Dr Abdur Rashid Consultant (Health Initiatives)
As per available data, Pakistan could not meet the Sustainable Development Goals ( SDG) till 2030, if continued with same pace of interventions . Majority of Population lives in rural areas. In 1984, Late Dr Mahboob ul Haq established basic health units in rural areas along with accommodation but unfortunately doctors were not willing to live in rural areas . History of Pakistan speaks, that Health Departments made majority projects for big cities and established tertiary care facilities while primary health care remained ignored. At least ten years matric pass technician run basic health units in Punjab and KP provinces. As a result the patients from Distt . Mianwali, Bhakkar etc move to either Lahore or MULTAN long journey . In far flang and remote areas , doctors are not willing to work in government hospitals. Majority of doctors prefer to work in capitals of four provinces. There is a dire need that in those areas or basic health units where doctors are not willing to work Five years Specialized Pharmacists trained in tertiary care hospital shall be posted . To meet the health crunch, Federal and Provincial Governments shall make a system in which they should trained the Pharm – D degree holder in tertiary care hospitals in the presence of clinician and clinical pharmacist. Federal and Provincial Secertries, Federal and Provincial DG, s Health, Federal and Provincial Health care Commissions, DG Pharmacy, DRAP, Chief Drug Inspectors , Provincial Secretary Quality Control Boards, experts from Academia , Hospital administrators, Clinical Pharmacists, Researchers shall sit together and have a brainstorming meeting to explore the role of prescribing pharmacists in primary health care delivery system . B.Pharm/ D-Pharm degree holder shall be trained for one year in the basic health unit and tertiary care hospital also. Special meetings shall be arranged for developing course outlined to be trained for one year with the support of Pharmacy Council of Pakistan and Higher Education Commission . Federal and Provincial Governments shall allocate annual budget as a internship/ stipend to trainee pharmacists. Training shall be given under direct supervision of Clinical Pharmacists and Clinician in the government hospitals.
Syllabus shall be prepared according to the guidelines of WHO and to the requirements in basic health unit ( BHU), Rural Health Complex (RHC ) and Tehsil Head Quarter Hospitals ( THQ) . A list of medicines shall be prepared say 30-50 drugs that will be prescribed by trained Pharmacists as per practices in developed countries like USA . In South Korea there are practicing Nurse which can prescribe some specified medicines and if required patient is referred . There is a dire need that policy makers , decision taking authorities, planners , regulators, health associations, stakeholders , patient welfare organisations ,Community representatives should sit together and take decision in the interest of the patients instead of vested interest and seeking own pockets.
There is still lacking of Health care workforce as per WHO recommendations in Pakistan. It has been observed by Public Health Specialists that Pakistan doctors are trained in tertiary care hospitals and perform all duties according to the requirement of emergencies , surgeries , trauma, delivery of pregnant mothers etc but when they work in basic health unit , they totally fail . As these doctors are not as per requirement of Basic health units . So new health care workforce shall be prepared in the shape of prescribing pharmacists with special training and posted in rural areas . Graduate Pharmacist with one year Clinical diploma course, well jointly trained in primary health unit and tertiary care hospital shall be notified as prescribing pharmacists for particular drugs . With this intervention burden on the district head quarter hospital , tertiary care hospital and hospitals located at provincial capitals will be reduced. Quackery due to absence or lack of doctors in far flang hilly and sandy areas, a well trained pharmacists can serve the patients with rational use and protect and safeguard the patients. Pharmacy Services as per international standards, ADR reporting , Antibiotic Stewardship programs, Patient Safety , patient counselling ,
