Hospitals, community health clinics, and some primary health care clinics have pharmacists manning the sites, but with the mandate to scale up treatment and the skills gap in South Africa, Kheth’Impilo recognized a need for pharmacy support personnel to strengthen pharmacy services. The Elton John AIDS foundation funded a training programme to train pharmacist assistants, and further funding contributions towards the training programme were received from USAID Public Private Partnership, the Health and Welfare SETA, and SASIX.
The pharmacist assistant learnership programme has now successfully surpassed the 800 mark in 2015, offering more than 800 learnerships since inception of the programme in 2011. 635 qualifications have been completed and another 242 learners are currently in progress with their pharmacist assistant training. Training takes place in Western Cape, Eastern Cape, KwaZulu-Natal and the Free State.
Kheth’Impilo Pharmaceutical Services aspire to improve health systems through three main focus areas: (1) improved quality of pharmacy and patient care; (2) continual uninterrupted provision of essential medication; and (3) ongoing innovations.
Improved Quality of Care
Since 2012, the Kheth’Impilo pharmacy department changed focus from direct service delivery to Technical Assistance and Health System Strengthening. Kheth’Impilo roving pharmacists focus on the continual coaching and mentoring of post basic pharmacist assistants and nurses at facility level.
Monthly audits review general Good Pharmacy Practise (GPP) compliance of the dispensaries, stock control and availability, the quality of prescribing as well as the quality of counselling provided to the patients. Quarterly pharmacy assessments are used in all facilities we support to analyse progress and identify areas in need of focussed support.
Kheth’Impilo is currently working with the NDOH on the expansion and improvement of the national Pharmacovigilance programme. The reporting of adverse drug reactions is of utmost importance in the ongoing management of HIV and TB programmes. Kheth’Impilo continues training, implementation and support of the Pharmacovigilance program.
Indirectly supervised post basic pharmacist assistants and roving pharmacist assistants are responsible for quality provision of essential drugs according to the National Core Standards and Essential Drug List. Mentoring and support by pharmacists focuses on daily stock management as well as the development of skills for stock procurement and forecasting.
The success of this intervention is measured on a monthly basis by looking at two specific indicators. Firstly, Kheth’Impilo measures the value of expired medication as a percentage of the total facility stock value, and secondly, reports on essential drug availability.
The load on the pharmacy staff is greater than ever with the rapid increase in the number of patients remaining in care and the integration of HIV, TB and, in many cases, also the treatment of non-communicable diseases. The environment does not allow for the increase in capacity and infrastructure at the same rate as growing patient numbers.
Meeting this growing demand requires new innovative methods of working to increase output while maintaining quality of patient care and reducing the number of patients at the Public Health Centres daily.
National Pharmaceutical Manager
National Pharmaceutical Manager
Lizette Monteith National Pharmaceutical Manager Lizette is a Pharmacist specializing in advanced health management. She has co-authored several publications around the impact of Pharmacist assistants and pharmacy services, specifically relating to antiretroviral treatment and improving patient care in a public health setting. Lizette worked in the United Kingdom for 5 years before she joined Absolute Return for Kids SA in 2008. She joined Kheth’Impilo in 2009 where she pioneered the Pharmacist Assistant Learnership program as a public health solution targeting unemployed youth in South Africa. Her extensive experience and international exposure allowed her to implement a unique approach to improve pharmaceutical health care in the public sector.