Table 4 Summary of policy actors and contextual factors serving as drivers and barriers and its outcome
Year | Actors, contextual factors serving as drivers | Actors, contextual factors serving as barriers | Outcome: changes in education and practice |
|---|---|---|---|
1880s - 1930 | Actors: Government built hospital (1878) Educators Professional regulators: Board of Examiners Contextual factors: Colonial era. Legislation of the profession (dispensers) through the enactment of Drugs and Poisons Ordinance No.14 of 1892. Government introduced village dispensaries | Contextual factors: Fewer indigenous people with minimum educational background Delayed legislation to reflect training in basic nursing | Education: Training of dispensers introduced Trainee title - Dispenser-in-training Certificate of Dispensing awarded Practice: Dispensing care (compounding and dispensing of prescriptions) and basic nursing in government hospitals and retail shops. Dispensers licensed as Druggists. |
1930–1939 | Actor: Secretary of State introduced ‘nurse-dispenser’ scheme Educators revised the curriculum Professional regulators: Board of Examiners Contextual factors: High demand for village dispensaries ‘Nurse-dispenser’ scheme already implemented in another British Colony [external context] | Contextual factors: The Drugs and Poisons Ordinance of 1892 not revised to reflect the new role of ‘nurse-dispenser’ | Education: ‘Nurse-dispenser’ scheme Curriculum revised Practice: Dispensing care and nursing including midwifery and sanitation in government hospitals, village dispensaries and retail shops. Nurse-dispensers licensed as Druggists |
1943–1960 | Actors: Medical Department revert to training nurses and dispensers separately Educators revised the curriculum Professional regulators: Pharmacy and Poisons Board Contextual factors: High demand for nurses Legislation of the profession (pharmacists) through the enactment of Pharmacy and Poisons Ordinance No.21 of 1946. Dispensing school relocated to Kumasi College of Science and Technology. Lesser number of pharmacists managing village dispensaries | Under the ‘nurse-dispenser’ scheme most individuals practiced as Druggists Under Pharmacy and Poisons Ordinance No.21 of 1946 ‘No registered pharmacist shall – give medical or surgical advice or aid except in his place of business and – i. In the case of simple ailments of common occurrence; ii. In the administration of antidotes in the case of acute poisoning; iii. In the application of immediate aid in cases of accident or injury, or iv. In urgent or emergent cases under the direct instructions of a medical practitioner’ | Education: Curriculum revised Certificate of Competency/ Diploma awarded Trainee title – pupil pharmacist introduced in 1946 Practice: Dispensing care (compounding and dispensing of prescriptions) and reduced role for nursing and medical care in hospitals, retail shop. Licensed as pharmacists. |
1961–2017 | Actors: Educators revised the curriculum Professional regulators: Pharmacy Board (Act 64) and Pharmacy Council (Act 489) Contextual factors: Kumasi College of Science and Technology gained a university status. Legislation of the profession through the passage of Pharmacy and Drugs Act, 1961 (Act 64) Act 64 repealed and replaced by Pharmacy Act, 1994 (489) National demand for pharmacists with clinical expertise Universities training pharmacists increased |  | Education: Curriculum revised BPharm degree awarded Department of Clinical and Social Pharmacy established Practice: Experts and advisers on drugs; compounding, preparing and dispensing prescriptions, pharmaceutical care in clinical and non-clinical settings: hospital, community, regulation, academia, industry Licensed as pharmacists |
2012 -date | Actors: Educators ECOWAS Ministers of Health Professional regulators: Pharmacy Council Other regulators: National Council for Tertiary Education and National Accreditation Board Pharmaceutical Society of Ghana Contextual factors: Demand for patient oriented pharmacists Pharmacy education evolved globally Global drive to train patient-oriented pharmacists e.g. ECOWAS harmonising pharmacists training Act 489 repealed and replaced by the Health Professions Regulatory Bodies Act, 2013 (Act 857) | Â | Education: Curriculum revised; longer experiential learning in clinical and non-clinical settings introduced PharmD awarded Practice: Experts and advisers on drugs, patient oriented care; compounding, preparing and dispensing prescriptions, pharmaceutical care in clinical and non-clinical settings: hospital, community, regulation, academia, industry Licensed as pharmacists |