control was 8.82 (95% CI = 4.38-17.76) per total PCAT score increasing. Especially, the aORs for those with good glycemic control were 3.92 (95% CI = 2.38-6.44) and 4.73 (95% CI = 2.73-8.20) per dimensional PCAT score of family-centeredness and community orientation increasing, respectively. Better PHC experiences were associated with better diabetes management. In particular, family-centered and community-oriented CHCs may help improve diabetes management in China and other low- and middle-income countries.

Focus on client satisfaction as a participatory strategy to promote access and quality of Primary Health Care in the Federal District

Resumo Para construir uma Atenção Primária à Saúde de qualidade deve-se considerar atributos essenciais e participação social. Este estudo, norteado pelo compromisso da saúde coletiva de fomentar processos de cogestão a partir de estratégias participativas, teve como objetivo compreender a percepção dos usuários sobre o atendimento recebido e o funcionamento de sua Unidade Básica de Saúde. O estudo transversal, qualitativo, de caráter exploratório-descritivo realizou a coleta de dados em 25 unidades de saúde urbanas e rurais do Distrito Federal, entre agosto de 2018 e fevereiro de 2019. Para elaborar este artigo, foram utilizadas as respostas a uma pergunta aberta de um questionário semiestruturado. Nelas, os usuários fizeram sugestões ou queixas a respeito dos serviços de saúde prestados. As respostas foram analisadas utilizando o software AtlasTI e sistematizadas em categorias temáticas. Ao final, foram organizadas nas seguintes categorias: elenco de profissionais, turnos de funcionamento, serviços disponíveis e infraestrutura. A escuta qualificada dos usuários permite conhecer as singularidades dos serviços para o planejamento e a construção de um modelo de atenção comprometido com o ato de cuidar, na perspectiva dos atores que compõem os territórios de saúde.

User’s satisfaction with the quality of Primary Health Care in the state of Paraíba: cross-sectional study

Resumo Objetivo Visa analisar a satisfação dos usuários em relação aos atributos essenciais da Atenção Primária à Saúde, no Estado da Paraíba, a partir de dados secundários do PMAQ- AB. Método Estudo transversal realizado entre 2020 e 2021, com dados de 5.347 usuários vinculados a 1.363 equipes de saúde na APS do Estado. Foram selecionadas questões do material utilizado na Avaliação Externa no 3º ciclo do PMAQ-AB referentes ao perfil demográfico, condição socioeconômica e instrumento elaborado pelos pesquisadores com 42 variáveis. As respostas dos usuários foram categorizadas por equipe de saúde: “Muito Bom” (valor 4), “Bom” (valor 3), “Regular” (valor 2), “Ruim” (valor 1) e “Muito Ruim” (valor 0). Os dados foram tabulados por meio de frequência, porcentagens simples e analisados sob forma de tabelas no Excel 2010. Resultado A classificação “Muito Bom” foi de 10.751 (52,5%) em Acesso de Primeiro Contato, 9757 (55,1%) em Longitudinalidade, 1.315 (48,2%) em Coordenação da Atenção; com menor, proporção 4.146 (25,3%) em Integralidade no Estado da Paraíba. Conclusão O estudo demonstrou classificação geral positiva com a satisfação dos usuários e a presença dos atributos, nas Macrorregiões e Estado. Todavia, verificou-se baixo desempenho no atributo Integralidade e piores avaliações atribuídas à Macrorregião I.

Quality of Primary Health Care During the COVID-19 Pandemic: Evaluation by Users Affected by the Disease

Quality of Primary Health Care During the COVID-19 Pandemic: Evaluation by Users Affected by the Disease

Teleconsultorias endodônticas do Telessaúde no estado de Minas Gerais, Brasil

Abstract Background The Telehealth Brazil Program aims to improve the quality of Primary Health Care. Objective This cross-sectional study evaluated the Telehealth Brazil Networks Program’s dental teleconsulting in Minas Gerais state to elucidate the prevalent questions in endodontics. Method Secondary databases of offline dental teleconsulting from the Clinical Hospital and Medical School of the Universidade Federal de Minas Gerais from July 2015 to July 2017 were used. The variables analyzed were telehealth center, dental specialty and sub-area, and question type. The results were descriptively analyzed using the SPSS v.22.0 program. Results A total of 3,920 teleconsulting sessions were carried out. Endodontics was the field with the sixth-highest demand for questions (7.4%). The most prevalent endodontic questions were related to pulpal and periapical alterations (32.3%), being more related to diagnosis, followed by dental trauma (15.6%), endodontic emergencies (11.4%), and intracanal medication (7.3%), all of them with most questions related to clinical conduct. Conclusion The endodontic field questions were related to prevalent conditions in the daily activities of the primary health care professionals. It is crucial to continuously update the professionals through continuing education programs and the search for new knowledge to reinforce these competencies.

Foco na satisfação dos usuários como estratégia participativa para fomentar o acesso e a qualidade da Atenção Primária à Saúde do Distrito Federal

Abstract Quality in Primary Health Care can only be endured by considering essential attributes and social participation. This study, guided by collective health and its commitment to foster co-management processes based on participatory strategies, examined user perception regarding the care received and the functioning of their Basic Health Unit. A cross-sectional, qualitative, descriptive exploratory study was conducted with data collected at 25 urban and rural Primary Health Units in the Federal District, between August 2018 and February 2019, using a validated semi-structured questionnaire. Answers were analyzed using the AtlasTI software and grouped into the following thematic categories: professional staff, working shifts, available services and infrastructure. Qualified listening to users allows us to know the singularities of the services for planning and building a care model committed to the act of caring, from the perspective of health care users.

Анализ удовлетворенности пациентов качеством медицинских услуг в сети первичной медико-санитарной помощи как основных провайдеров услуг здравоохранения

The purpose of the study: to study patient satisfaction with the quality of primary health care. Methods. An observational, descriptive, cross-sectional cross-sectional study was conducted using the Patient Satisfaction Questionnaire. We studied data on the gender and age composition of respondents, insurance status, social status, measured the satisfaction of respondents with primary health care doctors, access to medical care, nurses, service points and amenities. Separately, overall satisfaction with the services provided by the primary practice was measured. A total of 2080 people took part in the study. Of these, 1144 (55.0%) were women and 936 (45.0%) were men. The mean age (± SD) of the participants was 46 ± 8 years. The majority of patients - 1144 people (55.0%) had a higher education and had an income less than the calculated indicator. The vast majority of respondents (1872 - 90.0%) were insured. Results. The mean number of visits to a PHC facility (± SD) was 3 (± 1 visit) and the number of home doctor visits (± SD) was 1 (± 1 visit). 15% of the interviewed patients (312 people) had one or another group of disabilities. The vast majority of respondents (1456 people - 70.0%) were employed, 5.0% (104 people) were pensioners. Correlation analysis on overall satisfaction with the quality of medical care provided in the network of primary health care in Astana, depending on satisfaction with doctors, established a strong direct linear relationship between these variables (R2 = 0.917). Conclusions. Satisfaction with medical appointments has a strong influence on the degree of overall satisfaction with the quality of medical care. Most of the respondents positively assess the quality of medical reception.Key words: primary health care, patient satisfaction, Patient Satisfaction Questionnaire.

Data Quality and use in Primary Health Care: A Case Study of the Immunization Program in Ebonyi State, Nigeria

ABSTRACT Background: Reliable immunization data are vital for optimal coverage, informed decision-making, and efficient program implementation. Aim: This study assessed the quality of immunization data generation and use in primary healthcare centers (PHCs) in Ebonyi State, Nigeria. Methods: A cross-sectional study was conducted in 244 health facilities (HFs), selected through cluster sampling, across six local government areas (LGAs) in Ebonyi State. Information on the accuracy, completeness, timeliness, and monitoring system of the immunization program was collected using a validated Data Quality Self-Assessment (DQS) questionnaire and analyzed with IBM Statistical Package for the Social Sciences (SPSS) statistical software, version 25. The quality index was determined by the proportion of scores for all questions answered, “Yes,” divided by the maximum scores that could be obtained and converted into percentages. The quality index was defined as good for a score of ≥80%. The Chi-square and multivariate logistic regression analyses were conducted. The statistical significance level was set at a P value of <0.05. Results: Accurate, complete, and timely data were recorded in 137 (56.1%), 133 (56.6%), and 81 (33.3%) HFs, respectively. Overall, quality data were observed in a minor proportion, 14 (5.7%) of HFs. The HFs with good-quality data on specific monitoring indices include archiving (109 (44.7%)), reporting (106 (43.4%)), demographic information (58 (23.8%)), evidence of use of data (45 (18.4%)), recording (40 (16.4%)), and core output (14 (6.7%)). Accuracy was predicted by good reporting (AOR = 35.714, CI = 13.260–96.196); completeness was predicted by good archiving (OR = 26.749, CI = 11.514–62.144). Conclusion: Data quality and use in PHC are suboptimal. Integrating the quality self-assessment concept into staff training and supportive performance supervision could improve immunization data quality and use.

Self-reported health conditions, quality of Primary Health Care and associated factors according to sexual and gender minorities

Introduction: Lesbians, gays, bisexuals, transvestites, transsexuals, transgenders, queers, intersexes, asexuals, pansexuals and other sexual and gender minorities constitute a population that has been little studied regarding the use and care in health services. Objective: From this perspective, the general objective of this study was to evaluate the quality of Primary Health Care according to members of sexual and gender minorities. Methods: This is an evaluative research, with a cross-sectional and descriptive-analytical design and a quantitative approach, performed by means of a web survey in Brazil. The script for data collection addressed sociodemographic characteristics, sexual orientation, gender identity, self-reported health conditions and the 23 items of the Primary Care Assessment Tool, reduced version for adult users. Results: The results represent 314 LGBTQIAP+ people, predominantly young, white, cisgender, homosexual and bisexual, from the five Brazilian regions, highlighting the states of Minas Gerais and São Paulo. The use of alcoholic beverages and other substances, the weight change and the presence of mental diseases were the most frequent self-reported health conditions. Primary health care was mostly evaluated with low overall scores, thus indicating low quality. The attributes “community guidance” and “coordination” (care integration) were marked by negative evaluations, indicating small extension. People belonging to sexual and gender minorities who worked, had kidney problems, had been hospitalized recently and that had their gender identity and sexual orientation known by health professionals were more likely to evaluate the Primary Health Care as good. Conclusion: This work points out as weaknesses in the care of the LGBTQIAP+ population the following atributes: family guidance, accessibility, longitudinality and available services, which can be prioritized to improve the quality of Primary Health Care in the Brazilian Unified Health System.

Ethnic minority GP trainees at risk for underperformance assessments: a quantitative cohort study.

Recent studies suggest that ethnic minority students underperform in standardised assessments commonly used to evaluate their progress. This disparity seems to also hold for postgraduate medical students and GP trainees, and may affect the quality of primary health care, which requires an optimally diverse workforce. To address the following: 1) to determine to what extent ethnic minority GP trainees are more at risk of being assessed as underperforming than their majority peers; 2) to investigate whether established underperformance appears in specific competence areas; and 3) to explore first- and second-generation ethnic minority trainees' deviations. Quantitative retrospective cohort design in Dutch GP specialty training (start years: 2015-2017). In 2020-2021, the authors evaluated files on assessed underperformance of 1700 GP trainees at seven Dutch GP specialty training institutes after excluding five opt-outs and 165 incomplete datasets (17.4% ethnic minority trainees). Underperformance was defined as the occurrence of the following, which was prompted by the training institute: 1) preliminary dropout; 2) extension of the educational pathway; and/or 3) mandatory coaching pathways. Statistics Netherlands (CBS) anonymised the files and added data about ethnic group. Thereafter, the authors performed logistic regression for potential underperformance analysis and χ2 tests for competence area analysis. Ethnic minority GP trainees were more likely to face underperformance assessments than the majority group (odds ratio [OR] 2.41, 95% confidence interval [CI] = 1.67 to 3.49). Underperformance was not significantly nested in particular competence areas. First-generation ethnic minority trainees seemed more at risk than their second-generation peers. Ethnic minority GP trainees seem more at risk of facing educational barriers than the majority group. Additional qualitative research on underlying factors is essential.

A national analysis of the pharmacy workforce in Indonesia

BackgroundPharmacists play a fundamental role in healthcare systems and achieving Universal Health Coverage (UHC) through quality primary healthcare service provision. While the World Health Organization (WHO) forecasts a global shortage of health workforce by 2030, mainly affecting low- and middle-income nations (LMICs), limited published literature is found regarding pharmacy workforce capacity in LMICs, including Indonesia. This paper aims to analyse pharmacists’ capacity in Indonesia to identify emerging workforce planning gaps for future workforce planning and policies in Indonesia.MethodSeveral data sources were accessed, including a database from the National Pharmacy Committee and the professional leadership body in Indonesia. Descriptive (frequencies, percentages, and mean), correlational and time-series analysis using curve estimation were conducted. Secondary data on the number of programmes, pharmacy students, pharmacy workforce (pharmacists and pharmacy technicians) per province were obtained from the Ministry websites and reports.ResultThere were a total of 77 191 registered pharmacists in Indonesia in 2019. The pharmacists’ pyramid showed a youth bulge as a general indication of market expansion in the education sector correlating to the pharmacy programme’s number and size. There was a variation in pharmacy workforce density and access to pharmacy programmes across islands, which also were strongly correlated. Forecasting estimates that by 2030, women will represent around 86% of pharmacists in Indonesia. More female pharmacists were found working in the hospital and primary healthcare (providing direct services to patients) than male pharmacists. Younger pharmacists worked in the industrial sector, while older pharmacists worked in governmental and educational institutions.ConclusionThis study signposted workforce planning gaps for policy development in Indonesia, including a need to develop structured training to support early career pharmacists in their practice. There is also a need for better access to professional development programmes designed to support female pharmacists return to the regulated workforce following career breaks. National policy to promote equitable distribution and retention of pharmacists is recommended.