A pilot study of the implementation of good pharmacy practice in private and public sector pharmacies in Nepal

Introduction: With limited awareness of good pharmacy practice (GPP) and weak regulatory enforcement in Nepal there is a need to investigate and assess adherence to GPP in private and public sector pharmacies. Methods: A cross-sectional pilot study assessed in 2021 adherence to GPP guidelines in selected private (n=20) and public (n=19) sector pharmacies in the capital district, and two districts within each two of seven provinces. Hospitals and primary health care centre were randomly selected while health posts and private pharmacies were selected based on their proximity to these. Trained data collectors and regulatory inspectors used two sector- specific, indicator-based electronic inspection tools aligned with World Health Organization best practices to uniformly assess GPP implementation in public and private facilities—58 joint indicators overlapped in the two sector tools. The indicators were classified by importance as critical, major, and minor. Results and Discussion: On average, public pharmacies passed slightly more (not significant) GPP indicators than private pharmacies—62% and 57% of the 58 joint indicators, respectively. The aggregated compliance percentage for critical, major and minor joint indicators was 72 vs. 75%, with outliers such as labelling and refrigerator monitoring which is around 90% noncompliance, 73 vs. 84% and 46 vs. 50% in the private and public sector respectively. The lowest compliance rate was found in the operating requirements domain with 10% for private and 15% for public sector facilities. Conclusion: Although private and public sector pharmacies have not yet fully implemented the new GPP guidelines, the government is moving forward with strengthening GPP legislation and regulations, building GPP capacity, and bolstering the GPP inspection function, which are needed to improve pharmaceutical services and thereby safeguard the people of Nepal.