International Journal of Health Policy and Management

International Journal of Health Policy and Management

Beyond Placement: Power, Legitimacy, and Equity in Integrating Practice Pharmacists into Primary Healthcare; Comment on “Developing Integrated Extended Pharmacist Roles and Services for Equitable Access and Outcomes in Primary Healthcare: A Realist Evaluation”

Articles in Press

Document Type : Commentary

Author
Usangiphile Buthelezi
Centre for Research in Health Systems, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Abstract
Officer and colleagues show that integrating practice pharmacists into primary healthcare (PHC) involves more than adding a new professional to the team. It represents a health-system change shaped by policy, funding, workplace culture, professional relationships, infrastructure, and patient trust. Building on their realist evaluation, this commentary argues that extended pharmacist roles also redistribute authority, resources, and responsibilities within PHC. Sustainable integration therefore depends on institutional legitimacy, built through a clear policy mandate, secure employment, defined roles, access to shared information, acceptance within healthcare teams, and public understanding of the role. The arrangements through which this legitimacy is built also have important equity consequences, as funding, copayments, deployment, and local capacity shape where services are available, who can access them, and whether they can be sustained. The commentary therefore draws out implications for how extended pharmacist roles should be financed, governed, adapted, and evaluated to support equitable and sustainable integration into PHC.
Keywords
Primary Healthcare
Practice Pharmacists
Health Equity
Workforce Governance
Realist Evaluation
New Zealand
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International Journal of Health Policy and Management

Articles in Press, Corrected Proof
Available Online from 26 October 2026

  • Received Date 31 July 2026
  • Revised Date 30 September 2026
  • Accepted Date 05 October 2026
  • First Published Date 26 October 2026
  • Published Date 26 October 2026