Upscaling the pharmacy profession in Lebanon: workforce distribution and key improvement opportunities

Abstract

Background The critical role pharmacists play in the healthcare system necessitates close monitoring of their supply, distribution, and competencies. This is especially relevant considering the global increase in the demand for pharmacists. In Lebanon, the pharmacy profession is facing several challenges related to the unplanned supply of pharmacists. The aim of the study is to analyze the Order of Pharmacists registration database and generate workforce distribution over the last six decades. Methods This study entailed a detailed database analysis of a deidentified subset of the Order of Pharmacists in Lebanon registration records for years 1954–2018. The analysis generated workforce distribution in terms of growth in number, distribution by gender, age distribution, geographic location, workforce status, sector of employment, and employment position. A descriptive analysis was carried out with cross-tabulations to identify distribution across selected variables. Results The pharmacy profession in Lebanon witnessed significant growth over the period of analysis. The “Community” was the most common employment sector (63%), followed by “Pharmaceutical Sector” (24%) and “Hospitals” (5%). The high ratio of pharmacists to 10 000 population (20.3) was contrasted by a low ratio of hospital pharmacist per hospital and per 100 hospital beds (1.9 and 1.7, respectively). The high pharmacist to population ratio is indicative of an oversupply of pharmacists precipitated by poor workforce planning. While oversupply did not result in high unemployment, it may have negatively affected the income of pharmacists and their adherence to the professional and ethical requirements of their job. Despite the large number of pharmacists in Lebanon, findings elicit concerns over the adequacy and safety of pharmacists’ services in hospitals with a low ratio of hospital pharmacists to 100 hospital beds. Conclusion This study unearthed several opportunities and concerns related to planning the supply, distribution, regulation, and the professional scope of practice of pharmacists in Lebanon. A concerted multi-stakeholder effort to address some of the identified challenges will not only improve the professional status of pharmacists but will also enhance the safety and efficiency of pharmaceutical care in the country.

Developing the health workforce for universal health coverage

“…A good understanding of the dynamics of the health labour market is also a prerequisite; knowing how the participation rates, mobility patterns, aspirations and behaviour of workers will evolve is therefore critical. Certain countries have used this type of information to forecast requirements for skills and competencies in the health and social care workforce (United Kingdom of Great Britain and Northern Ireland), 9 improve the distribution of pharmacists (Lebanon) 10 and assess the planning implications of demographic change in the nursing workforce (Ghana). 11 Countries with a small population face additional challenges as they cannot expect to achieve economies of scale and be totally self-sufficient, for instance in the education of highly specialized health workers.…”

A Profession in Danger: Stakeholders’ Perspectives on Supporting The Pharmacy Profession in Lebanon

“…On the other hand, pharmacy graduates who studied outside the country can get easily licensed to practice after passing oral and written examinations [4]. A recent study showed that 29% of actively registered pharmacists in Lebanon have studied abroad [7]. Unlike Lebanon, many countries have developed a challenging and long-term process for foreign-trained pharmacists to be integrated in their health care system.…”

“…Perhaps more disconcerting, is the absence of a national health human resources forecasting model to advise on the current and future needs for pharmacists in Lebanon [4,7]. This has contributed to the lack of coordination between the educational and practice sectors.…”

“…For example, a previous study highlighted that pharmacists in Lebanon were underutilized in the hospital sector. The ratio of hospital pharmacists to hospitals was 1.9 pharmacists, with pharmacists mainly practicing their dispensary role rather than the much needed clinical responsibilities [7]. Other countries have enabled pharmacists to exercise their full scope, for example, community pharmacists in the UK have been involved in research to provide cost-effective and evidence-based support to communities and other healthcare professionals [17].…”

“…In fact, hospital pharmacists' roles are limited to dispensing medicines, compounding, and cost management. Thus, the clinical role is far from being achieved in Lebanon [7]. These ratios imply poor workforce planning and a generally poor regulatory environment.…”