[e-drug] Human resource capacity in pharmaceutical sector

[Kibumba George <kibumba@yahoo.com>]

E-drug: Human resource capacity in pharmaceutical sector
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In Uganda�s newspaper, The New Vision edition of August 15, page 40, The
Uganda National Health Consumers� Organisation (UNHCO), a Non Governmental
Organisation fronting for the rights of consumers of health care in Uganda,
released research study results from towns of Kampala, Luweero, and
Bushenyi.  The findings reveal that while 90% of health workers purportedly
provide information about side effects of drugs to patients, only 35% of
people reported that they are actually told side effects of medicines.

We need to remember, however, that telling patients side effects of
medicines is only about 0.001% of the knowledge, skills required to dispense
medicines effectively.   Consider a woman in a rural setting who swallows
nystatin tablets for oral thrush (candida in the mouth).  Yet using nystatin
tablets for candida in the mouth is cheap, safe, effective and CAN ONLY WORK
when the tablets are chewed, or crushed and the powder sucked.   Take this
other example of a gentleman who swallows suppositories for a rectal
condition (most suppositories work when they are placed directly into the
anal orifice).  The list is endless of major issues to look at when talking
about the rights of patients and the use of medicines.

Let us face the fact head-on.  In Uganda today, it is nurses and midwives,
and nursing assistants (assistants to nurses) who are doing most of the
dispensing.   Understanding that dispensing is a discipline that is apart of
a three-year diploma course in pharmacy at Mulago School of Pharmacy
Technicians, Kampala, we need some urgent, practical intervention.  Am going
to suggest what we can do given the current state of affairs, but let us
first look at the bigger picture.

Whereas the out put per year is just 15, there are only about 270 qualified
dispensers or pharmacy technicians in Uganda.  At this rate, it will take
Uganda over 50 years to achieve a ratio of one pharmacy technician for every
20,000 people.  On the other hand, with an output of 10 per year, and with
only 171 registered pharmacists in Uganda, it will take the Government over
90 years to hit a ratio of one pharmacist for every 20,000 Ugandans.

Recognising the lack of sufficient qualified man-power to directly run
pharmacies, and appreciating that the general public is receiving a raw deal
as far as dispensing medication is concerned, the following are the interim
measures that can rectify the problem that the UNHCO slightly unearthed.

�         A mandatory Government�supported programme to supply drills to
pharmacy and drug-shop auxiliary staff.  The Pharmaceutical Society of
Uganda, in collaboration with the Ministry of Health, our Drug Regulatory
Authority, National Drug Authority and other stake holders can dispense the
drills.

�         The 171 pharmacists available should stay at supervisory level and
must run a mass drug-use education programme, through their Society, in
collaboration with the Ministry of Health and the National Drug Authority.

The other strategy that I consider long-term and can produce tangible
results is empowering the School of Pharmacy Technicians, Mulago, Kampala
and the School of Pharmacy, Makerere University, Kampala. Having an
overwhelming pharmacist deficit of 650%, if we took the ratio of 1:20,000 as
our yard-stick,  in this millennium is no small matter.   It directly
affects the quality of pharmaceutical services, and health care in the
country.

We can notice that for us to be able to standardize or make our herbs sweet,
we should provide space, equip the School of Pharmacy with the necessary
gadgets,  upgrade the academic staff.   This investment will not only result
in producing quality pharmacists for the international labour market (and
pharmacists are highly paid and are on high demand abroad), but it will also
result in producing human resource capacity for the Ugandan pharmaceutical
sector.

George Kibumba, MPS
Lecturer, Clinical Pharmacy
Dept of Pharmacy, Makerere University
P.O.BOX 7072, KAMPALA, UGANDA.
Mobile: 071 81 54 28
E-mail: kibumba@yahoo.com




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