Introduction
Pharmacists play a crucial role in healthcare systems around the world, providing essential services and expertise in medication management. However, the scope of practice for pharmacists varies widely across countries. This review article aims to compare the scope of practice for pharmacists in Rwanda and Australia in several key areas, including competency, training, qualification or endorsement, funding mechanism, professional standards/guidelines, legislative authority, health conditions management vision, and ordering and interpreting laboratory tests. Moreover, it will explore the achievements and strategies adopted by each country to bridge the gap and optimize pharmacists' role within the healthcare system.
Competency and Training
In Rwanda, pharmacists undergo a comprehensive training program at the School of Medicine and Pharmacy at the University of Rwanda [1]. The curriculum covers core pharmaceutical sciences and clinical pharmacy. However, the ongoing professional development and acquisition of advanced clinical skills are vital to enhance pharmacists' competencies. Collaboration with international partners, such as the Clinton Health Access Initiative and Rwanda Human Resources for Health Program [2], supports further training and capacity-building opportunities.
In Australia, pharmacists complete a four-year Bachelor of Pharmacy degree or a five-year Master of Pharmacy program. Additionally, they are required to undergo an internship program to gain practical experience before becoming registered pharmacists. Continuous professional development is also encouraged by the Pharmacy Guild of Australia to ensure pharmacists stay up-to-date with the latest advancements.
Qualification or Endorsement
In Rwanda, pharmacists must be registered with the Pharmacy Council [3], which ensures their qualifications and competence meet the established standards. However, specific endorsements or additional qualifications for specialized areas of practice are still developing.
In Australia, pharmacists can obtain additional qualifications and endorsements, such as in hospital pharmacy, pharmacy management, or consultant pharmacy. These additional qualifications allow pharmacists to expand their scope of practice in specific domains.
Funding Mechanism
In Rwanda, the funding mechanism for pharmacists is primarily through the national healthcare system. However, there may be limitations in terms of the availability of resources, which may impact the ability to fully implement expanded roles and services.
In Australia, pharmacists have multiple funding mechanisms available, including reimbursement for professional services through the Pharmaceutical Benefits Scheme (PBS). This funding mechanism incentivizes the provision of extended pharmacy services and enables pharmacists to have a sustainable practice.
Professional Standards/Guidelines
Both Rwanda and Australia have established professional standards and guidelines for pharmacists to ensure the delivery of safe and effective care. In Rwanda, the Pharmacy Council publishes guidelines and standards [4] that serve as a reference for pharmacists. In Australia, the Pharmacy Guild of Australia, along with other professional organizations and regulatory bodies, develops and updates guidelines regularly [5].
Legislative Authority
In Rwanda, the legal framework governing the pharmacy profession is provided by the National Pharmacy Council Rwanda and the Ministry of Health [4,6]. Efforts are being made to strengthen the legislative authority to ensure pharmacists can practice to the full extent of their training and competence.
In Australia, pharmacists' legislative authority is well-established, allowing them to provide a broad range of services and interventions. Amendments to legislation and regulations have been made to support expanded roles and responsibilities.
Health Conditions Management Vision
Rwanda's Vision 2050 identifies the role of pharmacists in ensuring affordable and accessible quality healthcare. The vision seeks to integrate pharmacists as key healthcare providers in managing various health conditions, especially in chronic disease management.
In Australia, the health conditions management vision recognizes pharmacists as an integral part of the healthcare team. Pharmacists are involved in medication therapy management, chronic disease management, and preventive care services.
Ordering and Interpreting Laboratory Tests
In Rwanda, the capacity for pharmacists to order and interpret laboratory tests is still being limited. The the Ministry of Health [6] plays a crucial role in regulating and guiding the provision of laboratory services. Only Doctors, nurses or other clinicians (at Hospital or at clinics or at health facilities) are able to order laboratory tests (relevant to pharmacist care) on behalf of a patient.
In Australia, pharmacists have the authority to order and interpret specific laboratory tests, allowing for comprehensive medication management and monitoring of patient outcomes.
Achievements and Strategies to Overcome Challenges
While there is a scope of practice gap between Rwanda and Australia, both countries have made significant progress. Rwanda has achieved milestones in developing a trained workforce, establishing regulatory bodies, and setting standards and guidelines. Collaboration with international partners and ongoing professional development programs are helping to bridge the gap.
In Australia, the expansion of pharmacists' scope of practice has been facilitated through advocacy, collaboration with healthcare professionals and organizations, and ongoing professional development opportunities. The Pharmacy Guild of Australia has played a crucial role in championing the recognition of pharmacists' expertise and advancing their roles within the healthcare system.
To overcome the challenges faced in Rwanda, it is essential to continue investing in training and education, advocating for policy changes, strengthening legislative authority, and improving public awareness about the value of pharmacists in healthcare delivery. Building partnerships with other healthcare professionals, leveraging international collaborations, and ensuring equitable distribution of healthcare resources are key strategies for expanding the scope of practice.
Conclusion
The scope of practice for pharmacists in Rwanda and Australia varies across several key areas. While Rwanda has made progress in training pharmacists and establishing standards, the scope of practice is still developing. In comparison, Australia has successfully expanded the roles and responsibilities of pharmacists, enabling them to provide a wide range of services. Achievements in both countries reflect the dedication and commitment to improving patient care. By implementing strategies such as education and training, advocacy, partnership building, and resource allocation, both countries are working towards optimizing the pharmacist's role within the healthcare system.
Recommendations
1. Education and Regulation:
- Consider establishing standardized educational requirements for community pharmacists globally, taking into account factors such as duration of degree programs and content coverage.
- Facilitate opportunities for sharing best practices in pharmacy education between countries to enhance the quality of pharmacy programs.
2. Collaboration and Exchange Programs:
- Encourage exchange programs and collaborative initiatives between Rwandan and Australian pharmacy professionals to promote mutual learning and sharing of expertise.
- Create platforms for regular communication and collaboration between professional organizations in both countries to facilitate knowledge transfer and policy development.
3. Role Expansion and Enabling Legislation:
- Encourage the development and implementation of enabling legislation in Rwanda to enhance the scope of practice for community pharmacists.
- Consider the adoption of elements of the Australian model, such as expanded prescribing authority and involvement in chronic disease management, to enhance patient care and optimize medication management in Rwanda.
4. Technology Integration:
- Facilitate the establishment of technology infrastructure in Rwanda to support the integration of digital health records and automation in pharmacy practice.
- Foster collaborations between technology companies, governments, and professional organizations to overcome challenges related to resource availability and infrastructure.
5. Research and Evaluation:
- Encourage the conduct of research studies to evaluate the impact and effectiveness of expanded roles and responsibilities of pharmacists in both countries.
- Share research findings and best practices through international conferences and publications to facilitate global advancements in pharmacy practice.
6. Policy Advocacy:
- Pharmacist professional organizations in both countries should work together to advocate for policies that recognize and support the integral role of community pharmacists in healthcare systems.
- Collaborate with government agencies to raise awareness about the value and potential of community pharmacists in improving patient care and medication management.
7. International Collaboration and Support:
- Seek support from international organizations, such as the World Health Organization and the International Pharmaceutical Federation, to promote collaboration and knowledge sharing between countries.
- Explore opportunities for funding and technical assistance to enhance pharmacy practice and capacity building in Rwanda.
By implementing these recommendations, we can work towards bridging the gap in the scope of practice for community pharmacists in Rwanda and Australia, leading to improved patient care and better healthcare outcomes in both countries.
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References:
- School of Medicine and Pharmacy, University of Rwanda. (2023). Retrieved from https://cmhs.ur.ac.rw/?-School-of-Medicine-and-Pharmacy
- Pharmacy Council of Rwanda. (2022). Our Partners. Retrieved from http://www.pharmacycouncil.rw/our-partners/
- Pharmacy Council of Rwanda. (2022). Member Registration. Retrieved from http://www.pharmacycouncil.rw/member-registration/
- Pharmacy Council of Rwanda. (2022). Publications. Retrieved from http://www.pharmacycouncil.rw/publications/
- Pharmacy Guild of Australia. (2023). Scope of Practice 2023. Retrieved from https://www.guild.org.au/__data/assets/pdf_file/0023/106178/scope-of-practice-2023.pdf
- Ministry of Health Rwanda. (2016). Retrieved from https://www.moh.gov.rw/index.php?eID=dumpFile&t=f&f=39812&token=9d57cab15003851ffaa272af7f86ee178563c6ff
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