(P-151) Socio-epidemiological Approaches in Designing and Modelling Pharmacy Public Health Programs in Infectious Diseases Control in Developing Countries

Background: Developing countries in the majority have fragmented health care systems mainly because of either limited health care facilities or partial engagement of health care teams. Community pharmacies/staff remains one of the highly accessed resources/stakeholders for initial health-seeking in infectious disease by the population living in these countries. Although, the pharmacies are well-established for sale and dispensing the medications prescribed for infectious diseases to patients, their role in infectious disease prevention, health promotion, and active/passive case findings have not been elaborated well. In fact, the socio-cultural challenges and socio-epidemiological barriers are largely limiting the engagement of community pharmacies in public health roles in these countries.

Objectives: This study builds upon a large-scale national implementation (case-detection) trial conducted in a developing nation (i.e., Pakistan) with a high burden of infectious diseases and provides a way forward for designing similar interventions in infectious disease control in developing countries.

Methods: Using this systematic program planning approach, we studied the sequentially progressed steps of the community pharmacies referral network in Tuberculosis (TB) case detection in Pakistan; resource allocation, mapping, recruitment criteria, sampling frame development, training, implementation, and auditing. We also assessed the Implementation process data collected along with data on Tuberculosis patient screening and referral volume per pharmacy during this trial.

Results: Modeling Pharmacy Public Health Programs in Lower-middle-income countries need to incorporate the following indicators in developing guidelines for infectious diseases control in their countries:

Advocacy: Addressing the missing link of pharmacy inclusion into public health processes
Technology: Bridging the Urban Planning with Mapping Algorithms for feasible recruitment of pharmacies
Consent: Sequencing the willingness process to normalize the health services in pharmacies
Training: Capacity building of recruited pharmacies
Fidelity: Adopting hybrid implementation-effectiveness research designs (such as Capability, Opportunity, Motivation - Behavior Change Model)

Conclusions: Utilizing FACTT guidelines provide a socio-epidemiological way-forward not only to identify a specific method to improve the intervention design for infectious disease control, facilitate its scientific replication but also to develop an understanding of the nature of behavior to be changed with relevance to pharmacy professionals delivering healthcare and evidence-based public health in developing nations.