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43Introduction to Social Pharmacy
S. FIP development Elements
No. goals
Workforce Practice Science
the workforce to support the centered professional characteristics leading to
delivery of people-centered services to support the innovative personalized
care in practice prevention, screening, approaches for improved
clinical management, and people-centered care
therapeutic optimization
of non-communicable
diseases (NCDs) and long-
term conditions (LTCs)
including cardiovascular
diseases, chronic respiratory
conditions (such as asthma
and chronic obstructive
pulmonary disease COPD),
diabetes, cancer, mental
health conditions, dermato-
logical conditions, and others
16. Communicable Education and training infra- Strategies and people- Capacity to monitor and
diseases structures are in place to develop centered professional servi- respond to communicable
a workforce prepared to deliver ces for the prevention, with innovative approa-
quality services around commu- surveillance, management, ches for prevention and
nicable and vector-borne and therapeutic optimiza- treatment
diseases tion of communicable and
vector-borne diseases
(Contd.)
44 Social Pharmacy
Table 1.3: FIP development goals (contd.)
S. FIP development Elements
No. goals
Workforce Practice Science
17. Antimicrobial Strategies and systems in place Infrastructures and frame- Promote research and
stewardship to develop a pharmaceutical works in place to deliver development of new anti-
workforce prepared to deliver services for antimicrobial microbials, new antimicro-
quality services for anti- stewardship bial combinations, and
microbial stewardship new techniques and evalu-
ate the impact of antibiotic
stewardship programs
18. Access to Strategies in place to widen Systems in place to optimize Access to innovative
medicines, access to medicines and servi- access to effective medicines science and information,
devices and ces through a responsive, and pharmaceutical care new/innovative therapies,
services capable, available, and well- services through appro- and new delivery/
distributed pharmaceutical priate supply chains, quality manufacturing processes
workforce quality standards, self-care
and prevention services, and
affordability and fair pricing
policies
19. Patient safety Workforce and education strate- Patient safety mechanisms Safety in the development
gies linked to patient safety linked to reducing medi- and use of medicines is
mechanisms and reducing cation-related harm, quality promoted through the
medication-related harm in assurance processes, and advancement of drug
practice legislation and regulations safety science
20. Digital health Enablers of digital transforma- Systems and structures are Application of digital
tion within the pharmacy work- in place to develop and technology in healthcare
force and effective processes deliver quality digital health delivery and development
(Contd.)
45Introduction to Social Pharmacy
S. FIP development Elements
No. goals
Workforce Practice Science
to facilitate the development of and pharmaceutical care of innovative medical
a digitally literate pharmaceu- services through the digital products
tical workforce literacy and utilization of
technology and digital
enablers, and the configu-
ration of responsive digital
services to widen access
and equity
21. Sustainability in Strategies and systems in place Policies, regulations, and Scientific strategies and
pharmacy that utilize the workforce to strategies to ensure the policies are in place to
enhance sustainable pharmacy sustainability of the maintain a consistent
and services environment and minimize supply of medicinal
the impact of pharmaceu- products throughout the
ticals and pharmacy lifecycle while limiting
practice, but also the negative consequences for
appropriate mechanisms the environment
to ensure the sustainability
of pharmacy practice itself,
through appropriate
remuneration models for
pharmaceutical services
The FIP DGs also allow for research and evaluation by universities working with member organizations
and pharmacy and health leadership bodies, allowing a framework for national funding for development,
and maps to national policy initiatives.
46 Social Pharmacy
REVISION QUESTIONS
Long Answer Questions (10 Marks)
1. Define social pharmacy. Explain the scope of social
pharmacy.
2. Discuss the role of pharmacists in public health.
3. What do you mean by ‘health’? Explain different concepts
of health.
4. Discuss the important dimensions of health.
5. Give a brief account of different determinants of health.
6. What are indicators of health? Explain different indicators
of health and their uses.
7. Discuss National Health Policy.
8. Discuss the millennium development goals.
9. Discuss the sustainable development goals.
10. Explain the goals of the International Pharmaceutical
Federation (FIP).
11. How do the following differ?
a. DALYS and QALY
b. Virulence and pathogenicity
c. Prevalence rate and incidence rate
Short Answer Questions (5 Marks)
1. Define and explain social pharmacy.
2. Critically examine the different definitions of health.
3. Describe the role of heredity and environment as determi-
nants of health.
4. Explain the terms “Crude death rate”, “Age and sex-
specific death rate” and “Infant mortality rate”.
5. Write the goals of NHP (2017).
6. Discuss the principles of the National Health Policy.
7. What is the difference between public and private health
systems in India?
8. Write the goals of NUHM.
9. How do the following differ:
a. Mental health and spiritual health.
b. Determinants of health and indicators of health.
47Introduction to Social Pharmacy
Very Short Answers Questions (2 Marks)
1. Define Mental Health.
2. Define Infant Mortality Rate.
3. What is spiritual health?
4. What are morbidity indicators?
5. What is DALY?
6. What is HALE?
7. What is the prevalence rate?
8. What is the incidence rate?
9. What is the relationship between prevalence and
incidence?
10. Write the aims of NHM.
Multiple Choice Questions [answers are in bold]
1. Which of the following dimensions is included in the WHO
definition of health?
a. Physical
b. Mental
c. Social
d. All of the above
2. Which of the following indices are used for measuring
disability?
a. Sullivan’s index
b. HALE (health-adjusted life expectancy)
c. DALYs (disability-adjusted life years)
d. All of the above
3. Sullivan index is:
a. Expectation of life free of disability
b. Expectation of total life
c. Expectation of life at 25 years of age
d. Average life expectancy
4. Prevalence is related to incidence by equation:
a. Prevalence = incidence × duration
b. Incidence = prevalence × duration
c. Prevalence = incidence – duration
d. Incidence = prevalence – duration
48 Social Pharmacy
7. The number of years of healthy life of a person lost due to
premature mortality, mortality, or disability is known as:
a. HALE
b. DALYs
c. Sullivan’s index
d. QALY
8. The ability of an infectious agent to invade, multiply, and
produce infection in a host is known as:
a. Infectivity
b. Pathogenicity
c. Virulence
d. Prevalence
9. According to the ASHP statement, what is one of the roles
pharmacists can play in public health-related activities?
a. Performing surgeries
b. Designing healthcare policies
c. Developing and implementing disease prevention
programs
d. Conducting medical research
10. How many Millennium Development Goals (MDGs) were
established?
a. 5
b. 8
c. 10
d. 12
11. Which organization works with partners to support
national efforts to achieve the health-related MDGs?
a. United Nations Environment Programme (UNEP)
b. World Trade Organization (WTO)
c. International Monetary Fund (IMF)
d. World Health Organization (WHO)
12. When were the Sustainable Development Goals (SDGs)
adopted by the United Nations?
a. 2000
b. 2010
c. 2015
d. 2020
49Introduction to Social Pharmacy
13. How many Sustainable Development Goals (SDGs) are
there?
a. 10
b. 15
c. 17
d. 20
14. In what year did FIP launch the FIP development goals?
a. 2019
b. 2020
c. 2021
d. 2022
15. Which organization is FIP in official relations with?
a. United Nations (UN)
b. World Trade Organization (WTO)
c. World Health Organization (WHO)
d. International Monetary Fund (IMF)
16. What is the primary focus of social pharmacy?
a. Clinical diagnosis
b. Medicinal chemistry
c. Social aspects of pharmacy practice
d. Pharmaceutical manufacturing
17. According to the ASHP statement, what is the pharma-
cist’s role in public health?
a. Dispensing medications only
b. Participating in public health efforts
c. Conducting clinical trials
d. Managing drug product shortages
18. What does the ecological concept of health emphasize?
a. Absence of disease
b. Dynamic equilibrium between man and the environ-
ment
c. Genetic makeup
d. Social support systems
50 Social Pharmacy
INTRODUCTION
All of us have heard that prevention is better than cure.
Preventive healthcare encompasses a set of health services
meant to screen and possibly identify health issues before
symptoms develop. Preventive healthcare helps us live longer
and healthier lives.
Preventive healthcare improves our health in the long-run;
it increases lifespan and avoids high medical expenses. People
need to understand the importance of preventive healthcare
because one has to spend a lot of money on fixing a problem
rather than preventing it in the first place. Preventive health is
the key to helping us stay healthy and detecting health
problems early on before they cause other issues or become
more difficult to treat.
ROLE OF PHARMACIST IN DEMOGRAPHY AND FAMILY
PLANNING
DEMOGRAPHY
Demography is the scientific study of the human population.
It is mainly concerned with:
1. Change in population size.
2. Composition of population.
3. Distribution of population.
These three phenomena related to fertility, mortality,
marriage, migration, and social mobility; are commonly known
as demographic processes.
2
Preventive Healthcare
51Preventive Healthcare
Census: The process of complete counting of all individuals
in a country on a fixed date is known as census. In India, the
first census took place in 1881, and the last in 2011. It is being
conducted once every 10 years ending with the digit 1. Hence
next census was due in 2021 but was postponed due to COVID-
19. According to the 2011 census world population was around
2 billion and India’s population was 1.2 billion. The population
growth rate of India was estimated to be less than 2 percent.
Demographic gap: It is the difference between birth rate
and death rate. The wide demographic gap leads to a
population explosion. Four major population problems of India
are: (i) Rapid growth of population; (ii) disproportionate gender
composition; (iii) poor standard of living, and malnutrition,
and iv) unemployment.
Demographic transition: Demographic transition comprises
stages through which countries pass in their history from a
situation of high birth rate and high death rate to a situation of
low birth rate and low death rate. With a population of
1.4 billion, India accounts for about 17.5% of the world’s
population, 1 of every 6 people on the planet lives in India.
India is currently at a stage of demographic transition with a
substantial percentage of the youth population. India is
projected to surpass China as the world’s most populous
country in 2023.
Demography cycle: The history of the population of any
country follows a definite pattern called the demographic cycle,
which consists of five demographic stages (Table 2.1).
a. First stage (high stationary stage): This phase is characte-
rized by a stable population with a high birth rate and high
death rate.
b. The second stage (early expanding stage): This phase is
characterized by rapid population increase with a high
birth rate but declining death rate.
c. Third stage (late expanding stage): This phase is characte-
rized by a slight increase in population. The birth rate
starts declining while the death rate declines much faster.
52 Social Pharmacy
d. Fourth stage (low stationary stage): This phase is characte-
rized by a stable population with low birth and low death
rates.
e. Fifth stage (declining stage): This stage is characterized by
a fall in population. The birth rate is lower than the death
rate.
Thus, the demographic cycle is based on a population
balance equation:
Population = births – deaths
Different stages in the demographic cycle are summarized
in Table 2.1
Table 2.1: Stages in the demographic cycle
Stage Birth Death Population Examples
rate rate
First stage High High Stationary India (till 1920)
(high stationary)
Second stage High Decline Increase Africa and
(early expanding) South Asia
Third stage Decline Further Slight India
(late expanding) decline increase
Fourth stage Low Low Almost Austria
(low stationary) stationary
Fifth stage Lower than Low Decrease Hungary and
(declining) death rate Germany
The growth rate is the net difference between the crude birth
rate and the crude death rate in any country. It measures the
growth of the population. A decrease in population means a
negative growth rate.
The sex ratio is the number of females per 1000 males.
Fertility means the actual bearing of children. A woman’s
fertile age ranges between 15 and 45 years. During this period
a woman may give birth to children.
Total fertility rates It is the average number of children that
would be born to a woman if she experiences the current
fertility pattern throughout her reproductive life period
(15–45 years).