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Global Health Econ Sustain Assessing chronic community health needs

living in the Riverton community. The physical space of the prescribed medications present substantial challenges,
pharmacy comprises two rooms, totaling approximately particularly in marginalized communities that often
400 square feet. One room is equipped with cabinets for struggle with the ease of access (Curley et al., 2016). The
storing medical supplies and medications, along with an cost of service directly affects help-seeking behaviors.
examination table. The other room functions as a triage Related to general access challenges, there is a
area, housing the nurse’s desk and the basic equipment growing desire for autonomy among help-seekers (Rutter,
needed to operate a school nurse’s office. 2020). Perceptions about health-care products and the
During the authors’ first visit to the community in expectations of help-seekers drive this increased desire for
March 2020, interactions with the residents of Riverton autonomy in the context of help-seeking (Sabater-Galindo
highlighted numerous unaddressed health needs. A day et al., 2016). Consequently, such help-seeking behavior
of home visits conducted alongside local nursing students from a community pharmacy can be viewed, at least
led to the discovery of prevalent health issues, including partially, as a function of autonomous self-care practices
stage four pressure ulcers, uncontrolled hypertension, (Hassell et al., 2000).
chronic pain, diabetic foot sores, infected skin lacerations, At least partially, people tend to use what is most
and malnutrition. As nursing faculty and students sought accessible and what they believe will be beneficial for them.
to access the school pharmacy for essential supplies such This decision-making process is far from being purely
as gauze, peroxide, and antibiotic cream required for “objective.” Choices are influenced by the usage patterns
patient care that day, they were met with empty shelves. of others, recommendations they receive, and community-
This emptiness was attributed to the fact that the school held beliefs about the effectiveness of treatments (Hassell
pharmacy relied solely on donations. Within their small et al., 2000). Behind these choices lies an understanding
community, the citizens of Riverton lacked access to basic of the effectiveness and safety of the products. In many
healthcare supplies. To access the necessary materials, they cases, this results in a triage type of choice (Curley et al.,
had to have resources to travel outside their community, 2016). In short, if a product is accessible, deemed safe,
and to many citizens, that was simply not possible. This and effective, it gains community acceptance and is used
experience inspired the idea for a pharmacy quality (Rutter, 2020). An obvious concern is that these culturally
improvement project during the next visit. driven community practices can lead to the misuse of OTC
The quality improvement project focused specifically medications and misdiagnosis (Azzi et al., 2019). When
on providing necessary medical supplies and over-the- patients lack access to healthcare professionals, they often
counter (OTC) medications to the community. Onsite, resort to self-diagnosis and self-prescription. This behavior
only OTC medications were available because the school can be dangerous, as it can lead to delayed diagnoses and
pharmacy was not regulated by the government or staffed masking of symptoms crucial for clinical decision-making
by a pharmacist. The school principal and three assigned (Dunphy et al., 2019).
teaching staff members, equipped with basic first aid The 21 century has witnessed a marked growth in the
st
knowledge, were the only individuals with keys and access number of OTC medications (Rutter, 2020). While the range
to the pharmacy for distributing supplies. of products available may vary based on governmental
The demand for first-line relief of health-care challenges, regulations, the overall number of available medications has
particularly in poor, isolated communities across the globe, increased. Primarily driven by the profit-making strategies
is often met through some form of a community pharmacy of drug companies, the result is an overall increase in OTC
(Hermansyah et al., 2018). Numerous factors driving products (Rutter, 2020). This expansion has been further
help-seeking behavior and health service utilization have supported by the growth of online medical information.
been identified. Understanding these drivers is vital for Unfortunately, the lack of robust regulatory practices to
providing effective and competent treatment, making validate factual content has been linked to misuse (Carney
it a social justice issue, especially when considering et al., 2018). Taken together, these trends might lead help-
marginalized communities. Clearly, these factors are seekers to believe that they can manage their needs without
interconnected, emphasizing the need for a systematic and consulting a doctor (Rutter, 2020; Curley et al., 2016).
depth-oriented approach to consideration. The increased access to OTC medications, coupled
The realities of access in marginalized communities are with limited financial resources and a shortage of health-
limited due to the fiscal realities faced by residents. Cost care providers in the Riverton community, collectively
plays a major role in shaping healthcare-seeking behavior hindered comprehensive health-care access. The lack of
(Rutter, 2020). The expenses associated with health- both preventive services and acute care medicine is linked
care visits, accessing medical providers, and obtaining to elevated morbidity and mortality rates, resulting in a

Volume 1 Issue 2 (2023) 2 https://doi.org/10.36922/ghes.1030