Creating Better Opportunities for Pharmaceutical Training in Rural Parts of Tanzania

^{Video: Meet Faudhi, 19, a first-year pharmacy student at the Pharmaceutical Technical Institute in Mpanda}

In 2020, Sartorius supported the German medical aid organization action medeor with a donation to construct one classroom and contribute on the renovation and equipping of the compounding laboratory at a Pharmaceutical-Technical Institute (PTI) in Mpanda, Tanzania. Now the new, modernized classroom and laboratory have been completed, in cooperation with action medeor’s local partner organization Christian Social Service Commission (CSSC), and the school has officially opened, where middle cadre pharmaceutical students are already being trained. To find out more about how the project has progressed, the importance of pharmaceutical professionals in the country, and the challenges they face, Sartorius was able to interview Kathrin Rolka, a consultant for humanitarian aid and development cooperation in Tanzania at action medeor.

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Interview: How action medeor and their Partners are Improving Pharmaceutical Training in Tanzania

Kathrin Rolka, could you introduce yourself and action medeor’s project in Tanzania?

Of course! I have been working in the project department for action medeor since 2007 and our expertise is in pharmaceutical consulting. action medeor has had a branch in Tanzania since 2004, with 20 local employees working there. Over the years we have supported a variety of projects, including education, women’s rights, hygiene/education, and female genital mutilation. Since 2017, we have been working on improving the pharmaceutical education through a Multi-Actor-Partnership (MAP) with our partner organization CSSC in Tanzania. A focus in this project has been to improve quality of training offered to middle cadre pharmaceutical personnel by renovating and newly equipping a Pharmaceutical-Technical Institute in the rural town of Mpanda, which was made possible by Sartorius’ financial support.

Could you describe what the local situation was prior to the project?

Tanzania has a decent number of pharmacists on the academic and higher level of the profession. The midlevel pharmaceutical personnel, including the dispensers, pharmaceutical assistants and technicians, who are supposed to serve the more rural areas were limited in numbers. In 2009/2010 there were about 500 – which is not many, especially for a country of this size. Mpanda is in a very rural area that the Government wants to further develop as it is extremely underserved on all educational levels. Few pharmacists who were working in Mpanda were only available at township (Mpanda town) at regional or district and may only visit a rural area during supervision. In rural health facilities pharmaceutical services are offered by non-pharmaceutical staff such as nurses and in extreme cases medical attendants. Therefore, personnel who can take care of keeping a good stock of medications, correctly store the medicines, and be able to consult patients and offer alternatives if they do not have the recommended medication on hand are crucial. Explaining the provided drug or treatment is essential in rural areas to build a trust with patient.

We needed opportunities so young people would not have to travel to Dar es Salaam or Arusha for a pharmaceutical education but can stay in the area not only for training but their later career. 

Kathrin Rolka, Consultant for humanitarian aid and development cooperation in Tanzania at action medeor

What are the challenges regarding the middle cadre pharmaceutical education?

Back then, there were no regulations on what pharmaceutical training should look like. There were no standards at all, no curriculum, which meant that the schools taught to the best of their knowledge and experience. The quality of education was not comparable between schools. If students were lucky, they had a pharmacist standing in front of them who was eloquent and could convey the knowledge well.  In addition, there were very few technical schools, some of which were linked to colleges and universities. During those times, faith-based or private middle cadre PTI were almost non-existent. This prompted action medeor to support the formulation of the first curriculum in collaboration with the Kilimanjaro Schools of Pharmacy (KSP) and later with the Pharmacy Council. The efforts have contributed to the growth of the middle cadre pharmaceutical institution in the country.  Despite the growth PTI experienced, there was no middle cadre pharmaceutical training institution in Mpanda, so creating access to a high-quality education in the area was important. We needed opportunities so young people would not have to travel to Dar es Salaam or Arusha for a pharmaceutical education but can stay in the area not only for training but their later career.

Who was involved in this project and why?

The political interest in this topic grew as the demand and need for more and better educated pharmaceutical personnel grew.  Along with a variety of stakeholders, including the Ministry of Health, regulatory authorities, the Pharmaceutical Society of Tanzania (PST), and our local partner organization the Christian Social Service Commission (CSSC), our goal was to improve pharmaceutical education and care in Tanzania. These entities, along with teachers and pharmaceutical professionals, made up the MAP Project which is financially supported by the Federal Ministry for Economic Cooperation and Development (BMZ). The BMZ requested the building at Mpanda to be converted into a pharmaceutical training institution after the renovation of the compounding laboratory and the needed infrastructure, such as classroom.

What was achieved?

Two main things were achieved through the projects: a new curriculum and educational framework were developed and a Round Table for Improving Training in Pharmacy was established through the MAP Project, and the school in Mpanda was renovated to improve the infrastructure of the school for it to meet the new standards. Both have greatly improved the pharmaceutical education for students and those in Mpanda specifically will have better resources and a high-quality classroom in a rural area. The school and its compound already existed but needed renovations to modernize and meet the new standards developed through the MAP Project. That is where Sartorius came in – through the financial support we were able to renovate the building for the classroom and laboratory and received new equipment. Not only was the infrastructure of the classroom and laboratory improved, but the project was designed to be sustainable to the quality through preventive maintenance over time. 

How can we imagine what the program and teaching is like?

We immediately hit the ground running for the renovation project once we secured the sponsorship, as we wanted to open the new facilities and continue the students’ education as soon as possible. Teaching was happening throughout the period, but the new training started in October of 2021 and a total of 150 students have been accepted thus far.

There are three options for the education at the school, with each course building on the other. There is the dispenser course, which is one year, there is the pharmaceutical assistant course, which is two years, and there is the pharmaceutical technician course, which is 3 years. We are seeing that most students want to continue and finish the at least two-, if not three years of training, which is very positive. This curriculum was developed together with the Pharmacy Council in Tanzania. It is exciting to learn that the first batch of graduates at Mpanda HTI will graduate in October or November 2024. We are hopeful that, a good number of graduates will remain in rural areas of Mpanda.

What observations have you made about the project thus far?

As for students, interestingly there are slightly more women who are attending the school, not significantly more but slightly which is still impressive, as fields related to the natural sciences tend to be male dominated.

While there are application and admission requirements, and the students who are accepted must have good grades in school in scientific subjects, we have seen that there are gaps in knowledge. Students are especially confronted with those gaps in mathematics and English, as English is the official teaching language. Relevant stakeholders of the MAP are dealing with this challenge and discuss solutions during the Round Table. Feedback we received showed we needed to offer courses in relevant subjects, like math, chemistry, and physics. We now have short courses ranging from one to three months for students to be prepared for their pharmaceutical studies.

It is not only students who can receive additional training. Teachers need training in methodology and assessment too. As I mentioned earlier, teachers were not always well trained, the quality of education depended on who you got. Training in methodology and didactics as well as assessing students, such as pedagogy, was missing. So, within the MAP stakeholders like the Pharmacy Council, the Ministry of Health and the Center for Education Development and Health developed a four-week course, alongside the MAP and the teachers, to better train and prepare teachers for teaching. We actually have a WhatsApp group with colleagues, directors of the pharmaceutical technical schools and, teachers, graduates and students where lots of information is shared. It is a great communication tool, as we can share relevant information, can get feedback, and can discuss a variety of things. In addition, an E-Platform has been set up by colleagues of CSSC and the Catholic University of Health and Allied Sciences CUHAS to announce relevant information like Round Table meetings, symposiums, or publications in pharmaceutical education.  

Looking ahead: What are the biggest challenges for the future?

I think a challenge will be in e-learning. I would like to do more in this area, that is, to work more closely with teachers on content and give students access to literature that goes beyond the curriculum via the e-platform we built.

Something else that is not a challenge per se, but rather and exciting new opportunity is clinical pharmacy. Together with the BMZ, action medeor supports CSSC and the Muhimbili University of Dar es Salaam (MUHAS) is setting up studies to further elaborate on clinical pharmacy services in hospitals with the goal to have pharmacists advising the medical teams of nurses and physicians in medication of inpatients. Many other European countries are already doing this with success: fewer antibiotic resistances, counter reaction with other drugs or less side effects.

Meanwhile, the Pharmaceutical-Technical Institutes are popping up like mushrooms. While we need more pharmaceutical professionals and having them will improve the infrastructure and accessibility of healthcare in the country, on the other hand our partner CSSC and medeor need to support the regulatory authorities to enforce quality standards of the technical schools. It is currently a very exciting topic that is high on the agenda of the round table. In 2017 there were maybe 20-24, and it’s grown to around 73-75.

Something that is close to my heart is to see a young generation of women, in particular, in rural areas such as Mpanda being able to get this pharmacy middle cadre education.

Kathrin Rolka, Consultant for humanitarian aid and development cooperation in Tanzania at action medeor

Do you have a special wish for this project?

Something that is close to my heart is to see a young generation of women, in particular, in rural areas such as Mpanda being able to get this pharmacy middle cadre education. My hope is that they have a good time and receive high-quality training where they feel confident to register with the Pharmacy Council upon graduation. I hope that the many young women and men really take a passion for this profession with them, and that they feel it is a calling, and know how important it is. I also look forward to seeing the photos of the graduation ceremonies in one, two or three years, when these young women and men have completed their training and receive a good grade.