CASE DESCRIPTION: Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste.
DISCUSSION AND EVALUATION: These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders.
CONCLUSIONS: Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.
Methods: A qualitative design was conducted on community pharmacists in Baghdad, Iraq. Pharmacists were selected conveniently from different gender, age group, pharmacy type and years of experience. Face-to-face semi-structure interview was used with all the pharmacists to get in-depth understanding about their dispensing practice of antibiotics without prescription in community pharmacy. The data was coded and classified for thematic analysis.
Results: This study found that dispensing of antibiotics without prescription was a common practice in community pharmacy. Pharmacists' perception towards dispensing antibiotics without prescription was associated with the medical condition, safety and efficacy of antibiotics, patients request antibiotics by name, emergency cases, regular customer, promotions from pharmaceutical companies, saving time and cost, brand medications, and poor healthcare services. In addition, there were inadequate knowledge about antibiotic resistance and lack of awareness about antibiotic stewardship leading to inappropriate dispensing practice.
Conclusions: Community pharmacists have poor perception towards dispensing antibiotics without prescription. Educational interventions about antibiotics use focusing on community pharmacists are needed. This will help to optimize the practice of dispensing of antibiotics in the community. In addition, training programs about antibiotic resistance are important to enhance pharmacists' understanding about antibiotic stewardship.