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Background: Primary health care (PHC) re-engineering forms a crucial part of South Africa’s National Health Insurance (NHI), with pharmaceutical services and care being crucial to treatment outcomes. However, owing to a shortage of pharmacists within PHC clinics, task-shifting of the dispensing process to pharmacist’s assistants and nurses is common practice. The implications of this task-shifting process on the provision of pharmaceutical services and care remains largely unstudied.Aim: The study aimed to explore the pharmacist-based, pharmacist’s assistant-based and nurse-based dispensing models within the PHC setting.Setting: The Nelson Mandela Bay Health District, South Africa.Methods: A mixed methods approach was utilised comprising of Phase 1: a pharmaceutical services audit to analyse pharmaceutical service provision and Phase 2: semi-structured interviews to describe the pharmaceutical care provision within each dispensing model thematically.Results: Pharmaceutical services partially fulfilled minimum standards within all models, however, challenges exist that limit the quality of these services. Phase 2 showed that the provision of pharmaceutical care within all models was restricted by context-related constraints, thus patient-centred activities to underpin pharmaceutical services were limited.Conclusion: Although pharmaceutical services may have been available for all models, compromised quality of these services impacted overall quality of care. Limited pharmaceutical care provision was evident within each dispensing model. The results raised concerns about the current utilisation of pharmacy personnel, including the pharmacist, within the PHC setting. Further opportunities exist, if constraints allow, for the pharmacist to contribute to better patient-centred care.

The various trajectories of the development of the Doctor of Pharmacy (Pharm D) programs in BRICS countries were reviewed individually, showing the progress of Pharm D programs in each context. Evidence from developed countries indicates that Pharm D programs have contributed towards the positive development of public health and a country's local health requirements, with well-trained clinical pharmacists having a key role in the health and economic development of these emerging powers. The health systems of BRICS countries are heavily challenged with a dual burden of disease, weak health infrastructure and public health initiatives. Thus, not only will the development of Pharm D programs in BRICS countries strengthen pharmacy education contributing to a pharmacy workforce more readily able to target health-related problems, demographic and epidemiological shifts; but will also better equip public health systems with more patient-centered pharmaceutical care necessary for evidence-based, individualized and cost-effective healthcare.

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Globally, ∼5.9 million children under the age of 5 years died in 2015, with the challenges of child mortality and morbidity being common in developing countries. Many of these deaths are preventable and poor nutritional and hygienic practices contribute greatly to these rates. The spread of infectious disease through unhygienic practices, such as inadequate hand hygiene, remains high due to lack of education regarding hygienic infection control practices at home and in the workplace. The aim of this research was to design and implement a participatory health promotion intervention for caregivers at the Rhodes Day Care Centre (RDCC) that highlighted these important public health issues. We conducted a pre-intervention group feedback discussion with caregivers at the RDCC to identify current practices and to establish the current baseline knowledge of the caregivers. Health workshops with caregivers was facilitated by the researcher, and health information leaflets (HILs) were designed for and used during these workshops. Caregivers at RDCC exhibited fair baseline knowledge on the importance of providing nourishing meals to the infants, including the need for exclusive breastfeeding, and the importance of hand hygiene in preventing the spread of disease. This basic knowledge was positively built upon in the two health promotion intervention workshops. This initiative, held at RDCC, was able to catalyse the development of health knowledge that could have a substantial impact on the understanding of health literacy of the caregivers and on the promotion of adequate child health in the community.