Khan Shamshad, Eab-Aggrey Naessiamba
Department of Communication, University of Texas at San Antonio, San Antonio, TX, USA.
Department of Communication, George Mason University, Fairfax, VA, USA.
Digit Health. 2025 Mar 17;11:20552076251326224. doi: 10.1177/20552076251326224. eCollection 2025 Jan-Dec.
With the ongoing push for greater digitalization of healthcare in low- and middle- income countries (LMICs), the larger questions around who will benefit most from such efforts and what elements of disparities and inequities may further be created or reinforced are often overlooked. This study was undertaken to assess a pioneering e-pharmacy initiative in Ghana that aimed to explore issues of access and disparities in relation to pharmaceutical services.
The study used a qualitative research design where semi-structured interviews were conducted virtually with 21 licensed community pharmacists recruited through purposive and snowball sampling techniques. The data were analyzed using inductive thematic analysis approach.
Pharmacists recognized the transformative potential of e-pharmacies, particularly in resource constrained regions that face issues of pharmacy and healthcare deserts. However, drawing on their experiential knowledge, they highlighted the paradoxes and challenges of promoting digitalization of healthcare in a country characterized by poor infrastructure, poverty, and multiple intersecting layers of inequities, as well as digital divides and low digital/health literacy. In the absence of adequate infrastructure, funding support and regulation, the possibility of local pharmacies, often the first point of care, being replaced by big corporations was feared. Participants also cautioned to steer the discourse of e-pharmacy away from access, pricing, and convenience to safety and quality.
Digitalization of healthcare and e-pharmacies holds tremendous potential in the LMICs. However, such technological initiatives, if implemented without proper groundwork and adequate support, would run the risk of creating and exacerbating health disparities, especially in sub-Saharan Africa. A bottom-up approach, through grassroot engagement and implementation science, tethered to building safe, affordable, and equitable infrastructure and access to care will be essential for the success of e-pharmacy and other digitalization initiatives in the region and beyond. This research has direct implications for public health, policy, and pharmaceutical care.
随着低收入和中等收入国家（LMICs）对医疗保健数字化的持续推进，围绕谁将从这些努力中获益最多以及可能进一步产生或加剧的差距和不平等因素等更广泛的问题常常被忽视。本研究旨在评估加纳一项开创性的电子药房倡议，该倡议旨在探讨与药品服务相关的获取和差距问题。
本研究采用定性研究设计，通过目的抽样和滚雪球抽样技术虚拟采访了21名持牌社区药剂师。采用归纳主题分析法对数据进行分析。
药剂师认识到电子药房的变革潜力，特别是在面临药房和医疗保健荒漠问题的资源受限地区。然而，根据他们的经验知识，他们强调了在一个基础设施薄弱、贫困且存在多重交叉不平等层以及数字鸿沟和低数字/健康素养的国家推广医疗保健数字化的矛盾和挑战。在缺乏足够的基础设施、资金支持和监管的情况下，人们担心通常作为首要护理点的当地药房会被大公司取代。参与者还告诫要将电子药房的讨论从获取、定价和便利性转向安全性和质量。
医疗保健数字化和电子药房在低收入和中等收入国家具有巨大潜力。然而，如果在没有适当基础工作和充分支持的情况下实施此类技术举措，将有产生和加剧健康差距的风险，特别是在撒哈拉以南非洲地区。通过基层参与和实施科学的自下而上的方法，与建设安全、负担得起且公平的基础设施以及获得护理的机会相结合，对于该地区及其他地区电子药房和其他数字化举措的成功至关重要。本研究对公共卫生、政策和药学服务具有直接影响。
