Involvement and practice of community pharmacists in maternal and child health services: A systematic review

Introduction: Community pharmacists are pivotal in the provision of Maternal and Child Health (MCH) services, yet level of involvement, practice and barriers and facilitators in providing these services is largely unknown. Objective: The objective of this review is to summarize available evidence on the involvement and practice of community pharmacists in MCH services. Methods: Seven electronic databases (PubMed, CINAHL, ProQuest Health, Cochrane library, Scopus, Embase, and Web of Science) were searched for articles published in English since inception of the database to November 30, 2019. Papers were included if they assessed involvement and practices of community pharmacists in maternal and child health services. Full articles identified and included for the final analysis were assessed for quality using the Mixed Method Appraisal Tool (MMAT) (2018) by all authors and data were extracted by one author and cross-checked by all authors. Result: A total of 2830 articles were identified. Following the assessment against the inclusion criteria, 14 full text articles were included for the final analysis. In eight studies, community pharmacists were reported to have involvement in maternal health services, in terms of providing breastfeeding guidance, counselling about the benefit of vitamins during pregnancy, provision of emergency contraception advice, and responding to illness symptoms such as back pain. In three studies, community pharmacists were providing advice in managing acute diarrhea in children. Medication use services and counselling about medication for children were also reported in three studies. Perceived consumer attitudes, problem with insurance coverage, lack of time among pharmacists and lack of incentives for the services provided were reported by pharmacists as the main barriers to service provision. Conclusion: Community pharmacists were involved in various MCH services in community pharmacy settings. However, the extent of practices was not as per the joint International Pharmaceutical Federation (FIP)/World Health Organization (WHO) guidelines on good pharmacy practice in some services such as management of diarrhea.