Konduri Niranjan, Rauscher Megan, Wang Shiou-Chu Judy, Malpica-Llanos Tanya
Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, Management Sciences for Health, Arlington, VA USA.
Pharmaceuticals and Health Technologies Group, Management Sciences for Health, Arlington, VA USA.
J Pharm Policy Pract. 2017 May 8;10:16. doi: 10.1186/s40545-017-0104-z. eCollection 2017.
Medicines use related challenges such as inadequate adherence, high levels of antimicrobial resistance and preventable adverse drug reactions have underscored the need to incorporate pharmaceutical services to help achieve desired treatment outcomes, and protect patients from inappropriate use of medicines. This situation is further constrained by insufficient numbers of pharmaceutical personnel and inappropriate skill mix. Studies have addressed individual capacity building approaches of logistics, supply chain or disease specific interventions but few have documented those involving such pharmacy assistants/professionals, or health workers/professionals charged with improving access and provision of pharmaceutical services. We examined how different training modalities have been employed and adapted to meet country-specific context and needs by a global pharmaceutical systems strengthening program in collaboration with a country's Ministry of Health and local stakeholders.
Structured, content analysis of training approaches from twelve selected countries and a survey among conveniently selected trainees in Bangladesh and Ethiopia.
Case-based learning, practice and feedback, and repetitive interventions such as post-training action plan, supportive supervision and mentoring approaches are effective, evidence-based training techniques. In Ethiopia and Bangladesh, over 94% of respondents indicated that they have improved or developed skills or competencies as a result of the program's training activities. Supportive supervision structures and mentorship have been institutionalized with appropriate management structures. National authorities have been sensitized to secure funding from domestic resources or from the global fund grants for post-training follow-up initiatives. The Pharmaceutical Leadership Development Program is an effective, case-based training modality that motivates staff to develop quality-improvement interventions and solve specific challenges. Peer-to-peer learning mechanisms than traditional didactic methods was a preferred intervention among high level government officials both within country and between countries.
Interventions must involve local institutions in the design and delivery of content for both pre-service and in-service training as well as web-based methods where feasible. Such efforts would meet the changing demand in the pharmaceutical system, and promote the ownership of the human capacity development interventions. The cost-effective partnership with universities demonstrate that competency based pre-service training will prepare the future pharmaceutical workforce with a critical foundation of knowledge and skills required to meet the growing demand for patient-centered pharmaceutical services in resource-constrained countries.
与药物使用相关的挑战，如依从性不足、高水平的抗菌药物耐药性以及可预防的药物不良反应，凸显了纳入药学服务以帮助实现预期治疗效果并保护患者免受药物不当使用影响的必要性。而药学人员数量不足和技能组合不当进一步限制了这种情况。研究探讨了物流、供应链或特定疾病干预等个人能力建设方法，但很少有文献记录涉及药房助理/专业人员或负责改善药学服务获取和提供的卫生工作者/专业人员的相关情况。我们研究了一个全球药学系统强化项目如何与一个国家的卫生部及当地利益相关者合作，采用不同的培训方式并使其适应特定国家的背景和需求。
对来自十二个选定国家的培训方法进行结构化内容分析，并对孟加拉国和埃塞俄比亚方便选取的受训人员进行调查。
基于案例的学习、实践与反馈，以及诸如培训后行动计划、支持性监督和指导方法等重复性干预措施，都是有效的、基于证据的培训技巧。在埃塞俄比亚和孟加拉国，超过94%的受访者表示，由于该项目的培训活动，他们的技能或能力得到了提升或发展。支持性监督结构和指导已通过适当的管理结构得以制度化。国家当局已提高认识，以确保从国内资源或全球基金拨款中获得资金，用于培训后的后续举措。药学领导力发展项目是一种有效的、基于案例的培训方式，能激励工作人员开展质量改进干预措施并解决特定挑战。与传统讲授方法相比，同行间学习机制是国内和国家间高级政府官员更青睐的干预方式。
干预措施必须让当地机构参与职前和在职培训内容的设计与提供，以及在可行的情况下采用基于网络的方法。此类努力将满足药学系统不断变化的需求，并促进对人力能力发展干预措施的自主掌控。与大学建立的具有成本效益的伙伴关系表明，基于能力的职前培训将为未来的药学劳动力奠定关键的知识和技能基础，以满足资源有限国家对以患者为中心的药学服务日益增长的需求。
