Barriers in Pharmaceutical Services Focusing on Stunting and the Need for Digital Learning Media: A Qualitative Study of Community Pharmacists

  • Firdawati Amir Parumpu School of Pharmacy, Institut Teknologi Bandung, Bandung, Jawa Barat, Indonesia. Faculty of Mathematics and Natural Sciences, Universitas Tadulako, Palu, Sulawesi Tengah, Indonesia
  • Pratiwi Wikaningtyas School of Pharmacy, Institut Teknologi Bandung, Bandung, Jawa Barat, Indonesia
  • Satibi Satibi Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Daerah Istimewa Yogyakarta, Indonesia
  • Septi Muharni Department of Clinical Pharmacy and Pharmacy Community, Sekolah Tinggi Ilmu Farmasi Riau, Pekanbaru, Riau, Indonesia
  • Ananda Putri Purwanto Faculty of Mathematics and Natural Sciences, Universitas Tadulako, Palu, Sulawesi Tengah, Indonesia
  • Kusnandar Anggadiredja School of Pharmacy, Institut Teknologi Bandung, Bandung, Jawa Barat, Indonesia
DOI: https://doi.org/10.56338/jphp.v6i2.9982
Keywords: Stunting, Community Pharmacist, Pharmaceutical Services, Barriers, Digital Learning

Abstract

Introduction: The strategic role of community pharmacists in pharmacy services focused on stunting in Indonesia is still limited, thus requiring resource support. The presence of digital learning media is expected to enhance competence. This study explores the barriers to implementing pharmacy services focused on stunting and the needs in developing digital learning media to improve the competence of community pharmacists.

Methods: A descriptive-qualitative study with structured interviews covering two main research topics. Community pharmacists who are active in community facilities were recruited using purposive sampling techniques and have undergone interview consent.

Results: The research findings are mapped into two main domains, namely the barriers to the implementation of stunting-focused pharmaceutical services and the need for digital learning media to enhance the competence of community pharmacists. Barriers are found in 1) internal factors, 2) external factors, and 3) system factors, it indicates an urgent need for digital learning media with 4) comprehensive materials related to stunting, 5) specific competence, 6) management guidelines, and 7) integration of digital technology in pharmaceutical services related to stunting, which are highly needed to improve the competence of community pharmacists in implementing stunting-focused pharmaceutical services in Indonesia.

Conclusions: The finding of converging obstacles faced by community pharmacists in pharmaceutical services focusing on stunting and the enthusiasm for developing digital learning media to improve community pharmacists' competence becomes a strategic solution. There needs to be resource support for community pharmacists to play a role in pharmaceutical services focused on stunting in the future.

References

  1. Mulyani AT, Khairinisa MA, Khatib A, Chaerunisaa AY. Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction—A Narrative Review. Nutrients. 2025;17(9):1–29. https://doi.org/10.3390/nu17091493
  2. Hedima EW, Okoro RN. Primary Health Care Roles of Community Pharmacists in Low- and Middle-Income Countries: A Protocol for a Mixed Methods Systematic Review. https://doi.org/10.1186/s12913-025-13387-0
  3. Suleiman MA, Abdulwase I, Tukur KA, Umar ZB, Muhammad SS, Ladan MM, et al. Evaluating the Competency of Community Pharmacists in Identifying and Managing Malnourished Patients: A Cross-Sectional Survey. https://doi.org/10.1016/j.rcsop.2023.100341
  4. McGee RG, Wark S, Mwangi F, Drovandi A, Alele F, Malau-Aduli BS, et al. Digital Learning of Clinical Skills and Its Impact on Medical Students’ Academic Performance: A Systematic Review. https://doi.org/10.1186/s12909-024-06471-2
  5. Regmi K, Jones L. A Systematic Review of the Factors—Enablers and Barriers—Affecting E-learning in Health Sciences Education. https://doi.org/10.1186/s12909-020-02007-6
  6. Greer BD, Mitteer DR, Briggs AM, Fisher WW, Sodawasser AJ. Comparisons of Standardized and Interview-Informed Synthesized Reinforcement Contingencies Relative to Functional Analysis. https://doi.org/10.1002/jaba.601
  7. Swain J. A Hybrid Approach to Thematic Analysis in Qualitative Research: Using a Practical Example. https://doi.org/10.4135/9781526435477
  8. Ahmed SK, Mohammed RA, Nashwan AJ, Ibrahim RH, Abdalla AQ, Ameen BM, et al. Using Thematic Analysis in Qualitative Research. https://doi.org/10.1016/j.glmedi.2025.100198
  9. Guest G, Bunce A, Johnson L. How Many Interviews Are Enough? An Experiment with Data Saturation and Variability. https://doi.org/10.1177/1525822X05279903
  10. Hennink M, Kaiser BN. Sample Sizes for Saturation in Qualitative Research: A Systematic Review of Empirical Tests. https://doi.org/10.1016/j.socscimed.2021.114523
  11. Mahmoodi H, Bolbanabad AM, Shaghaghi A, Zokaie M, Gheshlagh RG, Afkhamzadeh A. Barriers to Implementing Health Programs Based on Community Participation. https://doi.org/10.1186/s12889-023-16961-5
  12. Obarcanin E, Aslani P, Ho AHY, Bandiera C, Baysari M, Bojic I, et al. Exploring Research and Education Opportunities in Digital Health for Pharmacy, Medicine and Other Health Disciplines. https://doi.org/10.1016/j.rcsop.2024.100469
  13. Backes C, Godot C, Gujer CY, Obegi N, Perez A, Gervaix A, et al. Digital Healthcare Services in Community Pharmacies in Switzerland. https://doi.org/10.1177/20552076241313164
  14. Widiasih R, Sunjaya DK, Rahayuwati L, Rusyidi B, Ermiati, Sari CWM, et al. Evaluating the Knowledge, Roles, and Skills of Health Cadres in Stunting Prevention. https://doi.org/10.33546/bnj.3722
  15. Siddique A, Ahmed E, Al Zoghabi M, Alsaif E, Alhawshani F. Exploring Community Pharmacist’s Knowledge, Attitude, and Practice toward the Provision of Pharmaceutical Care. https://doi.org/10.4103/jpbs.jpbs_16_21
  16. Hijazi MA, Shatila H, El-Lakany A, Al Rifai H, Aboul-Ela M, Naja F. Role of Community Pharmacists in Weight Management. https://doi.org/10.1186/s12913-020-05258-7
  17. Ayele AA, Cosh S, Islam MS, East L. Role of Community Pharmacy Professionals in Child Health Service Provision in Ethiopia. https://doi.org/10.1186/s12913-022-08641-8
  18. Kelly D, Chawke J, Keane M, Conway H, Douglas P, Griffin A. An Exploration of the Self-Perceived Nutrition Competencies of Pharmacists. https://doi.org/10.1016/j.rcsop.2022.100203
  19. Mohiuddin AK. The Excellence of Pharmacy Practice. https://doi.org/10.24926/iip.v11i1.1662
  20. Hamidzadeh Y, Hashemiparast M, Hassankhani H, Allahverdipour H. Obstacles for Iranian Rural Population to Participate in Health Education Programmes. https://doi.org/10.1136/fmch-2018-000020
  21. Saladdin IR, Handayani PW. Barriers to Healthcare Knowledge Management Implementation Based on Doctors’ Perspective. https://doi.org/10.1109/IC4E65071.2025.11075435
  22. Alshahrani A. Knowledge, Attitudes, and Practice of Community Pharmacists Towards Providing Counseling on Vitamins and Nutritional Supplements in Saudi Arabia. https://doi.org/10.3934/publichealth.2020054
  23. Owusu YB, Abouelhassan R, Awaisu A. Evaluation of Patient Safety Culture in Community Pharmacies in Qatar. https://doi.org/10.1111/ijcp.14055
  24. Norris P, Keown S, George M, Symon V, Richards R, Bhawan S, et al. Lived Experience of Affordability as a Barrier to Prescription Medicines. https://doi.org/10.1016/j.rcsop.2025.100571
  25. Lane J, Nakambale H, Kadakia A, Dambisya Y, Stergachis A, Odoch WD. A Systematic Scoping Review of Medicine Availability and Affordability in Africa. https://doi.org/10.1186/s12913-023-10494-8
  26. Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A Review of Child Stunting Determinants in Indonesia. https://doi.org/10.1111/mcn.12617
  27. Kartinah NT, Putri SI, Jayantari D, Hedo PK, Simarmata N, Sianipar IR. Estimating Pathways Affecting Stunting in Families with Children Under Aged 5 Years. https://doi.org/10.1177/22799036251397751
  28. Ilardo ML, Speciale A. The Community Pharmacist: Perceived Barriers and Patient-Centered Care Communication. https://doi.org/10.3390/ijerph17020536
  29. Kumaki R, Hatamoto M, Iida R, Kishimoto K. Toward Enhanced Nutritional Interventions in Community Pharmacies. https://doi.org/10.1186/s41043-025-01035-6
  30. Meilianti S, Smith F, Kristianto F, Himawan R, Ernawati DK, Naya R, et al. A National Analysis of the Pharmacy Workforce in Indonesia. https://doi.org/10.1186/s12960-022-00767-4
  31. Amakye WK, Bozovic S, Faraque A, Yao M. Nutrition Education in Medical School: The Case of International Medical Students in China. https://doi.org/10.1136/bmjnph-2020-000117
  32. Douglas PL, McCarthy H, McCotter LE, Gallen S, McClean S, Gallagher AM, et al. Nutrition Education and Community Pharmacy. https://doi.org/10.3390/pharmacy7010027
  33. Mizranita V, Sim TF, Sunderland B, Parsons R, Hughes JD. Pharmacists’ and Pharmacy Technicians’ Scopes of Practice in the Management of Minor Ailments at Community Pharmacies in Indonesia. https://doi.org/10.18549/pharmpract.2021.2.2295
  34. Alwidyan T, Abudalo R, Odeh M, Tayyem M, Banat A. Community Pharmacists’ Attitudes Toward the Implementation of Good Pharmacy Practice Guidelines in Jordan. https://doi.org/10.35516/jjps.v18i2.2643
  35. Almeman A. The Digital Transformation in Pharmacy: Embracing Online Platforms and the Cosmeceutical Paradigm Shift. https://doi.org/10.1186/s41043-024-00550-2
  36. Leong CM, Lee TI, Chien YM, Kuo LN, Kuo YF, Chen HY. Social Media–Delivered Patient Education to Enhance Self-Management and Attitudes of Patients with Type 2 Diabetes During the COVID-19 Pandemic. https://doi.org/10.2196/31449
  37. Nouri A. Exploring the Use of Mobile Health Applications in Palestinian Community Pharmacy Practice. https://doi.org/10.1016/j.curtheres.2025.100782
  38. Fathorrahman I, Athijah U, Hermansyah A, Rahem A. Pharmacist Expectations of Telepharmacy Services in Community Pharmacies in Indonesia. https://doi.org/10.1089/tmr.2024.0049
  39. Amoore BY, Gaa PK, Amalba A, Mogre V. Nutrition Education Intervention Improves Medical Students’ Dietary Habits and Their Competency and Self-Efficacy in Providing Nutrition Care. https://doi.org/10.3389/fnut.2023.1063316
  40. Leong CM, Lee TI, Chien YM, Kuo LN, Kuo YF, Chen HY. Social Media–Delivered Patient Education to Enhance Self-Management and Attitudes of Patients with Type 2 Diabetes During the COVID-19 Pandemic: Randomized Controlled Trial. Journal of Medical Internet Research. 2022;24(3):e31449. https://doi.org/10.2196/31449
  41. Nouri A. Exploring the Use of Mobile Health Applications in Palestinian Community Pharmacy Practice. Current Therapeutic Research. 2025;102:100782. https://doi.org/10.1016/j.curtheres.2025.100782
  42. Fathorrahman I, Athijah U, Hermansyah A, Rahem A. Pharmacist Expectations of Telepharmacy Services in Community Pharmacies in Indonesia. Telemedicine Reports. 2025;6(1):6–12. https://doi.org/10.1089/tmr.2024.0049
  43. Amoore BY, Gaa PK, Amalba A, Mogre V. Nutrition Education Intervention Improves Medical Students’ Dietary Habits and Their Competency and Self-Efficacy in Providing Nutrition Care: A Pre-, Post-, and Follow-Up Quasi-Experimental Study. Frontiers in Nutrition. 2023;10:1063316. https://doi.org/10.3389/fnut.2023.1063316
Published
2026-07-01
How to Cite
Amir Parumpu, F., Pratiwi Wikaningtyas, Satibi Satibi, Septi Muharni, Ananda Putri Purwanto, & Kusnandar Anggadiredja. (2026). Barriers in Pharmaceutical Services Focusing on Stunting and the Need for Digital Learning Media: A Qualitative Study of Community Pharmacists. Journal of Public Health and Pharmacy, 6(2), 252-267. https://doi.org/10.56338/jphp.v6i2.9982
Issue
Vol. 6 No. 2 (2026)
Section
Articles

Copyright (c) 2026 Journal of Public Health and Pharmacy

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Authors who publish with Journal of Public Health and Pharmacy retain the copyright of their work. The journal applies a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0), which grants the following rights:

  1. Copyright Retention: Authors retain the copyright of their work, maintaining full control over their intellectual property without restrictions.

  2. Right of First Publication: Authors grant the journal the right of first publication of their work. This ensures that the work is initially published and credited in Journal of Public Health and Pharmacy.

  3. License to Share and Reuse: The work is licensed under CC BY-SA 4.0, allowing others to copy, distribute, remix, and build upon the work for any purpose, even commercially, as long as proper credit is given to the authors, and any new creations are licensed under the same terms.