Argentina is a federal republic with approximately 44 million people, divided into 23 provinces and an autonomous city, Buenos Aires. The health system is segmented into public, social security and private subsystems. The social security and private sectors cover more than 60% of the population. Total health expenditure in 2017 was 9.4% of gross domestic product. Primary health care (PHC) was considered as the principal strategy for universal coverage policy for health system reform in Latin America at the end of 20th century. The most remarkable characteristics of the Argentinian health system are its fragmentation and disorganization. An increase of public sector demands, due to a socioeconomic crisis, led to the subsequent collapse of the system, caused primarily by a sustained lack of investment. First care level decentralization to the Integral Health Service Delivery Networks (IHSDN) becomes the cornerstone of a PHC-based system. Pharmacists and community pharmacies are not formally mentioned in PHC policies or IHSDN. However, pharmacies are recognized as healthcare establishments as part of the first care level. Community pharmacists are the only health care professional whose profit comes from the margin on product sales. Contracts with social security and private insurances provide small margins which reduce the viability of community pharmacies. There is a preference by community pharmacies to diversify product sales instead of providing professional services. This is driven by marketing and economic pressures rather than patient care and health policies. Dispensing is the main professional activity followed by management of minor illness and associated product recommendations. Currently, there are no national practice guidelines or standard operating procedures for the provision of pharmaceutical services and there is no nationally agreed portfolio of services. National pharmacy organizations appear to have no official strategic statements or plans which would guide community pharmacies. There are some isolated experiences in community pharmacies and in public first care level pharmacies that demonstrate the possibilities and opportunities for implementing pharmaceutical services under the PHC approach. There is a real lack of integration of community pharmacies and pharmacists in the healthcare system.

Objetivo Conocer las opiniones de los farmacéuticos con relación a los factores que explican la falta de visibilidad de la farmacia comunitaria como establecimiento sanitario y proponer estrategias de desarrollo profesional a fin de lograr mejorar la accesibilidad a los servicios profesionales mediante técnicas de investigación cualitativa. Material y métodos Se utilizó una Técnica de Grupo Nominal (TGN) en 2 rondas sucesivas, respondiendo a 2 consignas guía sobre factores y estrategias. Posteriormente se realizó un Framework analysis. Resultados Se aportaron 34 ideas referidas a factores y 32 a estrategias. Las estrategias fueron agrupadas en 14 temas, destacándose las vinculadas a la priorización de los servicios profesionales orientados a los pacientes, al cumplimiento de la ética y a la formación continua del farmacéutico. Discusión Las técnicas utilizadas permitieron evidenciar situaciones percibidas por los farmacéuticos que no están formalmente descriptas en la literatura. Aumentar la visibilidad de los servicios profesionales en las farmacias comunitarias implica acordar y abordar estrategias que deben sustentarse en la participación conjunta de los propios farmacéuticos, las asociaciones profesionales y las universidades.

Objective Ascertaining pharmacists' views related to factors explaining the lack of visibility of community pharmacies as being health facilities and proposing strategies for improving community pharmacy professional service accessibility using qualitative research techniques. Methods The nominal group technique (NGT) was used in two successive rounds using separate guidelines for factors and strategies. Framework analysis was then carried out. Results Thirty-four ideas related to "factors" and 32 related to "strategies" were obtained. Strategies were grouped into 14 topics, emphasising those prioritising patient-orientated professional services, ethical aspects and pharmacists' ongoing education. Discussion The techniques used led to identifying situations perceived by pharmacists which are not formally described in the literature. Raising awareness of professional services in community pharmacies implies agreeing on and developing strategies which should be based on joint participation by the pharmacists themselves, professional associations and universities.

Objective Ascertaining pharmacists' views related to factors explaining the lack of visibility of community pharmacies as being health facilities and proposing strategies for improving community pharmacy professional service accessibility using qualitative research techniques. Methods The nominal group technique (NGT) was used in two successive rounds using separate guidelines for factors and strategies. Framework analysis was then carried out. Results Thirty-four ideas related to "factors" and 32 related to "strategies" were obtained. Strategies were grouped into 14 topics, emphasising those prioritising patient-orientated professional services, ethical aspects and pharmacists' ongoing education. Discussion The techniques used led to identifying situations perceived by pharmacists which are not formally described in the literature. Raising awareness of professional services in community pharmacies implies agreeing on and developing strategies which should be based on joint participation by the pharmacists themselves, professional associations and universities.

Objetivo Conocer las opiniones de los farmacéuticos con relación a los factores que explican la falta de visibilidad de la farmacia comunitaria como establecimiento sanitario y proponer estrategias de desarrollo profesional a fin de lograr mejorar la accesibilidad a los servicios profesionales mediante técnicas de investigación cualitativa. Material y métodos Se utilizó una Técnica de Grupo Nominal (TGN) en 2 rondas sucesivas, respondiendo a 2 consignas guía sobre factores y estrategias. Posteriormente se realizó un Framework analysis. Resultados Se aportaron 34 ideas referidas a factores y 32 a estrategias. Las estrategias fueron agrupadas en 14 temas, destacándose las vinculadas a la priorización de los servicios profesionales orientados a los pacientes, al cumplimiento de la ética y a la formación continua del farmacéutico. Discusión Las técnicas utilizadas permitieron evidenciar situaciones percibidas por los farmacéuticos que no están formalmente descriptas en la literatura. Aumentar la visibilidad de los servicios profesionales en las farmacias comunitarias implica acordar y abordar estrategias que deben sustentarse en la participación conjunta de los propios farmacéuticos, las asociaciones profesionales y las universidades.

Objective Analysing the evidence regarding the validity and reliability of a patient-satisfaction questionnaire about professional advice received for minor illness in Argentinean community pharmacies. Methods This was a descriptive, cross-sectional study. All patients or their caregivers who visited the pharmacies during the study period (March and April, 2006) and knew how to read and write were included. Results 289 questionnaires were completed. Factorial analysis revealed one single component explaining 52.2 % of total variance. A 0.89 Cronbach's alpha coefficient was obtained. Patients made additional comments on 87 questionnaires (30.1 %) concerning the quality of care received and other aspects. Discussion By presenting evidence of content validity, validity as internal structure and reliability the questionnaire could assess patient-satisfaction with the advice received for minor illness in Argentinean community pharmacies.

Objetivo Analizar las evidencias de validez y fiabilidad de un cuestionario de satisfacción de pacientes con el servicio de indicación en las farmacias comunitarias argentinas. Material y Métodos Estudio descriptivo de corte transversal. Participaron todos los pacientes o sus cuidadores que concurrieron a las farmacias durante el período de estudio (marzo y abril de 2006) y que supieran leer y escribir. Resultados Se obtuvieron 289 cuestionarios. El análisis factorial reveló un único componente explicando el 52,2 % de la varianza total. Se obtuvo un coeficiente alfa de Cronbach de 0,89. Los pacientes expresaron comentarios adicionales en 87 cuestionarios (30,1 %) que se relacionaron con la calidad de la atención recibida y con otros aspectos de la asistencia. Discusión El cuestionario mostró evidencias de validez de contenido, validez como estructura interna y fiabilidad para valorar la satisfacción de pacientes con el servicio de indicación en las farmacias comunitarias argentinas.

Objetivo Analizar las evidencias de validez y fiabilidad de un cuestionario de satisfacción de pacientes con el servicio de indicación en las farmacias comunitarias argentinas. Material y Métodos Estudio descriptivo de corte transversal. Participaron todos los pacientes o sus cuidadores que concurrieron a las farmacias durante el período de estudio (marzo y abril de 2006) y que supieran leer y escribir. Resultados Se obtuvieron 289 cuestionarios. El análisis factorial reveló un único componente explicando el 52,2 % de la varianza total. Se obtuvo un coeficiente alfa de Cronbach de 0,89. Los pacientes expresaron comentarios adicionales en 87 cuestionarios (30,1 %) que se relacionaron con la calidad de la atención recibida y con otros aspectos de la asistencia. Discusión El cuestionario mostró evidencias de validez de contenido, validez como estructura interna y fiabilidad para valorar la satisfacción de pacientes con el servicio de indicación en las farmacias comunitarias argentinas.

Objective Analysing the evidence regarding the validity and reliability of a patient-satisfaction questionnaire about professional advice received for minor illness in Argentinean community pharmacies. Methods This was a descriptive, cross-sectional study. All patients or their caregivers who visited the pharmacies during the study period (March and April, 2006) and knew how to read and write were included. Results 289 questionnaires were completed. Factorial analysis revealed one single component explaining 52.2 % of total variance. A 0.89 Cronbach's alpha coefficient was obtained. Patients made additional comments on 87 questionnaires (30.1 %) concerning the quality of care received and other aspects. Discussion By presenting evidence of content validity, validity as internal structure and reliability the questionnaire could assess patient-satisfaction with the advice received for minor illness in Argentinean community pharmacies.