Assessment of Practice Details and Resource Availability of Community and Hospital Pharmacies in Mogadishu, Somalia

Introduction: Pharmacy has moved from dispensing to pharmaceutical care; pharmacists have a role in improving patient safety. Community and hospital pharmacy practice has a major impact on the health of the public. Standards of practice are not well defined and details of community pharmacy practice are unpredictable in Somalia and it is doubtful whether the practice is structured and follows prescribed standards. The resource availability profile has serious implications on the pattern of practice. The objectives of the present study were to identify routines activities performed in community and hospital pharmacies in Somalia and to determine the extent to which resource limitations affect the pattern of pharmacy practice. Methods: This study was a cross-sectional study conducted between October and December, 2019. It involved randomly selected 25 community pharmacies and 25 hospital pharmacies including the only 3 available public pharmacies in Mogadishu, Somalia. This study used a modified questionnaire based on current literature and it was designed to assess the respondents' demographics, resource availability of pharmacies surveyed and practice details of pharmacists. Pretesting of the questionnaire was done on 5 randomly selected pharmacies. Data were analyzed using SPSS (Statistical Package for Social Sciences) version 20.0 software. Descriptive statistics were used to report pharmacy employees' demographics [frequency and percentages; mean ±standard deviation (SD)]. Results: 50 distributed survey instruments were filled. Data analysis showed that only 12% of the pharmacy employees were pharmacists and that 86% of pharmacy employees give prescription drugs to patients without a prescription. Fifty percent (50%) of pharmacy employees admitted they administer an injection to patients. The rate of incoming prescriptions to pharmacies was generally low with 44% of pharmacy premises claiming that they had never received any prescriptions from private hospitals. Sixty percent (60%) of pharmacists surveyed admitted making drug recommendations to patients irrespective of the nature of the drug. Most pharmacies in the study had equipment to measure blood pressure, check body temperature, screen for diabetes and malaria. However many of them lacked necessary types of equipment required to measure body mass index, weigh patients, screen for high cholesterol levels; also tools that could facilitate more accurate dosing e.g., tablet cutter and tablet crusher were absent in most pharmacies. Conclusion: This study showed that resource availability of surveyed community and hospital pharmacies was average but the pharmacy practice standards were poor. No statistical difference was observed between both facilities. Prescribing and recommending drugs to patients; giving prescription drugs without prescription; not counseling the patients about their medications; practicing pharmacy by non-pharmacists are all activities that could have a negative impact on public health. Continuing education would be essential for pharmacists and pharmacy employees in promoting good pharmacy practice; practicing pharmacy by only pharmacists is recommended to avoid improper pharmacy practice.