Is Foundation of Primary care weakening? – ET HealthWorld

Is Foundation of Primary care weakening?
By Mevish P. Vaishnav & Himadri Bisht

Pharmacists and nurses are the foundation of primary care and the first responders for healthcare for an LMIC -India. Despite having a large workforce of nurses and pharmacists, both professions are facing an existential crisis. The first study conducted by Health Parliament for nursing made us to conclude that nursing was an endangered profession in India (, and the recently released study on pharmacist paint an equal gloomy picture of the pharmacist if not worse! Pharmacistis the third largest healthcare profession globallyand is the first port of callin case of a health crisis. Pharmacists are crucial in providing primary care to patients, but their role is limited to dispensing medicines in India. The pharmacy profession is facing a twin challenge. We have a shortage of pharmacists (considering the population size), and the potential of the current pharmacists is not being utilized completely. Even the vast network of pharmacies across rural and urban areas are underutilized, which could have been leveraged to provide primary care in the underserved areas.

In India, though, the number of pharmacists in the country recorded healthy gains, rising from 5,78,179 in 2006 to 9,08,523 in 2017. However, the density of pharmacists only grew from 4.976 in 2006 to 6.784 in 2017. According to the WHO data, the number of the medical workforce has been steadily increasing in recent years, but the country’s ranking in these areas is far below developed nations. Rapid growth in prescription volume, cut-throat competition from online pharmacies, a lack of recognition and under-utilization of the skills are some of the factors contributing to low pharmacists’ density.

In a study conducted by the Health Parliament, India’s leading Healthcare Think Tank, it was revealed that 82% of pharmacists believe their potential is not being completely utilized and if given a chance, they could deliver more. The study findings also showed that 76% of the respondents feel there is a shortage of pharmacists. It was also seen that 51% of pharmacists feel that the vast existing network of pharmacies is not being leveraged fully to provide primary care in rural and urban areas. These study findings reveal that the profession and practice are both taking a hit, and because of this, we are facing a huge crisis in delivering primary care through our healthcare system. We need to act immediately to turn things around before things get out of hand.

Expanding the role of pharmacists: Study findings suggest that the pharmacists see a much broader role for themselves, which is more relevant in terms of; population and public health, health counsellors, primary care, legal pharma consultants and health coach. This gives us a sense of what pharmacists could be doing in the future when we talk about empowering them and re-orienting their roles.

We need to reimagine how we look at pharmacists and their role in the healthcare setting. We need to empower them by upskilling them and providing roles that deal with public health and primary care. We need to realise the role of pharmacists is much beyond just dispensing medicines. Given the fierce competition of online pharmacies, setting up pharmacies in rural areas should be incentivised and the pharmacists should be trained to provide comprehensive services ranging from patient education, counselling, prevention and management of chronic conditions. With the advent of Digital Health, we need to train them to use digital solutions to serve the community. Upskilling and training of pharmacists should not be limited to just computers; they should be made acquainted with IOT, wearables, remote patient monitoring, mHealth and Digital consultation tools.

We should have stringent laws in place to ensure only registered pharmacists dispense drugs, and patient counselling at the time of drug dispensing should be made mandatory. We need to have inclusive policies, and pharmacists should have a say in drafting and implementing policies related to their areas. Such policy interventions will go a long way in giving back the lost sheen of this profession and practice.

We need to take action quickly to empower pharmacists to strengthen the healthcare system and bring the lost glory back to the profession of pharmacy practice. The government of Odisha amending the act and allowing pharmacists to prescribe drugs are some futuristic steps to empower them.There is an urgent need to address these issues through appropriate policy reforms in pharmacy education and practice. Health Parliament is joining hands with the Indian Pharmacists Association for transforming the profession of pharmacy and pharmacy practice.

The complete report on pharmacists is available for download at the following link (

By Mevish P. Vaishnav, Chief Operating Officer, Health Parliament & Dr.Himadri Bisht works as a Senior Project Associate at Health Parliament, a Think – Tank dedicated to health policy and reform

(DISCLAIMER: The views expressed are solely of the author and does not necessarily subscribe to it. shall not be responsible for any damage caused to any person/organisation directly or indirectly.)

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