Research | Open Access | Volume 9 (4): Article  163 | Published: 12 Oct 2026

Health system resilience in action: Lessons from Ghana’s pharmaceutical workforce during the COVID-19 pandemic

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Table 1: Distribution of key informants by pharmaceutical sector

Keywords

  • Pharmacist
  • Ghana
  • COVID-19
  • Pharmaceutical care
  • Public health

Ekua Trebea Aikins1,&, Thelma Ohene-Agyei1, Mark Anum Nortey2

1School of Pharmacy, University of Ghana, Accra, Ghana, 2University of Ghana School of Public Health, Accra, Ghana

&Corresponding author: Ekua Trebea Aikins, School of Pharmacy, University of Ghana, Accra, Ghana, Email: trebea.oacquaah@gmail.com ORCID: https://orcid.org/0009-0001-6656-8040

Received: 21 Oct 2025, Accepted: 08 Oct 2026, Published: 12 Oct 2026

Domain: Health Systems Strengthening

Keywords: Pharmacist, Ghana, COVID-19, Pharmaceutical care, Public health

©Ekua Trebea Aikins et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Ekua Trebea Aikins et al., Health system resilience in action: Lessons from Ghana’s pharmaceutical workforce during the COVID-19 pandemic. Journal of Interventional Epidemiology and Public Health. 2026; 9(4):163. https://doi.org/10.37432/jieph-d-25-00249

Abstract

Introduction: Health emergencies function as stress tests for health systems, exposing structural weaknesses while revealing adaptive capacity within critical workforce sectors. This study examines how Ghana’s pharmaceutical workforce contributed to health system resilience during the COVID-19 pandemic, positioning the crisis as a case study for future emergency preparedness.
Methods: A qualitative multisector study was conducted using key informant interviews across hospital, community, regulatory, academic, industrial, and professional association sectors. Document review complemented the interviews. Data were analyzed using thematic analysis to explore adaptive roles, system integration, and institutional responses during the pandemic.
Results: Four major themes emerged: the multi-faceted nature of pharmaceutical practice, challenges and threats posed by COVID-19 to the practice of pharmacy, adaptive contributions and innovations under crisis conditions, and post-COVID innovations and public perceptions. Pharmacists contributed to national treatment protocol development, vaccine logistics (including drone-enabled distribution), accelerated regulatory processes, pharmacovigilance strengthening, local manufacturing of IPC commodities, digital service expansion, and continuity of chronic disease care. These contributions reflect cross-sector coordination, regulatory agility, and workforce adaptability central to health system resilience.
Conclusion: Ghana’s experience demonstrates that pharmacists are critical actors in health system resilience and emergency preparedness. Embedding pharmaceutical expertise within preparedness planning, regulatory reform, workforce development, and local production strategies will be essential to strengthening national response capacity in future public health crises.

Introduction

The COVID-19 pandemic uncovered latent structural weaknesses within the global health system, especially for resource-constrained settings that are already grappling with gaps in workforce capacity, supply chain readiness, and health governance issues [1,2]. Health system resilience – often described as the capacity for health systems to absorb the shocks and pressures, adapt to disruptions while maintaining core functions – was placed on a stress test globally during COVID-19 [3], accordingly, various national health systems responded as best as they could to protect their populations and mitigate the devastating impact of the pandemic [3,4].

Across the globe, pharmacists took on expanded roles during the pandemic including vaccination support, development of protocols, management of chronic diseases, public health education and pharmacovigilance [5,6]. Their professional roles moved beyond compounding and dispensing to embrace a more patient-centred role [6,7]. They offered patient care, counselling, and continuity of treatment for common illnesses such as malaria, tuberculosis, and HIV, while hospitals were overwhelmed by COVID-19 [2,8]. Pharmacists across hospital, regulatory, industrial, and community sectors worked to ensure the availability of essential medicines and supplies [8–10]. Community pharmacists, in particular [11], expanded healthcare access through electronic platforms, serving patients with chronic conditions unable to visit hospitals regularly [12,13].

While governments focused on recruiting additional doctors, nurses, and other healthcare professionals to support COVID-19 testing and treatment [14,15], pharmacists demonstrated their ability to devise innovative approaches to safeguard public health in various communities. Ghana’s Ministry of Health witnessed a significant surge in health worker recruitment, with a reported 35% increase, totalling 45,107 newly employed health workers within the public sector [16]. Most were nurses and midwives (76%), while pharmacists accounted for less than 1% sparking controversies and debates [17]. Though some isolated reports have described some sector-specific activities [8,18], there is limited multi sector analysis examining how pharmacists collectively adapted across hospital, community, industrial, regulatory, academic, and policy domains; and what these adaptations reveal about pharmaceutical workforce governance and system preparedness. A comprehensive assessment of these adaptations offers an opportunity to move beyond documentation toward structural analysis. COVID-19 offers a critical case study for examining how pharmaceutical systems respond under stress, where bottlenecks emerge, and which innovations have potential for institutionalization. This study, therefore, provides a comprehensive, multisector analysis of pharmacists’ adapted roles during COVID-19, generating insights on what these adaptations reveal about health system resilience, workforce governance, and emergency preparedness in a lower-middle-income context.

This study addresses these questions: How did Ghanaian pharmacists across multiple sectors expand their roles during the COVID-19 crisis? Which pandemic innovations demonstrate the potential for strengthening future emergency preparedness? By contextualising Ghanaian pharmacists’ contributions within a resilience governance framework, this study provides relevant insights for integrating the expertise of pharmacists into national health emergency strategies.

Methods

Study design
This study utilised a descriptive qualitative design to examine the roles played and contributions of licensed pharmacists in Ghana across different sectors during the COVID-19 pandemic. A qualitative approach was appropriate as the study sought to gather in-depth information, insights and experiences of pharmacists who were active in the COVID-19 fight [19].

Study setting and participants
The study was conducted in Greater Accra, the region most affected by the pandemic and a major hub for pharmaceutical services. It involved 30 key informants across seven sectors: hospital pharmacy, community pharmacy, academia, industrial practice, regulatory and policy institutions, ethical pharmaceutical industries, and professional pharmacy associations (Table 1). Participants were recruited through purposive and snowball sampling, with two to five pharmacists selected from each sector. Recruitment continued until thematic saturation was achieved [19,20].

Data collection
Data collection combined key informant interviews and document review in an iterative process. Interviews were semi-structured, lasted 45 –75 minutes, were audio-recorded, and transcribed verbatim. A second researcher checked the transcripts against the audio recordings to verify transcription accuracy. Interviews were conducted in person, by phone, or via Zoom, with informed consent obtained. A semi-structured interview guide was used to explore participants’ professional roles, challenges experienced during the COVID-19 pandemic, adaptive responses and innovations, perceived impacts of these innovations, and perceptions of pharmacists’ contributions to the health sector. The interview guide is provided in the Supplementary material section. Public documents, including reports and memos from pharmacies, hospitals, and associations, were reviewed and validated using Scott’s four criteria to ensure rigor: (1) Authenticity, (2) Credibility, (3) Representativeness, and (4) Meaning [21]. This helped further validate information that was generated through interviews.

Researcher positionality and reflexivity
The primary interviewer is an experienced Ghana-trained pharmacist whose professional background may not only have facilitated access and rapport but may also have shaped participant narratives. To mitigate potential bias, the interview guide was pilot-tested, probing questions were used to validate assumptions, and coding decisions were reviewed by a second researcher. Discrepancies were discussed, and consensus was used to resolve all disagreements.

Data analysis
The study employed a manual inductive thematic analysis guided by Braun and Clarke’s six-step framework [22]. This involved familiarisation with the data, generation of initial codes, development and review of the candidate themes, assessment of their coherence and alignment with the research questions, definition and naming of final themes, and preparation of the report. The primary researcher conducted the coding, which was independently reviewed by a second researcher to enhance consistency. Methodological triangulation was achieved by integrating evidence from interviews and document reviews, while the independent review of the coding decisions strengthened analytical credibility and reduced the risk of bias [23,24].

Ethical considerations
Ethical approval was obtained from the School of Pharmacy Ethics Committee (UGSOPEC/AC2021-2022/023). All participants provided informed consent, and participation was voluntary. Confidentiality was maintained throughout the study. Interviews were conducted in English, and transcripts were anonymised and returned to respondents for verification. Electronic data were stored securely on a password-protected laptop.

Results

The thematic analysis identified four major themes: (1) the multifaceted nature of pharmaceutical practice; (2) challenges and threats posed by COVID-19 to pharmacy practice; (3) adaptive contributions and innovations under crisis conditions; and (4) post-COVID-19 innovations and public perceptions.

Theme 1: Multi-faceted nature of pharmaceutical practice
Key informants offered insights into different dimensions of pharmacy practice across the respective sectors, highlighting the breadth and complexity of the pharmacy profession.

Hospital pharmacy
Hospital pharmacists reported playing central roles in medication management, handling administrative, distributive, clinical, and educational functions. They manage formularies, standardize practices, oversee staffing, ensure cost-effective procurement, support revenue generation, and promote equitable access to medicines under the National Health Insurance Scheme.

A respondent noted-

“Apart from making sure your [the pharmacist’s] drugs are available, and that your patient is getting the right thing, you will have to counsel and must keep account of the medication used and manage the revenue accrued. There is a lot of documentation involved too.”

Hospital pharmacists were seen to offer critical clinical services such as medication review and adherence initiatives, patient counselling, and therapeutic drug monitoring. One respondent stated,

“The pharmacists used not to be on the ward, but because of PharmD and specializations in clinical pharmacy and all of these continuous trainings and talk about moving pharmacy from behind the counter to the bedside, we now have pharmacists on the ward who also take part in ward rounds. So, in the mornings, I usually review all the cases on the hospital ward from the Electronic Medical Records (EMR) before joining the team on rounds.”

Additional roles included training students undergoing clinical rotations and internships for their pharmacy degrees and residents undertaking clinical training for specialisations.

Pharmacists are crucial for multidisciplinary collaboration with other health care teams, ensuring optimal therapeutic outcomes and enhancing quality patient care. A respondent explained;

“So, with our training and per what we do, pharmacists can multitask even beyond what is core pharmacy. Everybody knows, we consult with various kinds of people. We liaise with the doctor, your patient who is your number one priority, the nurse, the lab personnel, auditors, accounts, insurance companies, Environmental Protection Agencies (EPA) for safe disposal of expired medicines, the Food and Drugs Authority (FDA), manufacturers, and wholesalers. It is a lot. We are at the centre of it all.”

Community pharmacy
Community pharmacists serve in retail and wholesale settings, ensuring medicine supply to individuals and institutions. Administratively, they supervise staff, optimise workflow, manage compliance, control inventory, and maintain customer relations within pharmaceutical services.

One respondent added;

“As soon as I get to work at 8:00 am, I check on my staff to ensure everything is in place and that we have the needed stocks. I go on to check -It is a 24-hour pharmacy…. I check if there are pending issues from the night shift that need my attention. I also follow up on client requests that could not be fulfilled and scout for medications from our warehouse and other suppliers around. After all that, I go to the counter and attend to the many customers waiting.”

Community pharmacists were found to offer clinical services and free consultations to the public, demonstrating their role as accessible healthcare providers within the community, as one of the key informants explained,

“We don’t just dish out the medications – we’re here to make sure that the patients understand their drugs and any possible side effects.”

Their services encompassed drug information dissemination, clinical interventions, identification of drug-related problems, proposal of suitable alternatives, and collaboration with prescribers to optimize therapy outcomes.

Regulatory pharmacy
Pharmacists play central roles in regulatory and policy matters, including registration and licensing of professionals, drug regulation, and enforcement of pharmacy laws. Institutions like the Pharmacy Council, FDA, and Health Facilities Regulatory Authority (HeFRA) collaborate to ensure compliance and shape healthcare policies. Pharmacists contribute across directorates in training, inspection, licensing, and registration. Within the FDA, their expertise supports regulation, safety, and standards enforcement. In pharmaceutical manufacturing, pharmacists oversee formulation, bottling, and quality control, ensuring medicines meet the highest standards. Key informants emphasised that industrial pharmacists safeguard product quality, highlighting their integral contribution to public health through regulatory oversight and pharmaceutical production.

Pharmacists in academia
The roles and responsibilities of pharmacists in academia include engaging in mentorship, guiding students, and providing career advice to nurture the next generation of pharmacy professionals. One key informant stated,

“As lecturers, a typical day will involve preparing lectures, working on some manuscripts for research work, and collaborating with colleagues to advance pharmaceutical knowledge.”  Another said:

“Work will basically revolve around facilitating some workshops, updating lectures and examinations for candidates during the primaries, and then preceptorship when you’ll oversee clinical rotations for the residents.”

Pharmaceutical marketing
Pharmacists in pharmaceutical marketing enhance access to innovative products by researching global trends, identifying healthcare gaps, aligning treatments with guidelines, and providing scientific updates through continuous professional education for improved local healthcare practices. One respondent added:

“I particularly like presentations at hospital morning meetings. I see it as an avenue to teach a discerning audience on the latest guidelines and new molecules for the goal of shaping practice to improve patient care.”

Theme 2: Challenges and threats posed by COVID-19 to the practice of pharmacy.
Respondents noted challenges in pharmaceutical care delivery during COVID-19, including supply disruptions, drug safety, occupational risks, and reduced customer interactions. Pharmacists adapted rapidly, navigating uncertainties, evolving evidence, and combating misinformation to ensure effective healthcare responses.

A respondent explained;

“COVID put much pressure on us as regulatory pharmacists because here comes a strange disease we didn’t know much about and then we needed drugs to treat it.”

Another added,

“We were not even done with the COVID simulation training when we were told a patient was already on the way to the facility. You can imagine the fear and panic. I had to quickly set up the pharmacy at the isolation centre, but at the time we didn’t even know what drugs to take.”

Respondents faced medicine, supply, Personal Protective Equipment (PPE), and raw material shortages from disrupted supply chains, worsened by demand surges, reduced production, stockpiling, and price hikes threatening public health and security. One respondent shared;

“Everybody wanted some intervention of some sort, preventive measures to take. You had to come in as remote supply chain personnel for people who needed drugs and could not access them because there was a shortage of certain drugs on the market.”

Another highlighted the global shortage of hand sanitisers and the unpreparedness of local pharmaceutical manufacturers to produce an adequate supply to meet the demand. “Eventually, alcoholic beverage distilleries had to step in because they already had significant stocks of ethanol available.”

Pharmacists confronted safety concerns while persistently delivering essential healthcare services during the pandemic. As one respondent emphasised,

“In the midst of the anxiety, we still had to work. We still had to go on. Those were some of the challenges. We were working and simultaneously putting ourselves and our families at risk.”

These challenges were made more significant by the risks of virus exposure resulting from inadequate workplace safety engineering controls.

For many professionals in social and administrative pharmacy, academia, pharmaceutical marketing, and even in regulation, the lockdown and social distancing measures posed difficulties in conducting in-person meetings. A respondent shared;

“Commercial Pharma being face-to-face driven was under threat due to lockdown. The restrictions imposed by the government and the companies affected our Health Care Professional engagements.”

The challenges and threats faced by pharmacists during the COVID-19 pandemic significantly impacted pharmacy practice across different sectors.

Theme 3: Adaptive contributions and innovations under crisis conditions
Pharmacists adopted innovative measures during COVID-19, ensuring service continuity, patient safety, and strengthened public health responses.

Treatment protocol development and adaptation
Pharmacists shaped COVID-19 treatment protocols by applying expertise in drug therapy and patient care, actively contributing to effective guidelines that enhanced outcomes despite uncertainty. One respondent explained;

“As soon as Ghana recorded the first COVID-19 case, we [pharmacy department] came together quickly- Ghana didn’t have any protocols then. The pharmacy team quickly set up a meeting to review treatment protocols from other countries. We looked at what they were doing and drafted our own protocol. What we put together is what the hospital used for treatment at the time.”

Pharmacists, forming over half of Ghana’s Emergency National Medicines Selection Committee, collaborated to develop the Provisional Standard Treatment Guidelines for COVID-19, published in June 2020, significantly shaping national pandemic response efforts.

COVID-19 case management
Hospital pharmacists in COVID-19 centres provided frontline expertise, optimising treatments and monitoring drug interactions and adverse effects. One shared;

“We developed a specific data collection tool that gathered valuable information about patients’ medical and medication history. It was very useful in triaging patients and identifying those who had started some form of treatment before coming to the hospital. Our doctors used this to determine the next line of therapy.”

Pharmacists coordinated remote medication delivery for quarantined patients, addressing dosage, side effects, and medication-related concerns.

Pharmacists’ dual role in COVID-19 pharmacovigilance and community care
Pharmacists played critical roles during COVID-19, particularly in pharmacovigilance and community practice. They actively monitored and reported adverse drug reactions (ADRs) from off-label treatments and newly introduced vaccines, with reports submitted to the FDA and reviewed by the Joint COVID-19 Vaccine Safety Committee. Pharmacists in marketing companies further supported national updates by escalating ADRs to the Qualified Person for Pharmacovigilance (QPPV). At the community level, pharmacists ensured uninterrupted access to medicines and essentials during lockdowns, managed minor ailments, and refilled prescriptions for chronically ill patients, thereby reducing pressure on primary healthcare facilities while safeguarding vulnerable populations. A respondent noted:

“The hypertensive patients still had hypertension. People were still getting malaria and other comorbidities, so we still had to work like there was nothing happening.”

Pharmacists’ roles in vaccine logistics, public education, local production, regulation, digital innovation, and donations during COVID-19
Pharmacists supported Ghana’s COVID-19 response through activities extending beyond traditional pharmacy practice. Within the Expanded Programme on Immunization (EPI), they contributed to vaccine forecasting and coordinated aspects of logistics, including airport reception, ultra-cold storage, regional distribution, and drone-enabled delivery to remote districts. Respondents described these activities as improving timely access to vaccines in underserved areas. Pharmacists also received vaccination-related training to support national rollout efforts.

A respondent shared:

“Over 2.5 million doses of COVID vaccines have been delivered to the remote districts – to the most vulnerable in society and thereby improving access. Ghana became the first country to deliver vaccines using drones. We also supported Ghana Health Service (GHS) and Ministry of Health (MOH) with sample collection from the districts to KCCR [Kumasi Centre for Collaborative Research] In Kumasi and Noguchi [Noguchi Memorial Institute for Medical Research] in Accra for testing and thereby improving the testing process for the country.”

Another respondent shared;

“To date, 765 pharmacists have completed conceptual training, with 339 receiving hands-on training and 291 undergoing first-aid training. Simultaneously, around thirty pharmacies have undergone inspections and are progressing towards accreditation by the Pharmacy Council.”

Simultaneously, they fought the COVID-19 “infodemic,” serving as trusted educators on safe medicine use, dispelling myths, and promoting evidence-based practices through media engagements in local dialects.

A respondent added:

“Okay, pharmacists also educated the public on COVID-19 and the misuse of medications. I remember at that time, Pharmaceutical Society of Ghana had a slot at United Television, so I had to go and do it…I spoke about the azithromycin and dexamethasone because people were just abusing that. It was one of the interviews done in the local dialect, which went down very well.”

In response to inflated prices and shortages, pharmacists spearheaded local production of sanitizers and disinfectants, swiftly stabilizing supply and affordability.

As one informant shared, “At the height of the crisis, the price of a gallon of hand sanitizer, which should have been sold for GHS100, skyrocketed to GHS450 due to demand and supply. We were called upon by Jubilee House [the presidency] to see what could be done. Pharmacist and management in industry swiftly converted a massive portion of our liquid production lines to manufacture hand sanitizers, rapidly reducing the price from GHS450 to GHS150 within just two weeks.”

Regulatory pharmacists expedited drug registrations, balancing fast-track approvals with rigorous quality standards to meet urgent needs.

A respondent shared this:

 “We had to work overtime and be extremely fast and thorough. We treated all the applications as fast-track applications. As regulatory pharmacists involved in drug registration, I think we gave our time- our time was really the most valuable resource that we used to fight the pandemic.

Digital solutions further enabled service continuity, from telepharmacy and virtual CPD to online regulatory submissions. Complementing these interventions, pharmacists demonstrated solidarity through impactful donations, including a GHS100,000 contribution by the Pharmaceutical Society of Ghana to the National COVID-19 Trust Fund, providing PPE to treatment centers and community pharmacists nationwide.

Theme 4: Post-COVID-19 innovations and public perceptions
Pharmacist-led innovations during and after the COVID-19 pandemic have had enduring effects on Ghana’s health ecosystem. Enhanced drug production improved the industry’s resilience to demand surges and supply chain vulnerabilities, while digital health solutions such as telepharmacy and remote monitoring enhanced patient care. The expansion of pharmacist-vaccinators strengthened immunization services, and new collaborations fostered a culture of cooperation and agility in addressing future health threats. However, the study also revealed a gap in public understanding of pharmacists’ contributions. Many still perceive them primarily as dispensers, overlooking their broader expertise in medication management, patient care, and public health. This under-recognition stems from limited direct interactions beyond dispensing, as patients often associate care with doctors and nurses. Raising awareness of pharmacists’ critical interventions and specialized knowledge is essential to reposition them as integral healthcare professionals. Public education will be key to bridging this gap and sustaining post-COVID pharmaceutical advancements.

Discussion

This study offers a comprehensive multisector analysis of pharmacists’ roles during the COVID-19 pandemic in Ghana, highlighting a profession marked by adaptability, novelty, and resilience.

Pharmacists as adaptive system actors
Coherent with global shifts, this study corroborates a reform in pharmacy practice, with pharmacists adapting to non-traditional roles beyond their conventional scope. Consistent with earlier work  [25], which noted that pharmacists globally adjusted to broader roles including triage and chronic care management, Ghanaian pharmacists emerged as first-line responders, particularly during the COVID-19 lockdown. Likewise, hospital pharmacists in this study were intricately engaged in therapeutic reviews, ward rounds, protocol development, and administrative roles – a finding that was also observed in other studies in Europe [26] and in Ghana [8], reflecting adaptive capacity under uncertainty. The proactive participation of Ghanaian pharmacists in national treatment guideline development is also consistent with studies from the United States and Europe where pharmacists were integral members of national task forces and working groups [26,27]. Nonetheless, these adaptations happened without a corresponding formal recognition or structured integration into national emergency preparedness frameworks.

Systemic hurdles buttressing structural inequities
Constraints such as limited supply of PPE, drug availability and challenges with digital infrastructure were frequently reported in this study, a finding that was also consistent with challenges observed globally [11,28]. Respondents’ narration of experiences that reflect occupational exposure and psychological drain reiterates issues pointed out by earlier studies [29,30] that reported increased levels of anxiety among pharmacists involved in the delivery of COVID-19 services. Additionally, supply chain and importation problems reported in this study confirm earlier studies [31,32], that observed that unregulated markets and misrepresentation of facts muddled efforts to ensure drug safety oversight.

Innovations as strategic leverage points
The pandemic stimulated numerous innovations within the pharmacy sector in Ghana. This study’s findings, including the roles of pharmacists in vaccine logistics and uptake, and community pharmacy-based chronic care services, parallel progress in other settings, such as France and Jordan [9,10]. The institutionalisation of pharmacists’ contributions, including their formal training as vaccinators, demonstrates a health system that drives these temporary adaptations toward structural reforms. These shifts are coherent with the earlier works that posit that pharmacy practice, when leveraged, is central to healthcare system resilience [33–36].

Perceptions and the public visibility gap
Although pharmacists made significant contributions during the pandemic, the study acknowledges that pharmacists remain less recognised. This reflects findings from other studies  [37,38] that reported that the public often undervalues the clinical expertise of pharmacists. Although other studies [39,40] in Ghana and elsewhere [33,34,37] reported budding trust in pharmacists, such trust seems divided and context-driven. This perception gap in Ghana highlights the need for intentional public education, engagement, and awareness to shape pharmacists’ reputation from dispensary stereotype to a much wider grasp of pharmacists as important healthcare providers and policy stakeholders.

Study limitations
The authors acknowledge that the retrospective nature of the study may introduce recall bias as participants recounted experiences after the acute phase of the pandemic. Participants may also have emphasised their professional contributions because of social desirability bias. Triangulation through document review and independent review of coding decisions was used to mitigate these limitations.

Conclusion

This study reframes COVID-19 as a stress test of Ghana’s pharmaceutical workforce, demonstrating how pharmacists contributed to health system resilience through innovation, regulatory agility, and cross-sector collaboration. Embedding pharmaceutical expertise within emergency preparedness strategies will be essential for strengthening national response capacity in future crises.

What is already known about the topic

  • Globally, pharmacists played important roles in the COVID-19 response, including medication management, chronic disease care, and public health interventions.
  • Studies from high-income countries have documented pharmacists’ adaptive roles in developing treatment protocols, supporting vaccination campaigns, and ensuring the continuity of pharmaceutical supply chains during the pandemic.
  • However, evidence from low- and middle-income countries remains fragmented, with limited multisector analyses examining how pharmaceutical workforces contribute to broader health system resilience and emergency preparedness.

What this  study adds

  • This multisector qualitative study reframes COVID-19 as a stress test of Ghana’s pharmaceutical workforce, providing empirical insight into how pharmacists across hospital, community, regulatory, academic, and industrial sectors adapted under crisis conditions.
  • The study highlights how pharmacists in Ghana were instrumental in system-level resilience through the development of national treatment protocols, vaccine logistics (including drone deliveries), local manufacturing of IPC commodities, and adoption of digital health solutions.

Competing interest

The authors of this work declare no competing interests.

Funding

The authors did not receive any specific funding for this work.

Acknowledgements

The authors wish to express their sincere gratitude to all the pharmacists who participated in this study for sharing their valuable time, experiences, and insights. We also acknowledge the support of the various pharmacy institutions, professional bodies, and stakeholders who facilitated access to relevant documents and information.

Authors’ contributions

Conceptualization and Design: ETA, TOA.  Data Collection: ETA, TOA. Analysis and Interpretation: ETA, TOA, MAN. Manuscript Development and Write-up: MAN. Critical Review and Editing: ETA, TOA, MAN. All the authors have read and agreed to the final manuscript.

Tables & Figures

Table 1: Distribution of key informants by pharmaceutical sector

SectorPractice Setting DescriptionNumber of Participants
HospitalPublic and private hospital pharmacies5
Community PracticeRetail and community pharmacies5
AcademiaSchools of Pharmacy / Universities5
Industrial PracticeLocal pharmaceutical manufacturing5
RegulatoryMultinational/importer pharmaceutical firms3
Ethical Pharmaceutical IndustriesNational medicines regulatory authority5
Pharmacy Interest Groups and AssociationsProfessional bodies and advocacy groups2
Total—30
 

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