Barriers in Pharmaceutical Services Focusing on Stunting and the Need for Digital Learning Media: A Qualitative Study of Community Pharmacists
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
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
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
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
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
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
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
Swain J. A Hybrid Approach to Thematic Analysis in Qualitative Research: Using a Practical Example. https://doi.org/10.4135/9781526435477
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
Guest G, Bunce A, Johnson L. How Many Interviews Are Enough? An Experiment with Data Saturation and Variability. https://doi.org/10.1177/1525822X05279903
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
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
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
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
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
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
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
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
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
Mohiuddin AK. The Excellence of Pharmacy Practice. https://doi.org/10.24926/iip.v11i1.1662
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
Saladdin IR, Handayani PW. Barriers to Healthcare Knowledge Management Implementation Based on Doctors’ Perspective. https://doi.org/10.1109/IC4E65071.2025.11075435
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
Owusu YB, Abouelhassan R, Awaisu A. Evaluation of Patient Safety Culture in Community Pharmacies in Qatar. https://doi.org/10.1111/ijcp.14055
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
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
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
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
Ilardo ML, Speciale A. The Community Pharmacist: Perceived Barriers and Patient-Centered Care Communication. https://doi.org/10.3390/ijerph17020536
Kumaki R, Hatamoto M, Iida R, Kishimoto K. Toward Enhanced Nutritional Interventions in Community Pharmacies. https://doi.org/10.1186/s41043-025-01035-6
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
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
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
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
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
Almeman A. The Digital Transformation in Pharmacy: Embracing Online Platforms and the Cosmeceutical Paradigm Shift. https://doi.org/10.1186/s41043-024-00550-2
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
Nouri A. Exploring the Use of Mobile Health Applications in Palestinian Community Pharmacy Practice. https://doi.org/10.1016/j.curtheres.2025.100782
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
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
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
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
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
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
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