Strengthening Primary Healthcare through accelerated advancement of the global pharmacy workforce: a cross-sectional survey of 88 countries.

Objective: Advancing the pharmacy workforce contributes to strengthening primary healthcare and accelerating progress towards universal health coverage. This study aimed to identify key enablers to support policy development for national pharmacy workforce advancement.

Design: A cross-sectional country-level questionnaire was distributed from July 2018 to March 2019.

Setting: National-level or country-level pharmacy workforce development policy.

Participants: Professional leadership associations and national agencies of the International Pharmaceutical Federation (FIP). The FIP global database included 129 countries.

Measures: The questionnaire was designed to collate data on the scope of advanced and specialist practice in respondent countries. Multiple correspondence analysis and subsequent cluster analysis were conducted to explore the associations and patterns of country-level attributes of systems in place for the pharmacy workforce advancement in order to develop a general transnational model for country-level advanced practice development.

Results: Eighty-eight countries (68.2% response rate) responded to the questionnaire. Factors that enhance and contribute to advanced practice policy development include the country's socioeconomic factors and the availability of national practice advancement concepts. The essential advancement concepts include the availability of framework and professional recognition systems, programmes assisting advanced practice development and workforce advancement and recognition opportunities. Cluster analysis identified three clusters of country respondents. First cluster included low-income and middle-income with poor pharmacy advancement implementation, second cluster included a higher socioeconomic status with weaker pharmacy workforce advancement implementation and third cluster included upper middle-income to high-income countries and high rates of pharmacy advancement implementation.

Conclusion: The key factors identified in this study can be used to support a transnational approach to pharmacy workforce advancement. The three clusters identified highlighted that workforce advancement was not an exclusive trait of higher-income countries. Lessons from countries that have already adopted concepts of advancement in pharmacy practice could be adopted to other countries to accelerate the progress of advanced practice globally.