Pharmacist's role in the health care services provision is advanced.

Effective practice of Clinical pharmacy services in health facilities fosters people's safety and is the vital responsibility of every hospital-based multidisciplinary team member. Clinical pharmacy services ensure effective medication management in the health facility, and effective and safe medicine use, improving the communities well-being. In Tanzania, it is believed that the role of a pharmacist in the health care system is only dispensing at the pharmacy. Thanks to the efforts of the Christian Social Services Commission (CSSC) and its partners' action medeor e.v and Muhimbili University of Health and Allied Science (MUHAS) role of pharmacists have been upgraded.

Pharm. Annette Kalimba is a pharmacist at Dodoma region referral hospital in Tanzania. She holds a degree in pharmacy from St. John's University in Tanzania and three years of experience in service. She explains her experience in her pharmacy career: "I have been dispensing since I started my career. I knew Clinical pharmacy services from my university studies but never practiced it.”

In 2021, CSSC through “Improving Training in Pharmacy through a Multi-Actor Partnership” (ITRAP/MAP) project funded by action medeor e.v collaborated with MUHAS and conducted a need assessment to identify the provision of clinical pharmacy services in Tanzania and found that: 96% had adequate knowledge on Clinical Pharmacy Services (CPS), 48.6% had a negative attitude towards CPS and 48.8% have poor practice on the provision of CPS. The pharmacists working in faith-based hospitals were three times more likely to rate CPS positively than those in private hospitals. At the same time, those at public facilities were four times more likely to rate CPS positively than those at private facilities. The findings revealed low participation in ward rounds, therapeutic management, and outpatient clinics. To intervene, the project supported the Muhimbili University of Health and Allied Sciences in launching a 10-day theory and practical short course on providing clinical pharmacy services for pharmacists of referral and zonal hospitals in Tanzania on February 2022.

Pharm. Annette is among twelve Dodoma region referral hospital pharmacists who attended the short clinical pharmacy services course conducted in May and July 2022 at Mbeya and Dodoma region referral hospitals, respectively. Previously, Pharm. Annette and the other pharmacists' role at the hospitals was to dispense Outpatient, Inpatient, Health Insurance, and Cash clients until after attending the short course.

“We lacked basic knowledge of the implementation of clinical pharmacy services. During the training at Mbeya region referral hospital, we learned and practiced attending ward rounds, customer care, and communication skills, and implementing clinical pharmacy services effectively.”

After the training, Pharm. Annette and colleagues presented the training report and proposed action plan to the hospital management, who were convinced to establish a Clinical Pharmacy Services Unit with a designated office and allocate pharmacists per ward. Each pharmacist has a ward to attend all major ward rounds together with other medical team members of the hospital. The pharmacists prepared their action plan and monthly schedule for attending the ward rounds and placed it in their office and hospital boards for their colleague’s information.

Explaining her experience prior to attending the clinical pharmacy services course Pharm. Annette says; “While at the pharmacy dispensing medicine, it was hard to understand the prescription. Sometimes before I provide a particular medicine as per the prescribed dosage, I may feel the dosage is too much for the patient or the medicine prescribed are all of the same group, and I would wish to observe a patient or ask for complete patient information from the doctor.”

“Currently, as we practice clinical pharmacy services, we have more time to interact with patients, observe and understand their condition, jointly as the medical team agrees on the medicine.”

Dr. George Mkila, the internal medicine doctor who always attends major rounds with the pharmacists, says, “We are so relieved to have pharmacists in our ward. At first, we couldn't understand they have more role to play, but having them has increased our teamwork, making our diagnosis easier and improving the quality of our healthcare service provision to patients. We share experience, and they advise us on the availability of medicine in the hospital and shares research and country's drugs information and status."

“Pharmacists play a big role here at Dodoma region referral hospital. They advise us on the proper medication based on the patient history, especially on drug interaction for people with special conditions like HIV/AIDS, hypertension, and other special needs. We believe this practice is a solution to the antimicrobial and drug resistance issue currently trending in our country. They are helping us a lot. We love having them in the wards. I wish we could have started this sooner.”

The nurse in charge of the wards, Grace Mlata appreciated the role of the pharmacists, she said “Thanks to you (CSSC and partners) for that training. Pharmacists have become a great help for us since they started practicing clinical pharmacy services. They advise us on adverse drug reactions and assist us in the fast recovery of the patients since they prescribe proper medicine timely.”

Dodoma region referral hospital have 13 pharmacists, 12 attended clinical pharmacy services course and among them 6 practice ward rounds while others dispense at the pharmacy and work at the medicine storage. One of the pharmacist trained, inspired to study further. She has started her Masters in Clinical Pharmacy at Muhimbili University of Health and Allied Science on private/individual sponsorship.

More than 100 pharmacists of 38 government, private owned and faith-based organizations referral, zone and specialized hospitals trained on Clinical pharmacy services and supervised by the Trainers of Trainees (TOTs) to ensure efficiency.

CSSC and its partners action medeor e.v and MUHAS through MAP/ITRAP project is committed to advocate and ensure effective implementation of CPS in the health facilities in Tanzania to improve quality of health care and well being of the community while closing the gap of shortage of pharmacists in the country.