Ethical Dilemmas in the Provision of Expanded Pharmacy Services During Public Health Emergencies
1
Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, Obafemi Awolowo University (OAU), Ile-Ife, Nigeria, Ile-Ife/Osun, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Limited access to hospital care was a challenge during the COVID-19 pandemic and heath-care seekers resorted to community pharmacists (CPs). This study investigated the attitudes of CPs towards provision of expanded services and the ethical dilemmas they encountered.
METHODS:
A descriptive cross-sectional study design was employed for a mixed data collection among CPs. Twenty-one participated in audio-recorded in-depth-interviews and 376 were surveyed in Southwestern Nigeria using a semi-structured pre-tested questionnaire (Cronbach ∞ =0.86), and an In-depth Interview guide. Comments were thematically analysed. Data from the survey were analysed using IBM SPSS version 25.
RESULTS:
Expanded services provided included paediatric treatments (56.3%), contraceptive services (30.1%), management of chronic conditions (43.7%), handling asthmatic emergencies (27.9%), and cardiopulmonary resuscitation (11.5%). Comments included, “…clients who could not go to the hospitals for their contraceptives come to us for pills instead” and opinions of CPs expressed were divided, “If it is an emergency, I think anything the pharmacist can do should be done”,“We respond using our discretion. There are no guidelines for our response to the ill and vulnerable clients this period” ”I think pharmacists should stick to the regulations of our service provisions…”, and, “I don’t do consultations”. Professional and economical ethical dilemmas were expressed in comments such as, “some of the services we provided were not what we were trained to do” “if community pharmacists don’t make money this period, I don’t know when they will”.
CONCLUSIONS:
Community pharmacists show a pragmatic response to emerging healthcare demands but the responses in the absence of formal frameworks remain largely discretionary and unregulated, and the economic upturn for some pose ethical dilemmas to pricing. Frameworks and guidelines should be updated and strengthened, and standard operating procedures should be developed to manage these services, ensuring uniformity and quality assurance during any future public health emergency.
Limited access to hospital care was a challenge during the COVID-19 pandemic and heath-care seekers resorted to community pharmacists (CPs). This study investigated the attitudes of CPs towards provision of expanded services and the ethical dilemmas they encountered.
METHODS:
A descriptive cross-sectional study design was employed for a mixed data collection among CPs. Twenty-one participated in audio-recorded in-depth-interviews and 376 were surveyed in Southwestern Nigeria using a semi-structured pre-tested questionnaire (Cronbach ∞ =0.86), and an In-depth Interview guide. Comments were thematically analysed. Data from the survey were analysed using IBM SPSS version 25.
RESULTS:
Expanded services provided included paediatric treatments (56.3%), contraceptive services (30.1%), management of chronic conditions (43.7%), handling asthmatic emergencies (27.9%), and cardiopulmonary resuscitation (11.5%). Comments included, “…clients who could not go to the hospitals for their contraceptives come to us for pills instead” and opinions of CPs expressed were divided, “If it is an emergency, I think anything the pharmacist can do should be done”,“We respond using our discretion. There are no guidelines for our response to the ill and vulnerable clients this period” ”I think pharmacists should stick to the regulations of our service provisions…”, and, “I don’t do consultations”. Professional and economical ethical dilemmas were expressed in comments such as, “some of the services we provided were not what we were trained to do” “if community pharmacists don’t make money this period, I don’t know when they will”.
CONCLUSIONS:
Community pharmacists show a pragmatic response to emerging healthcare demands but the responses in the absence of formal frameworks remain largely discretionary and unregulated, and the economic upturn for some pose ethical dilemmas to pricing. Frameworks and guidelines should be updated and strengthened, and standard operating procedures should be developed to manage these services, ensuring uniformity and quality assurance during any future public health emergency.
| eISSN: | 2654-1459 |
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