A national analysis of the pharmacy workforce in Indonesia

Meilianti, Sherly; Smith, Felicity; Kristianto, Franciscus Cahyo; Himawan, Roy; Ernawati, Desak Ketut; Naya, Rasta; Bates, Ian

doi:10.1186/s12960-022-00767-4

Cited by 7 publications

(8 citation statements)

References 22 publications

(30 reference statements)

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“…Thus, our finding of the low involvement of pharmacists in this type of care is plausible. A national study showed that young female pharmacists are more likely to engage in patient-centred activities,23 which might be the case for TB care, as we also found a higher proportion of young females (in their 30s) than male pharmacists working in hospitals, that is in line with that study.…”

Section: Discussionsupporting

confidence: 91%

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Multidisciplinary tuberculosis care: leveraging the role of hospital pharmacists

Iskandar,

Pradipta,

Anggriani

et al. 2023

BMJ Open Resp Res

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IntroductionOptimal pharmacological treatment of tuberculosis (TB) requires a multidisciplinary team, yet the hospital pharmacist’s role is unclear. We aimed to analyse hospital pharmacist-provided clinical pharmacy services (CPS) implementation in TB care.MethodA nationwide survey-based online cross-sectional study was conducted on hospital pharmacists in Indonesia from 1 November 2022 to 22 November 2022. Outcomes were the extent of pharmacists’ involvement in multidisciplinary TB care, TB-related CPS provided and views on TB-related CPS. The probability of pharmacists’ involvement in multidisciplinary TB teams was assessed using logistic regression.ResultsIn total, 439 pharmacists (mean age 31.2±6.22 years, 78% female) completed the survey. Thirty-six per cent were part of multidisciplinary TB care, and 23% had TB-related tasks. Adherence monitoring (90%) and drug use evaluation (86%) were the most conducted TB-related CPS. Pharmacists’ views on TB-related CPS implementation were generally positive, except for financial incentives. Work experience (OR 1.99, 95% CI 1.09 to 3.61), ever received TB-related training (OR 3.51, 95% CI 2.03 to 6.14) and specific assignments to provide TB-related CPS (OR 8.42, 95% CI 4.99 to 14.59) significantly increased pharmacist involvement in multidisciplinary TB care.ConclusionAround one-third of hospital pharmacists are part of multidisciplinary TB care, with medication adherence and drug use monitoring as primary tasks. Pharmacists’ experience, training, assignment to provide TB-related CPS and financial incentives are key elements for further implementation in multidisciplinary TB care. Pharmacists should proactively support current TB care and conduct operational research, sharing data with healthcare peers and fostering a collaborative multidisciplinary TB care team.

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Section: Discussionsupporting

confidence: 91%

“…Several strengths and limitations should be noted. A strength was the nationwide survey in Indonesia based on the sampling adequacy and participating pharmacist workforce proportion 23. The survey was extensively validated and reported according to the CHERRIES checklist.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary tuberculosis care: leveraging the role of hospital pharmacists

Iskandar,

Pradipta,

Anggriani

et al. 2023

BMJ Open Resp Res

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“…We observed that the proportion of female pharmacy students (74.4%) is higher than male pharmacy students (16.6%) in this study which is in line with national data showing that females will represent around 86% of pharmacists in Indonesia by 2030 [ 28 ]. We further observed that the level of knowledge of telepharmacy among pharmacy students in this study is lower than those of pharmacy students in Malaysia [ 21 ] and the USA [ 29 ] in which majority of the respondents also female pharmacy students.…”

Section: Discussionsupporting

confidence: 89%

Knowledge, perception, and willingness to provide telepharmacy services among pharmacy students: a multicenter cross-sectional study in Indonesia

Alfian,

Khoiry,

Andhika A. Pratama

et al. 2023

BMC Med Educ

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Introduction The coronavirus disease 2019 (COVID-19) pandemic accelerated the provision of telepharmacy services. However, little is known about the knowledge, perception, and willingness of pharmacy students as future key players in telepharmacy adoption to provide such a service, particularly in a setting without well-established telepharmacy services before the COVID-19 pandemic. Objective With this survey we aimed to assess the level of knowledge, perception, and willingness to provide telepharmacy services and to identify associated factors among pharmacy students in Indonesia. Methods We applied a multicenter cross-sectional study design with convenience sampling technique among pharmacy students in three public universities in Bandung City, Surabaya City, and Special Region of Yogyakarta, Indonesia. The knowledge, perception, and willingness to provide telepharmacy services were assessed using an online questionnaire. Ordinal regression analysis was performed to determine factors associated with a high knowledge level, whereas binary logistic regression analyses were performed to determine factors associated with a positive perception of telepharmacy services. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results Among 313 respondents, 83.4% were female, and the mean age was 20 years. Although only 13.2% showed a high knowledge level, 66.5% showed a positive perception of telepharmacy services and 97.4% were willing to provide telepharmacy services in the future. An increase in age (OR 1.33; 95% CI 1.14–1.54) and being advance in smartphone usage (OR 5.21; 95% CI 2.03–13.42) are associated with an increased likelihood of having a high knowledge level about telepharmacy services. Male students had a lower likelihood of having a positive perception of telepharmacy services than females (OR 0.46; 95% CI 0.24–0.85). Conclusion Despite limited knowledge of telepharmacy, the majority of pharmacy students reported a positive perception and willingness to provide telepharmacy services in their future careers. Therefore, telepharmacy practice models must be included as a subject course in the curriculum, better preparing future pharmacists to perform their roles effectively. Furthermore, student-specific factors such as age and expertise in smartphone usage that associated with knowledge and gender that associated with perception should be considered to facilitate telepharmacy adoption in Indonesia.

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“…However, the issue extends beyond mere numbers; the distribution of these workers plays a critical role in ensuring that all regions, irrespective of their geographic or demographic characteristics, have access to adequate healthcare services. This challenge is further compounded by the issue of healthcare workforce production in Indonesia, which is not accompanied by equitable distribution [8][9][10] . The imbalance in the distribution of health workers, particularly in a geographically diverse country like Indonesia, presents a multifaceted challenge that needs comprehensive analysis and targeted interventions 11 .…”

Section: Introductionmentioning

confidence: 99%

The Indonesia Health Workforce Quantity and Distribution

Muharram,

Sulistya,

Swannjo

et al. 2024

Preprint

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BackgroundIndonesia, the world’s largest archipelago, faces unique challenges in distributing its health workforce across its diverse geographic barriers, leading to disparities in health worker number and distribution. By dissecting the distribution patterns and identifying areas of critical need, the research seeks to inform policy interventions that can more effectively bridge the gap on health worker quantity and inequity.MethodsWe conducted a descriptive analysis of healthcare workforce data across all 514 districts in Indonesia. The study focused on five categories of health workers: General Practitioners (GPs), medical specialists, dentists, nurses, and midwives. We calculated the health worker ratio to determine the availability of healthcare workers relative to the population. To evaluate the distribution of these workers, we employed the Gini Index as a measure of distribution equality. Additionally, we conducted a comparative metric approach to assess both the quantity and the equity of healthcare worker distribution across the districts.ResultsIn Indonesia, the current health worker ratio stands at 3.84 per 1000 population, falling short of the WHO’s threshold of 4.45 for achieving 80% Universal Health Coverage. This shortfall translates to a need for an additional 166,000 health workers. Our analysis reveals a varied distribution of health worker categories: while midwives show a relatively equitable distribution, specialists and dentists exhibit significant inequality, especially at the district level. The Gini Index, used to measure this inequality, indicates greater disparities at the district level compared to the provincial level. There has been notable progress in the distribution of medical specialists across provinces, with the between-provinces Gini Index for specialists decreasing from 0.57 in 1993 to 0.44 in 2022. However, the inter-district Gini Index remains high at 0.53 in 2022, signifying a concentration of specialists in major cities and provincial capitals.ConclusionThis study shows that human resources for health in Indonesia suffer not only in quantity but also in distribution. Our finding underscores the importance of considering inter-province and inter-district disparities to tailor policies to tackle unique problems each region faces.Evidence Before StudyPrior research has established that the quantity and distribution of health workers are critical factors in improving life expectancy and are fundamental components of the health system.Following Indonesia’s constitutional changes in 2001, which included the autonomy and decentralization of healthcare services, assessing the number of health workers at the district level has gained significant importance for determining national healthcare needs.There has been a notable gap in studies analyzing the quantity and distribution of health workers in Indonesia’s district level. Previous research often missed the nuances of district-level challenges, focusing instead on broader, national-level assessments.What This Study AddsFirst National Study on Health Workforce:This is the first study of health workforce quantity and distribution at Indonesia’s National level. so this paper serves as a basic reference for future researchQuantitative Analysis of Distribution Equity:Utilizing the Gini Index, the study quantifies the level of inequality in the distribution of healthcare workers, offering a clear metric to guide policymakers in assessing and addressing regional disparities.Identification of Regional Variations:The study highlights significant regional variations, with some provinces showing an inequitable distribution of health workers, demonstrating a critical need for increased healthcare personnel and better distribution strategies.Dual-dimensional assessment:The study introduces a quadrant comparative approach that simultaneously evaluates the quantity of healthcare workers and the equity of their distribution across Indonesian provinces. This dual-dimensional analysis is a significant methodological advancement, providing a more holistic understanding of healthcare workforce allocation.How This Study Might Affect Research, Practice, and/or PolicyThis study has the potential to become the basis of policy-making related to the distribution of health workers and provide constructive feedback and strategical insights that could be utilized to decrease the gap between health workers and their maldistribution.

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A national analysis of the pharmacy workforce in Indonesia

Cited by 7 publications

References 22 publications

Multidisciplinary tuberculosis care: leveraging the role of hospital pharmacists

Multidisciplinary tuberculosis care: leveraging the role of hospital pharmacists

Knowledge, perception, and willingness to provide telepharmacy services among pharmacy students: a multicenter cross-sectional study in Indonesia

The Indonesia Health Workforce Quantity and Distribution

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