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Neighborhood pharmacies in South Asia offer first-contact care and community orientation, but lack formal continuity and family-centeredness. Enhanced training is crucial for them to become effective primary care providers.

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community resourcehealth systemsinformal providersprimary caretask shifting

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Area of Science:

  • Health Services Research
  • Global Health
  • Pharmacy Practice

Background:

  • Primary care is vital but challenging to establish in developing nations.
  • Neighborhood pharmacies are ubiquitous in South Asia, serving as key points for medicine acquisition and health advice.
  • Globally, pharmacies are increasingly integrated into primary care systems.

Purpose of the Study:

  • To explore the potential of pharmacies as formal primary care providers in South Asia.
  • To evaluate pharmacy performance against the seven Starfield attributes of primary care.
  • To analyze data from pharmacy interventions in Bangladesh and India.

Main Methods:

  • Qualitative Comparative Analysis (QCA) framework.
  • Analysis of data from four pharmacy-related interventions (one in Bangladesh, three in India).
  • Assessment of pharmacies against Starfield attributes: first contact, continuity, comprehensiveness, coordination, family-centeredness, cultural competency, and community orientation.

Main Results:

  • Pharmacies demonstrate strong community orientation and provide first-contact care.
  • No direct evidence of pharmacies offering continuity of care, family-centeredness, or cultural competency was found.
  • Anecdotal evidence suggests pharmacists engage in these aspects informally and inconsistently.

Conclusions:

  • Pharmacies possess inherent characteristics for effective primary care delivery and access to health information.
  • Additional training and resources are necessary to enhance pharmacy competency and role as a healthcare gateway.
  • A long-term strategy focusing on fundamental capability enhancement is required to fully leverage pharmacy potential in primary care.