Institutional Drug Information Dissemination in Ghana: Barriers, Enablers, and System-Level insights

Institutional Drug Information Dissemination in Ghana: Barriers, Enablers, and System-Level insights | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Institutional Drug Information Dissemination in Ghana: Barriers, Enablers, and System-Level insights Brian Adu Asare, Emmanuella Abassah-Konadu, Ivy Amankwah, Justice Naa Tabariyeng, and 13 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9012942/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background: Drug Information (DI) services are essential for safe and rational use of health technologies by providing timely, unbiased information to health professionals, policymakers, and the public. In Ghana, DI dissemination remains poorly institutionalised. Implementation Research (IR) offers a structured approach for identifying context-specific bottlenecks and practical strategies for integrating DI services into routine healthcare delivery. We explored the strengths, weaknesses, barriers, enablers, and strategies for strengthening DI services. Methods: We conducted a qualitative exploratory study using purposive sampling of eight (n=8) key stakeholders involved in DI service delivery and use, including hospital pharmacists, a medical doctor, and Ministry of Health officials. In-depth interviews were conducted to elicit experiences and perceptions regarding DI systems. Interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis to identify key strengths, weaknesses, barriers, enablers, and recommended implementation strategies. Results: Participants identified important strengths within Ghana’s DI landscape, including residual human resource (HR) capacity supporting services, sustained demand for DI in clinical practice, and updated curricula incorporating DI. These strengths were undermined by weaknesses, including the absence of a clear national drug information strategy, limited and inconsistent institutional management support compounded by HR constraints, limited technical capacity, limited visibility and awareness, and the perception of DI as a project rather than a core health system function. Key barriers included weak institutional support, inadequate-funding, infrastructural and logistical constraints, limited-access to reference materials, limited technical capacity, limited visibility/awareness with under-utilisation of services, continuous shift to digital through self-sourced information and weak stakeholder engagement. Enablers included recognition of the importance of timely and accurate information dissemination, its linkage to the wider health system and policy context, and its impact on health outcomes. Suggested strategies to address the identified barriers included evaluating the DI system to inform a new strategy and manual, active stakeholder engagement, reintroducing the DI newsletter via the digital DI platform, re-establishing the National Drug Information Resource Centre, and providing continuous training. Conclusion: Functional DI services are critical to evidence-based care and safe medicine use. Strengthening the system will require coordinated reforms to move DI from a fragmented to a sustainable health system function. Drug Information Services Implementation Research Barriers Enablers Drug Information Unit Health Systems Ghana Background Health technologies play a pivotal role in the functioning of any healthcare system( 1 – 3 ). These technologies are crucial tools for preventing, diagnosing, treating, and managing various health conditions( 4 , 5 ). In a rapidly evolving healthcare system, access to information about new health technologies is essential for improving their use and the intended health outcomes The effective dissemination of accurate, timely drug information (DI) should play a critical role in a health system’s capacity to ensure safe and effective application of these health technologies. This also has the potential to enhance clinical decision-making, streamline healthcare delivery processes, and empower patients to take an active role in managing their health. Drug Information Centres (DICs) serve as centralised hubs that organise, evaluate and provide unbiased information on safety, efficacy, use, interactions and costs of health technologies, particularly drugs, to health professionals (i.e., clinicians, pharmacists, nurses, etc.), policymakers, and the general public. They are critical in-service delivery, education on health technologies and research ( 6 ). When fully functional and institutionalised, DICs support evidence-based decision-making and contribute to improvements in prescribing behaviour and reduction in medication errors ( 7 , 8 ). Global guidelines, such as the World Health Organization (WHO) guidelines on good pharmacy practice, emphasise the value of promoting evidence-based prescribing and mitigating medication-related harm, particularly in resource-limited settings, like Ghana ( 9 ). In Ghana, the National Medicines Policy (NMP) 3rd edition, 2017 ( 10 ) defines the broad framework for a functioning DI system. This framework includes structural and operational components. The structural components include the establishment of a functional National Drug Information Resource Centre (NDIRC) and the establishment of functional DICs in all teaching hospitals and regional hospitals. Some operational components include: collection, compilation, processing, presentation and dissemination of information regarding appropriate medicine use; collation of all documents related to the pharmaceutical sector at a designated centre (library); collaboration with all stakeholders, including Herbal Medicine Practitioners, to facilitate DI function; resourcing of NDIRC and generation of funds internally to support DI activities. Despite the intended benefits from these NMP components, Ghana struggles to establish and sustain robust DI services, a situation which may be common to other low- and middle-income countries (LMICs). In the Ghana health system, the Ministry of Health (MoH) provides governance and oversight in policy formulation, the Pharmacy Council( 11 ) and Ghana Food and Drugs Authority (FDA)( 12 ) share oversight responsibilities for regulation of practice and products respectively, while the Ghana Health Service (GHS) brings together products (health technologies) and practitioners (users of information on health technologies) for frontline service delivery. DICs were established based on recommendations from previous drug policies to provide information on medicines to support service delivery( 13 , 14 ). However, a 2014 drug policy assessment highlighted broad challenges with the functionality of these DICs in the health system ( 15 ), negatively impacting the system. Unraveling and addressing the suboptimal functioning of the DICs could be best undertaken using implementation research methods. Implementation Research (IR) offers a structured and systematic approach to identify and address gaps in translating evidence to practice, i.e., “know-do” gaps, including context-specific barriers, enablers and determinants across individual, organizational and system levels( 16 ). It also tests strategies to integrate innovations into standard practice ( 17 , 18 ), paving the way for tailored implementation of proven strategies ( 19 ). Applying IR to Ghana’s DI system can illuminate both supply-side constraints (e.g., staffing, infrastructure, governance) and demand-side factors (e.g., clinician attitudes, incentive structures), and guide interventions to strengthen institutionalisation and functionality of DICs. The SAVING (Sustainable Access and Delivery of New Vaccines in Ghana) Consortium( 20 ) made up of the University of Health and Allied Sciences (UHAS) as Consortium lead, the MoH, the Ghana Food and Drugs Authority (FDA), the Swiss Tropical and Public Health Institute (SwissTPH), collaborating with WHO (World Health Organization) TDR (special programme for Research and Training in Tropical Diseases) and Programme for Appropriate Technology in Health (PATH)/Access and Delivery Partnership (ADP) aims to build capacity in the use of implementation research to support policy implementation. The work of the Consortium draws on the Access and Delivery Partnership (ADP) framework( 21 ), which highlights the dissemination of information on new health technologies as essential in bridging information gaps across the policy-to-practice continuum. Hence, identifying and addressing barriers to functional DI systems( 22 , 23 ) would promote the successful adoption and integration of new health technologies. This study employs an IR approach, pre-intervention, to identify critical barriers and enablers to effective information dissemination on health technologies and propose pragmatic strategies as pathways to institutionalise sustainable, high-quality DI dissemination services. Methods Study design A qualitative approach was used to explore insights into the factors affecting functional systems for information dissemination on new technologies. Sampling A purposive sample, informed by stakeholder analysis of actors involved in medicines information dissemination, was employed. Stakeholder entities with high interest and high power in relation to the subject of enquiry (medicines information dissemination) were identified as participants for the study. These included eight ( 8 ) participants representing a mix of perspectives from practitioners, policymakers, subject matter experts and consumers of DI services. The team was open to reaching any other relevant stakeholder(s) beyond this initial list of participants. A profile of participants interviewed is provided in Table 1 . Data collection In-depth interviews (IDIs) of study participants were conducted by trained researchers from February to March 2026, using open-ended questions using an interview guide with participant consent (See Supplementary material 1) . The interviews were conducted in a manner ensuring privacy and lasted approximately 40 minutes. They were audio-recorded with the consent of the participants, transcribed verbatim and cross-checked for accuracy within the research team before data analysis. The transcriptions were captured in Microsoft Word and imported into Atlas.ti Web Edition version v9.24.3-2025-12-12 ( 24 ), for coding and analysis. Data Analysis The analysis used inductive thematic analysis through a stepwise, iterative process: transcripts were read and re-read for familiarisation and initial impressions, then openly coded using the research questions to maintain focus on the core concepts of inquiry. Similar and related codes were aggregated and synthesised in an iterative process to identify emerging themes under the research goals ( 25 ). Validity and credibility of theme synthesis were enhanced through peer debriefing sessions. Key quotations were extracted to support synthesised themes. Anonymity was ensured as participant quotes were labelled using generic identifiers. Barriers and enablers were framed using the recommendations from the NMP as a framework for functional DICs. Results Table 1 summarises the characteristics of key informants interviewed in the qualitative study. Most participants were pharmacists from the public sector, with representation from drug information practitioners, policy makers, policy implementers, a doctor from the private sector, and a development partner. Table 1 , Profile of Participants for the in-depth interviews Participant role/type Professional background Sector / affiliation 1. DI practitioner Pharmacist Public sector 2. Health Professional Doctor Private sector 3. DI practitioner Pharmacist Public sector 4. Policy implementer Pharmacist Public sector 5. Policy maker Pharmacist Public sector 6. Policy maker Pharmacist Public sector 7. DI practitioner Pharmacist Development partner 8. Policy implementer Pharmacist Public sector Strengths and weaknesses of the DI system in Ghana The DI setup in Ghana reflects a system that is operational but faces multiple challenges. A DI unit exists under the Pharmacy Directorate of the MoH, with some teaching hospitals and facilities continuing to provide DI services. However, day-to-day utilisation has declined significantly over the years. Below are the strengths and weaknesses identified. Strengths Despite the reported decline in the operationalisation of DICs, there are important strengths within Ghana’s DI landscape that can be leveraged for future improvement. These include: (1) Residual HR Capacity supporting services : A key strength lies in the HR capacity that remains in the system. Experienced personnel who helped institutionalise DI services are still active and can serve as a foundation for re-vitalising DI services. Some major facilities like teaching hospitals continue to maintain DI activities, preserving institutional memory and expertise that can be drawn upon to strengthen DI services across the country. Participants stated, "There are key players still in the system… we can still use them as well-resourced persons to help shape the future of drug information delivery in Ghana." [Policy maker, Pharmacist, Public sector] “ So if you go to the teaching hospitals, they seem to have structured drug information services. More than, say, the secondary facilities and then the primary hospitals.” [Policy implementer, Pharmacist, Public sector] (2) Sustained demand for DI in Clinical practice : There is also demand among health professionals for DI services in clinical practice. Pharmacists are increasingly responding to real-time drug queries from doctors and nurses. The delivery of services in an integrated manner involving all professional groups helps to embed DI more deeply into healthcare delivery. "Now, during ward rounds, when doctors or nurses want information related to a drug, the pharmacist is readily available," [DI practitioner, Pharmacist, Public sector] (3) Updated Curricula incorporating DI : In addition, participants indicated that some pharmacy schools in Ghana have incorporated DI into their curricula, ensuring that new graduates are better equipped with DI skills. “ I know some of the schools, pharmacy schools, are also training or they've added DI to their curriculum.” [DI practitioner, Pharmacist, Development partner] Weaknesses (1) Absence of a clear national drug information strategy : One of the most significant weaknesses undermining DI services is the absence of a clear national DI strategy. There is no strategic framework or operational manual to guide the establishment, expansion, or standardisation of DI services across the country. One respondent stated that, "We do not have a drug information strategy for the country, which will guide us where we are going, what we want to achieve in the next five or ten years." [Policy maker, Pharmacist, Public sector] (2) Limited and inconsistent institutional support compounded by HR constraints : Institutional support for DI services has been weak and inconsistent. Leadership changes often disrupted continuity. HR constraints further compounded the problem. Facilities often lacked the staff needed to maintain a consistent DI service, with recruitment challenges cited as a major issue. Respondents mentioned: "The one who was in charge, once the person left, nobody took it over," [DI practitioner, Pharmacist, Development partner] "Recruitment is one…. we are not getting recruitment from the Ministry of Finance for HR to directly recruit new people into the facilities…" [Pharmacist, Policy maker, Public sector] (3) Limited technical capacity : There is also a clear gap in technical capacity. Effective DI service requires skills in information retrieval, appraisal, and communication that are not widespread among available personnel. As a respondent noted, "It takes a bit of skill and somebody with the know-how to interpret whatever you are getting." [DI practitioner, Pharmacist, Development partner] (4) Limited visibility and awareness : Another persistent weakness is the limited visibility and lack of awareness of DI services, both within institutions and nationally. Many healthcare providers are unaware that DICs exist or that they can access these services easily. As one respondent shared: "Health professionals not knowing that there's an institutionalized drug information unit or centres in their hospitals or nationally… that's a major barrier." [Policy maker, Pharmacist, Public sector] (5) Perception of DI as a project rather than a core health system function : Finally, the perception of DI services as a secondary or project-based activity, rather than an integral part of routine clinical care, continues to undermine its value. This view limits the institutional ownership and sustainability of DI efforts. A participant explained, “I realized that people saw DI like a project, and though they embrace the concept all right, they saw it like somebody's job. Yeah. And they separated it from the routine work of the facility” [DI practitioner, Pharmacist, Development partner] Barriers to functional and institutionalised information dissemination In addition to the strengths and weaknesses of the DI system in Ghana, participants highlighted key barriers to functional and institutionalised DI services from the study. These include: weak and inconsistent institutional support compounded by HR constraints; inadequate funding and budgetary allocation; infrastructural and logistical challenges, including inadequate communication infrastructure and internet, and inadequate human resources; limited access to reference materials and alternative information sources; limited HR technical capacity to man DICs; limited visibility and lack of awareness of DI with subsequent under-utilisation of services; continuous shift to digital and self-sourced information; as well as poor stakeholder engagement. Among these, weak and inconsistent institutional support compounded by HR constraints, limited HR technical capacity to man DICs, as well as limited visibility and lack of awareness of DI with subsequent under-utilisation of services, were identified as weaknesses which were also barriers to DI services. (1) Weak institutional support, compounded by HR constraints and weak governance systems : The absence of institutional or consistent management support was also identified as a barrier to the effective dissemination of information on health technologies. Aside from weak institutional management, weak governance oversight of the DI system was also identified as a barrier. It was highlighted that there was a need to ensure people are held responsible to ensure accountability, so that the centres serve the needs of the facility. Participants noted: “ Dealing with management, there are some things that you make a case for, but you keep on making the case, but you're not getting the support. So, sometimes it leads to even fatigue on your side. So, you just decide to make do with what you have in the best way possible” [Pharmacist, DI practitioner, Public sector] “… People are held responsible, make sure that people report on whatever it does, and the centre is serving the needs of the facility; otherwise it will be a white horse”….. "Since I transitioned and moved out of that place, I have not seen any national action to sustain what was started." [DI practitioner, Pharmacist, Development partner] (2) Inadequate funding and budgetary allocation : Funding and budgeting issues were also identified. It was noted that DI services often do not have any budget lines for their set-up and operations. One participant said, “ One of the structural barriers is funding. With less funding, definitely, things are going to be at a standstill. So, I would suggest in this case that the Health Information Department make a strong case for the PPME to include it in their subsequent budgets” [Pharmacist, Policy makers, Public sector] (3) Infrastructural and logistical constraints, including inadequate communication infrastructure and internet : Structural and logistical barriers were widely reported, including inadequate space, weak communication infrastructure, lack of functioning telephones and intercom systems, and unreliable internet access. Some staff are reported to have attempted to fix these challenges on their own initiative. These challenges limited providers’ ability to reach DI pharmacists and access or disseminate health technology information effectively. Participants responded: “ With structural barriers, the first thing that comes to my mind is a place reserved for drug information. There should be a very good place for the drug information service so that people who work there would work with convenience”. [Policy implementer, Pharmacist, Public sector] “ So, with the barriers, I'll categorize them. So, let's say the first one has to do with the resources and then the structure”. … "At some point there were technical challenges across the whole institution, so the phones were not working at all… it went on for a very long time."... “Some staff had to find a way to fix these telephones by themselves . At some point there was some technical challenges which was across the whole institution, so the phones were not working at all I mean it went on for a very long time.” [Pharmacist, DI practitioner, Public sector] “ But in present times, we have a lot of information, but you need internet access“ , said one respondent. [Policy implementer, Pharmacist, Public sector] “… So, wherever you are, so far as you have internet access, which has improved compared to years back, I think yes, that structure is not an issue now . ” [DI practitioner, Pharmacist, Public sector] Where the information is available or accessible, the absence of appropriate digital technologies to facilitate the effective dissemination of health technologies was identified as a challenge. One respondent said, “So, the structural barriers include the absence of a digital platform which will be well known to professionals or care providers that if they need information on certain medicines, they can easily go to and have themselves updated on the current technologies available in the system”. [Policy maker, Pharmacist, Public sector] (4) Limited access to reference materials : Limited access to current reference materials, journals, and affordable subscriptions was identified as a key barrier to effective DI. Although online information is widely available, outdated resources and concerns about reliability often leave professionals unable to find or verify needed information. Participants added that: “Okay, so the resources I'm talking about are reference materials and specifically online reference materials, so access to journals, access to published work, and all that” [Pharmacist, DI practitioner, Public sector] (5) limited technical capacity, to man DICs : A notable barrier also identified was staff challenges. Most facilities needed human resources to man DI units. However, the Ministry of Finance is unable to provide clearance for the recruitment of personnel. With a lack of recruitment, there will be fewer staff to effectively execute DI work. Participants indicated, “Personnel, which can also be a barrier, affects effective DI services” [DI practitioner, Pharmacist, Development partner] “…it takes a bit of skill, and it takes a bit of somebody with the know-how to interpret whatever you are getting.” [DI practitioner, Pharmacist, Development partner] (6) Limited of visibility and limited awareness of DI with subsequent under-utilisation of services : Structural and institutional shifts have reduced the visibility and functionality of DI units. The relocation of the DI secretariat, though intended to strengthen DI, did not improve its visibility or use. Many facilities, especially private ones, lack formal DI units due to limited awareness of their role and resource needs. Even where DI units exist, services are often underutilised, with few formal email requests and most enquiries handled informally by phone calls or occasional walk-ins. This suggests that, beyond larger public institutions, DI services remain poorly integrated into routine healthcare delivery. Respondents mentioned, "Yes, so currently I would say that it's not serving the purpose for which it was established because even the location in the past, it has moved from the premises of the Pharmacy Council to the current position of the Ministry of Health itself and that's what informed the development of the new Ministry of Health organizational manual that this unit should be now housed at the Pharmacy Directorate of the Ministry of Health."… “ Another one is the health professional not knowing that there's an institutionalised drug information unit or centres in their hospitals or nationally for them to quickly access the information that they need on health technologies” … “ …updating or informing other healthcare providers that there is this service on drug information in the system. It's one of the policy barriers that we can look at” [Policy maker, Pharmacist, Public sector] "I don't have such a thing in my facility… most of them may not even have any idea what you are talking about” [Doctor, Private sector] "Patronage has gone down drastically when it comes to passive drug information delivery where you receive a drug-related question and then generate a response." [Pharmacist, DI practitioner, Public sector] (7) Continuous shift to digital through self-sourced information : The widespread shift to digital tools has become a barrier to facility-based DI services. Increased use of smartphones, apps, and internet resources has changed how health professionals seek drug information, often bypassing institutional DI units. While digital access enables quicker information retrieval, it also increases reliance on self-sourced information unless users are guided to reliable, up-to-date sources. Participants stated that: "Currently it looks like almost every healthcare professional has one or two apps or even more installed on their smartphones. So mostly whenever they are looking for information, they resort to these apps that they have. Or even they will go on to the internet, try to get information”. [Pharmacist, DI practitioner, Public sector] "…Even the handset that we use… our mobile phones, can equally provide that." … “… the era that we find ourselves in now has made it much easier, and it's even getting much easier for people to look for information by themselves” … “So, they only contact you when probably what they are looking for, they were not able, or they are not able to get it from the internet or from the app." [Pharmacist, DI practitioner, Public sector] (6) Weak stakeholder engagement : Respondents noted that, in terms of DI services, many stakeholders have been left out. They added that non-engagement of stakeholders in the institutionalisation of DI services had been a major obstacle. A respondent stated that, “… And then set up the drug information in the hospitals, so that all stakeholders are engaged to know that there is a service like this else it will not work.” [Policy maker, Pharmacist, Public sector] Enablers to functional and institutionalised information dissemination (1) Recognition of the importance of accurate, effective and timely Information Dissemination on New Technologies: Respondents underscored that effective dissemination of information is essential for the successful rollout and proper use of new health technologies in Ghana. The overarching message was that without adequate drug information, healthcare professionals and patients may misuse or underutilise these technologies. Respondents pointed out that clear, accurate, and timely information helps improve not only the adoption of technologies but also their lifespan and value. Participants explained, "It's very, very important because, I mean, in the healthcare system, those who matter, the key stakeholders, those who are the healthcare professionals should be well-versed with any new medical technology which is being, which is going to be rolled out. So, I think that one is very, very crucial and very, very important." [Pharmacist, DI practitioner, Public sector] "If we have the right information on such things, it will even improve the longevity of these equipment and then of the technology and then we'll be able to make better use of them." [Policy implementer, Pharmacist, Public sector] "The fact that there's a new technology means that there should be somebody there disseminating information on the new technology to targeted populations... because you come to realize that most times it is lack of information that makes us do things in a way that we shouldn't do." [Policy implementer, Pharmacist, Public sector] Several respondents emphasised that the impact of information extends directly to patient outcomes. Noting that the accuracy of information contributes to patients’ treatment outcomes. Respondents also pointed to national-level interventions, such as the rapid dissemination of information during the COVID-19 pandemic. Respondents said, "Yeah, to me, I think it's very, very important because when the information that you give out is not accurate, it goes a long way to actually impact on treatment, patient treatment outcome." [DI practitioner, Pharmacist, Public sector] “Where good information dissemination has made a difference, let me say COVID. When the COVID vaccines came into being and we quickly developed a standard treatment guideline for COVID treatment or management, this information was quickly shared on platforms.” [Policy maker, Pharmacist, Public sector] The importance of timely and effective information dissemination was also linked to ensuring broad access to new treatments. One respondent noted that without it, many people may miss out on new treatments. "Without effective information on this new intervention, a lot of people are going to lose out on new treatments. Whereas in developed countries, they will benefit." [Pharmacist, Policy makers, Public sector] (2) Recognition of the linkage between DI and broader system and policy context: Several respondents linked drug information with broader system functions like guidelines, formularies, and national adoption of technology. Others stressed the policy-level significance. Respondents noted, "Yes, so it's very, very important. Sometimes when new medicines are added to the national standard treatment guideline and essential medicine list, we need this information to. be disseminated properly so that the medicines are properly used at the facility level." [Policy maker, Pharmacist, Public sector] "Drug information or information sharing on technologies, including medicines, are very crucial and well-acknowledged by the policy documents in the Ministry of Health."- [Policy maker, Pharmacist, Public sector] (3) Recognition of the impact of strong information dissemination on health outcomes: Respondents shared specific examples where strong information dissemination had clear, positive outcomes. One respondent described a case involving methylated spirit that had caused adverse reactions among ward staff due to improper handling and the use of chlorhexidine for umbilical cord care. The DI unit intervened: There was a case I think was it last year?, there was a case of adverse reaction with handling of methylated spirit at the ward level... so the drug information was tasked to bring out… material like the currency of print regards to safety handling of methylated spirit. So, we broke it down to the level where the orderlies and all those ward assistants could also [understand]. So, I mean, it worked very, very well. Since then, the incidence of mishandling of these methylated spirits also went down. “There was also an incident with the use of chlorhexidine in the management or treatment of the umbilical cord. That one too, there was an education to that effect on the proper handling or the proper use of the chlorhexidine.” [Pharmacist, DI practitioner, Public sector] Despite systemic limitations, some DI initiatives in Ghana have shown promise. Respondents referenced a range of facility-level interventions that improved access to information. For instance, one respondent described efforts to share information with prescribers and staff: It was recommended that education on DI should be added to continuous professional development sources for doctors. Collaboration with drugs and therapeutic committees (DTCs) and clinical staff was also identified as key. “We also do CPDs for the prescribers, the doctors. Yes. We also have health staff meetings. So sometimes we get the opportunity to educate them. So, we join the DTCs and the MTCs and then we also work with the clinicians in the facilities.” [DI practitioner, Pharmacist, Public sector] Solutions and Strategies for Improvement Stakeholders across all interviews offered concrete proposals for how the DI system in Ghana could be revitalised. Their ideas, drawn from experience and a clear sense of what is practical, can be organised across three implementation phases. (1) Evaluation of the current situation of DICs and DI system The first step proposed by participants is a situational analysis, which could inform a new strategy and manual. This includes mapping all existing DI units, evaluating their performance, and identifying gaps in infrastructure and human resources. A retired policy advisor emphasised, "First of all, we need to know what we have. These assessments. What is there? Now, when we know that, then we take our policies, and we compare what is there with what should be there..." [DI practitioner, Pharmacist, Public sector] “So, we need to go back and do a needs assessment... Know your gaps. Know your requirements. Then you do the plus or minus. Then you’ll be fine.” [Policy implementer, Pharmacist, Public sector] (2) Active engagement of stakeholders, including the media and general public Participants underscored the active participation of stakeholders as part of the solution. Healthcare professionals were identified as the frontline communicators. The general public is important as a user of accurate information. Some selected quotes: “When we do community-based programs, we also take the opportunity to educate the public on drug safety and how to use their medicines well.” [Pharmacist, Policy makers, Public sector] “Ideally, these things should be disseminated, not just to health professionals, but the public as well.” [Doctor, Private sector] (3) Re-introduction of the drug information newsletter into DI operations Participants recommended the re-establishment of known information dissemination platforms, such as the previous periodic DI newsletter, possibly via a digital platform. This was seen as a basic and standard dissemination platform which should exist to retain the visibility and relevance. As one participant put it, “We should have a standard newsletter that could be sent to every region... Even if it is quarterly.” [Pharmacist, Policy maker, Public sector] (4) Re-establishment of the National Drug Information Resource Centre (NDIRC) Participants also alluded to the re-establishment of the NDIRC as foundational. A participant noted, “It has been a challenge even sustaining that place… I’ve not seen any other national action to sustain what was started.” [DI practitioner, Pharmacist, Development partner] (5) Continuous training for DI practitioners Additionally, stakeholders emphasised the need to train pharmacists using continuous training models in order to sustain the skills to manage DI centres. One participant said, “You need to do continuous training for them to get the needed skills to manage these centres.” [DI practitioner, Pharmacist, Public sector] These efforts, though described informally, reflect the beginnings of localised solutions such as bulletins, education sessions, and committee involvement. However, such successes remain fragmented and unevenly distributed across the country. Limitations Due to the time lapse between the period of functional DICs and the time of the assessment, responses could be affected by recall bias, especially those respondents who worked within the DI system. To reduce this, respondents selected were a mix of those currently working in the few DI systems and previous staff, to recollect institutional memory. Discussion The study provides critical insights into the state of Ghana’s DI system and highlights both enabling factors and significant obstacles that must be addressed to enhance information dissemination and utilisation. Our findings corroborate the importance of policy frameworks such as the National Medicines Policy (2017–2021) ( 10 ) and the establishment of the Drug Information Research Monitoring and Evaluation Unit (DIRMEU) and Health Technology Assessment (HTA) secretariat ( 26 )in creating an enabling environment for DI activities. However, although these structures exist, the absence of a clear national DI strategy, weak institutional support, and limited technical capacity undermine their potential impact. Despite the reported formal incorporation of DI roles into curricula in pharmacy schools and the willingness among pharmacists to integrate DI into clinical rounds, day-to-day service, utilisation has waned. Our study identified key strengths, residual experienced personnel, curricular integration, and pockets of sustained DI services in major teaching hospitals, which can serve as anchors for revitalisation efforts. Yet, weaknesses such as inconsistent leadership continuity, inadequate recruitment, and the perception of DI as a project rather than a routine practice have eroded institutional ownership and visibility of DI units. Mapping these weaknesses onto the nine primary barriers elucidated by the participants reveals a complex interplay of factors: Shift to digital/self-sourced information reduces reliance on formal DI units and emphasises the need for official, up-to-date digital platforms. Limited awareness and visibility of DI services lead to underutilization, particularly in private facilities where units are often unknown. Restricted access to reference materials, both paid subscriptions and current online databases- hampers evidence retrieval and appraisal. Infrastructural/logistical constraints, including broken telecommunication systems, a lack of dedicated DI spaces, and unreliable internet connectivity, impede timely responses. Inadequate human resources and technical skills limit the ability of the remaining staff to retrieve, interpret, and communicate drug information effectively. Weak governance and management support create accountability gaps, such that DI units lack champions to sustain operations through leadership transitions. Insufficient funding and budget allocations prevent the expansion of services or the procurement of essential resources. Poor stakeholder engagement, with clinicians, administrators, and information and communications technology (ICT) partners not fully mobilised around DI objectives. Loss of institutional oversight arising from the physical relocation of DI secretariats further dilutes service awareness. These barriers not only echo challenges observed in other LMIC settings(27–29) but also point to unique institutional gaps within Ghana’s health system. For instance, while the DIRMEU was conceived to serve as a hub for accurate, timely drug information, it has struggled to maintain visibility and stakeholder buy-in, highlighting the disconnect between policy intent and operational reality. Going forward, strengthening Ghana’s DI system will require a multi-phase approach leveraging the IR model ( 17 – 19 ). Phase 1 should include a comprehensive situational analysis to map existing DI units, assess infrastructure and staffing levels, and benchmark against international guidelines. Phase 2 must institutionalise DI services by securing dedicated budget lines, assigning physical space in all major hospitals, and deploying a centralised digital platform accessible via web and mobile. Phase 3 will focus on capacity building, embedding DI competencies into continuous professional development, leveraging experienced personnel as trainers, and establishing performance indicators tied to DI outputs such as bulletins and query response times. A sustained stakeholder engagement strategy is essential: clinical staff, pharmacists, policy makers, academia, media, and the public must be mobilised to demand and participate in robust DI services. Ultimately, translating Ghana’s policy frameworks into effective practice hinges on bridging the gap between institutional mandates and on-the-ground operations, an endeavour anchored by the empirical findings of this study and informed by global best practices in DI service delivery. Conclusion We highlight key weaknesses and barriers to functional and institutionalised DI dissemination in Ghana, while also identifying residual strengths, including existing HR capacity, sustained clinical demand, and DI in training curricula. Functional DI services are essential for evidence-based care, rational medicine use, and patient safety, but remain constrained by weak institutional support, inadequate funding, infrastructural and communication challenges, limited access to reference materials, low technical capacity, poor visibility, growing reliance on self-sourced digital information, and weak stakeholder engagement. Proposed solutions included evaluating the DI system, engaging stakeholders and the public, re-establishing the National Drug Information Resource Centre, reintroducing the DI newsletter, and strengthening continuous training. These findings call for sustained institutional commitment and coordinated investment to build visible, well-resourced, and sustainable DI services in Ghana. Abbreviations ADP Access and Delivery Partnership COVID-19 Coronavirus Disease 2019 CPDs Continuous Professional Development DI Drug Information DICs Drug Information Centres DIRMEU Drug Information Research Monitoring and Evaluation Unit DTCs Drugs and Therapeutic Committees EDCTP European and Developing Countries Clinical Trials Partnership FDA Ghana Food and Drugs Authority GHS-ERC Ghana Health Service Ethical Review Committee GHS Ghana Health Service HR Human resource HTA Health Technology Assessment IDIs In-depth interviews ICT Information and Communications Technology IR Implementation Research LMICs Low- and middle-income countries MoH Ministry of Health MTCs Medicines and Therapeutic Committees NDIRC National Drug Information Resource Centre NMP National Medicines Policy PATH Programme for Appropriate Technology in Health PPME Policy Planning Monitoring and Evaluation SAVING Sustainable Access and Delivery of New Vaccines in Ghana SwissTPH Swiss Tropical and Public Health Institute TDR Special Programme for Research and Training in Tropical Diseases UHAS University of Health and Allied Sciences WHO World Health Organization Declarations Ethics approval and consent to participate. The study was approved by the Ghana Health Service Ethical Review Committee (GHS-ERC 003/05/22) and the Ethical Review Committee of the University of Health and Allied Sciences (UHAS-REC A.9[1] 21-22). All participants provided informed consent before participating in the study. Participants were assured of their right to withdraw from the study at any time without any negative consequences. Confidentiality was maintained by anonymising the data and storing it securely. Consent for publication Not applicable Availability of data and materials All data and materials underlying the analysis are available, provided it does not breach ethical confidentiality clauses for best research practices. Where the sources are articles or documents, these are cited, and references are provided to the source articles. Competing interests The authors declare that they have no competing interests. Funding The conduct of this study was made possible through funding from the European and Developing Countries Clinical Trials Partnership (EDCTP), project (Grant number CSA2018HS-2528), implemented by the SAVING Consortium in Ghana. Authors' contributions BAA prepared the initial draft of the manuscript. MG, EA, AH, TO, and OO provided leadership and guided the design of the study. EA, IA, DDO and BAA collected data for the study. DDO, SKY, JA, MAD, MI, MA, AA, JNT, and MAA reviewed the draft manuscript, providing inputs and perspectives. SKY and JA provided policy perspectives to the analysis. BAA, EA, JNT and MA edited the manuscript. All authors reviewed the manuscript. Acknowledgement This study was made possible through funding from the European and Developing Countries Clinical Trials Partnership (EDCTP), through the SAVING Consortium. The Access and Delivery Partnership (ADP) is acknowledged for the various roles it has played in this study. We also thank the study participants for their participation in providing vital information. Author information Brian Adu Asare, Ministry of Health, Ghana and SAVING Consortium Email: [email protected] Emmanuella Abassah-Konadu, Ministry of Health, Ghana and SAVING Consortium Email: [email protected] Ivy Amankwah, Ministry of Health, Ghana. Email: [email protected] Justice Naa Tabariyeng, Ministry of Health, Ghana. Email: [email protected] Agneta Afriyie-Twumasi, Ministry of Health, Ghana. Email: [email protected] Michael Adu, Ministry of Health, Ghana. Email: [email protected] Desmond Dzidzornu Otoo, University of Ghana, Ghana. Email: [email protected] Saviour Kwame Yevutsey, Ministry of Health, Ghana and SAVING Consortium Email: [email protected] Maxwell Ayindenaba Dalaba, University of Health and Allied Sciences, Ghana and SAVING Consortium Email: [email protected] Mustapha Immurana, University of Health and Allied Sciences, Ghana and SAVING Consortium Email: [email protected] Matilda Aberese-Ako, University of Health and Allied Sciences, Ghana and SAVING Consortium Email: [email protected] Joycelyn Azeez, SAVING Consortium Email: [email protected] Evelyn Ansah, University of Health and Allied Sciences and SAVING Consortium Email: [email protected] Tuoyo Okorosobo, SAVING Consortium Email: [email protected] Olumide Ogundahunsi, SAVING Consortium Email: [email protected] Abraham Hodgson, SAVING Consortium Email: [email protected] Margaret Gyapong, University of Health and Allied Sciences and SAVING Consortium Email: [email protected] Corresponding author Brian Adu Asare, Ministry of Health, Ghana and SAVING Consortium [email protected] References WHO. Everybody’s business -- strengthening health systems to improve health outcomes: WHO’s framework for action [Internet]. Geneva: World Health Organization. 2007. Available from: https://apps.who.int/iris/handle/10665/43918 WHO. Monitoring the building blocks of health systems. 2010. WHO. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. 2010. HtaGlossary.net. HtaGlossary.net | health technology [Internet]. 2021 [cited 2021 Aug 24]. Available from: http://htaglossary.net/health-technology Jamal A, Vaccines. Advancements, Impact, and the Road Ahead in Medicine. BULLET: Jurnal Multidisiplin Ilmu. 2023;2(5):1047–55. Amerson AB. Drug Information Centers: An Overview. Drug Inf J. 1986;20(2):173–8. Inamdar SZ, Londhe SK, Kategri S, Kulkarni R, Badiger S, Biradar S. Evaluation of Drug Information Services in a Tertiary Care Hospital. Indian J Pharm Pract. 2023;16(4):349–52. Cardoni AA, Thompson TJ. Impact of drug information services on patient care. Am J Hosp Pharm. 1978;35(10):1233–7. WHO, Joint. FIP/WHO guidelines on good pharmacy practice: standards for quality of pharmacy services. Geneva; 2011. (WHO Technical Report Series). Report No.: No. 961. Ministry of Health. National Medicines Policy, 3rd Edition. Vol. 3rd edition, NMP. Ministry of Health; 2017. Parliament of Ghana. Pharmacy Act – 1994 (Act 489). Accra; 1994. Government of Ghana. Ghana Public Health Law Act, 851. 2nd Editio. Accra, Ghana: Ghana Publishing Corporation; 2012. Ministry of Health Ghana. Ghana National Drug Policy (Second Edition) [Internet]. 2nd Editio. Accra, Ghana: Yamens Press, Ministry of Health, Ghana National Drugs Programme. 2004. Available from: http://www.ghndp.org Ghana National Drugs Programme, Ministry of Health. National Drug Policy. Ministry of Health (GNDP) Ghana; 2004. Hogerzeil H, Macé C, Annan EA. Assessment of the implementation of the Ghana National Drug Policy 2004–2013, and Proposed policy directions for 2014–2020. Accra, Ghana; 2014. Access and Delivery Partnership. Framework for Strengthening Health Technology Access and Delivery in LMICs. 2018 [cited 2024 Oct 30]; Available from: https://adp.health.org Fixsen DL, Naoom SF, Blase KA, Friedman RM, Wallace F, Implementation Research. A Synthesis of the Literature. Tampa, FL, University of South Florida. Louis de la Parte Florida Mental Health Institute: The National Implementation Research Network (FMHI Publication #231).; 2005. Theobald S, Brandes N, Gyapong M, El-Saharty S, Proctor E, Diaz T, et al. Implementation research: new imperatives and opportunities in global health. Lancet. 2018;392(10160):2214–28. Peters DH, Adam T, Alonge O, Agyepong IA, Tran N. Republished research: Implementation research: what it is and how to do it. Br J Sports Med. 2014;48(8):731–6. Savings Consortium [Internet]. [cited 2025 Feb 12]. Available from: https://savingconsortium.org/ Amundstuen Reppe L, Spigset O, Schj\o{}tt J. Drug Information Services Today: Current Role and Future Perspectives in Rational Drug Therapy. Clin Ther. 2016;38(2):414–21. Shrestha S, Khatiwada AP, Gyawali S, Shankar PR, Palaian S. Overview, Challenges and Future Prospects of Drug Information Services in Nepal: A Reflective CommentaryJ Multidiscip Healthc. 2020;Volume 13:287–95. Vasileiou K, Barnett J, Thorpe S, Young T. Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period. BMC Med Res Methodol. 2018;18(1):148. ATLAS.ti Scientific Software Development GmbH. ATLAS.ti Web. ATLAS.ti Scientific Software Development GmbH; 2023. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3:77–101. Ghana Ministry of Health. Terms of Reference and meeting norms for the Ghana HTA governance structures. 1st edition. MOH, editor. Accra: MOH; 2019. Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterial1InterviewGuide.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 31 Mar, 2026 Reviewers invited by journal 26 Mar, 2026 Editor invited by journal 05 Mar, 2026 Editor assigned by journal 04 Mar, 2026 Submission checks completed at journal 04 Mar, 2026 First submitted to journal 02 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9012942","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":612797545,"identity":"7c749712-a68e-442c-9366-33ed90618cb6","order_by":0,"name":"Brian Adu 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Consortium","correspondingAuthor":false,"prefix":"","firstName":"Olumide","middleName":"","lastName":"Ogundahunsi","suffix":""},{"id":612797560,"identity":"8b36e742-db05-43c9-b90c-6a1809a4c4a8","order_by":15,"name":"Abraham Hodgson","email":"","orcid":"","institution":"SAVING Consortium","correspondingAuthor":false,"prefix":"","firstName":"Abraham","middleName":"","lastName":"Hodgson","suffix":""},{"id":612797561,"identity":"01afdc5c-d598-472c-b3dc-d544f6ec0402","order_by":16,"name":"Margaret Gyapong","email":"","orcid":"","institution":"University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Margaret","middleName":"","lastName":"Gyapong","suffix":""}],"badges":[],"createdAt":"2026-03-02 18:23:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9012942/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9012942/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107479847,"identity":"f4cfa3c5-3e88-41d5-9aef-f71f341d2825","added_by":"auto","created_at":"2026-04-22 01:55:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1194417,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9012942/v1/69c3e6ab-dd63-419d-b5a6-5add897c4d8b.pdf"},{"id":105690458,"identity":"0dbccdd1-4c69-419f-83ce-389e03ccf8dc","added_by":"auto","created_at":"2026-03-30 02:07:44","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":16829,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial1InterviewGuide.docx","url":"https://assets-eu.researchsquare.com/files/rs-9012942/v1/9a702e6bca76be367e615054.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Institutional Drug Information Dissemination in Ghana: Barriers, Enablers, and System-Level insights","fulltext":[{"header":"Background","content":"\u003cp\u003eHealth technologies play a pivotal role in the functioning of any healthcare system(\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e–\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e). These technologies are crucial tools for preventing, diagnosing, treating, and managing various health conditions(\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e5\u003c/span\u003e). In a rapidly evolving healthcare system, access to information about new health technologies is essential for improving their use and the intended health outcomes The effective dissemination of accurate, timely drug information (DI) should play a critical role in a health system’s capacity to ensure safe and effective application of these health technologies. This also has the potential to enhance clinical decision-making, streamline healthcare delivery processes, and empower patients to take an active role in managing their health.\u003c/p\u003e \u003cp\u003eDrug Information Centres (DICs) serve as centralised hubs that organise, evaluate and provide unbiased information on safety, efficacy, use, interactions and costs of health technologies, particularly drugs, to health professionals (i.e., clinicians, pharmacists, nurses, etc.), policymakers, and the general public. They are critical in-service delivery, education on health technologies and research (\u003cspan class=\"CitationRef\"\u003e6\u003c/span\u003e). When fully functional and institutionalised, DICs support evidence-based decision-making and contribute to improvements in prescribing behaviour and reduction in medication errors (\u003cspan class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e8\u003c/span\u003e). Global guidelines, such as the World Health Organization (WHO) guidelines on good pharmacy practice, emphasise the value of promoting evidence-based prescribing and mitigating medication-related harm, particularly in resource-limited settings, like Ghana (\u003cspan class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn Ghana, the National Medicines Policy (NMP) 3rd edition, 2017 (\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e) defines the broad framework for a functioning DI system. This framework includes structural and operational components. The structural components include the establishment of a functional National Drug Information Resource Centre (NDIRC) and the establishment of functional DICs in all teaching hospitals and regional hospitals. Some operational components include: collection, compilation, processing, presentation and dissemination of information regarding appropriate medicine use; collation of all documents related to the pharmaceutical sector at a designated centre (library); collaboration with all stakeholders, including Herbal Medicine Practitioners, to facilitate DI function; resourcing of NDIRC and generation of funds internally to support DI activities.\u003c/p\u003e \u003cp\u003eDespite the intended benefits from these NMP components, Ghana struggles to establish and sustain robust DI services, a situation which may be common to other low- and middle-income countries (LMICs). In the Ghana health system, the Ministry of Health (MoH) provides governance and oversight in policy formulation, the Pharmacy Council(\u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e) and Ghana Food and Drugs Authority (FDA)(\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e) share oversight responsibilities for regulation of practice and products respectively, while the Ghana Health Service (GHS) brings together products (health technologies) and practitioners (users of information on health technologies) for frontline service delivery. DICs were established based on recommendations from previous drug policies to provide information on medicines to support service delivery(\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e). However, a 2014 drug policy assessment highlighted broad challenges with the functionality of these DICs in the health system (\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e), negatively impacting the system. Unraveling and addressing the suboptimal functioning of the DICs could be best undertaken using implementation research methods.\u003c/p\u003e \u003cp\u003eImplementation Research (IR) offers a structured and systematic approach to identify and address gaps in translating evidence to practice, i.e., “know-do” gaps, including context-specific barriers, enablers and determinants across individual, organizational and system levels(\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e). It also tests strategies to integrate innovations into standard practice (\u003cspan class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e18\u003c/span\u003e), paving the way for tailored implementation of proven strategies (\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e). Applying IR to Ghana’s DI system can illuminate both supply-side constraints (e.g., staffing, infrastructure, governance) and demand-side factors (e.g., clinician attitudes, incentive structures), and guide interventions to strengthen institutionalisation and functionality of DICs.\u003c/p\u003e \u003cp\u003eThe SAVING (Sustainable Access and Delivery of New Vaccines in Ghana) Consortium(\u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e) made up of the University of Health and Allied Sciences (UHAS) as Consortium lead, the MoH, the Ghana Food and Drugs Authority (FDA), the Swiss Tropical and Public Health Institute (SwissTPH), collaborating with WHO (World Health Organization) TDR (special programme for Research and Training in Tropical Diseases) and Programme for Appropriate Technology in Health (PATH)/Access and Delivery Partnership (ADP) aims to build capacity in the use of implementation research to support policy implementation. The work of the Consortium draws on the Access and Delivery Partnership (ADP) framework(\u003cspan class=\"CitationRef\"\u003e21\u003c/span\u003e), which highlights the dissemination of information on new health technologies as essential in bridging information gaps across the policy-to-practice continuum. Hence, identifying and addressing barriers to functional DI systems(\u003cspan class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e23\u003c/span\u003e) would promote the successful adoption and integration of new health technologies.\u003c/p\u003e \u003cp\u003eThis study employs an IR approach, pre-intervention, to identify critical barriers and enablers to effective information dissemination on health technologies and propose pragmatic strategies as pathways to institutionalise sustainable, high-quality DI dissemination services.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eA qualitative approach was used to explore insights into the factors affecting functional systems for information dissemination on new technologies.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSampling\u003c/h3\u003e\n\u003cp\u003eA purposive sample, informed by stakeholder analysis of actors involved in medicines information dissemination, was employed. Stakeholder entities with high interest and high power in relation to the subject of enquiry (medicines information dissemination) were identified as participants for the study. These included eight (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) participants representing a mix of perspectives from practitioners, policymakers, subject matter experts and consumers of DI services. The team was open to reaching any other relevant stakeholder(s) beyond this initial list of participants. A profile of participants interviewed is provided in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eIn-depth interviews (IDIs) of study participants were conducted by trained researchers from February to March 2026, using open-ended questions using an interview guide with participant consent \u003cb\u003e(See Supplementary material 1)\u003c/b\u003e. The interviews were conducted in a manner ensuring privacy and lasted approximately 40 minutes. They were audio-recorded with the consent of the participants, transcribed verbatim and cross-checked for accuracy within the research team before data analysis. The transcriptions were captured in Microsoft Word and imported into Atlas.ti Web Edition version v9.24.3-2025-12-12 (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e), for coding and analysis.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe analysis used inductive thematic analysis through a stepwise, iterative process: transcripts were read and re-read for familiarisation and initial impressions, then openly coded using the research questions to maintain focus on the core concepts of inquiry. Similar and related codes were aggregated and synthesised in an iterative process to identify emerging themes under the research goals (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Validity and credibility of theme synthesis were enhanced through peer debriefing sessions. Key quotations were extracted to support synthesised themes. Anonymity was ensured as participant quotes were labelled using generic identifiers. Barriers and enablers were framed using the recommendations from the NMP as a framework for functional DICs.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarises the characteristics of key informants interviewed in the qualitative study. Most participants were pharmacists from the public sector, with representation from drug information practitioners, policy makers, policy implementers, a doctor from the private sector, and a development partner.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e, Profile of Participants for the in-depth interviews\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParticipant role/type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProfessional background\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSector / affiliation\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. DI practitioner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic sector\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. Health Professional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePrivate sector\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. DI practitioner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic sector\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. Policy implementer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic sector\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5. Policy maker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic sector\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6. Policy maker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic sector\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7. DI practitioner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDevelopment partner\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8. Policy implementer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic sector\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and weaknesses of the DI system in Ghana\u003c/h2\u003e \u003cp\u003eThe DI setup in Ghana reflects a system that is operational but faces multiple challenges. A DI unit exists under the Pharmacy Directorate of the MoH, with some teaching hospitals and facilities continuing to provide DI services. However, day-to-day utilisation has declined significantly over the years. Below are the strengths and weaknesses identified.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStrengths\u003c/h3\u003e\n\u003cp\u003eDespite the reported decline in the operationalisation of DICs, there are important strengths within Ghana\u0026rsquo;s DI landscape that can be leveraged for future improvement. These include:\u003c/p\u003e \u003cp\u003e(1) \u003cb\u003eResidual HR Capacity supporting services\u003c/b\u003e: A key strength lies in the HR capacity that remains in the system. Experienced personnel who helped institutionalise DI services are still active and can serve as a foundation for re-vitalising DI services. Some major facilities like teaching hospitals continue to maintain DI activities, preserving institutional memory and expertise that can be drawn upon to strengthen DI services across the country. Participants stated,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"There are key players still in the system\u0026hellip; we can still use them as well-resourced persons to help shape the future of drug information delivery in Ghana.\"\u003c/em\u003e \u003cb\u003e[Policy maker, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;\u003cem\u003eSo if you go to the teaching hospitals, they seem to have structured drug information services. More than, say, the secondary facilities and then the primary hospitals.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Policy implementer, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(2) \u003cb\u003eSustained demand for DI in Clinical practice\u003c/b\u003e: There is also demand among health professionals for DI services in clinical practice. Pharmacists are increasingly responding to real-time drug queries from doctors and nurses. The delivery of services in an integrated manner involving all professional groups helps to embed DI more deeply into healthcare delivery.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"Now, during ward rounds, when doctors or nurses want information related to a drug, the pharmacist is readily available,\"\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(3) \u003cb\u003eUpdated Curricula incorporating DI\u003c/b\u003e: In addition, participants indicated that some pharmacy schools in Ghana have incorporated DI into their curricula, ensuring that new graduates are better equipped with DI skills.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;\u003cem\u003eI know some of the schools, pharmacy schools, are also training or they've added DI to their curriculum.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Development partner]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003eWeaknesses\u003c/h3\u003e\n\u003cp\u003e(1) \u003cb\u003eAbsence of a clear national drug information strategy\u003c/b\u003e: One of the most significant weaknesses undermining DI services is the absence of a clear national DI strategy. There is no strategic framework or operational manual to guide the establishment, expansion, or standardisation of DI services across the country. One respondent stated that,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"We do not have a drug information strategy for the country, which will guide us where we are going, what we want to achieve in the next five or ten years.\"\u003c/em\u003e \u003cb\u003e[Policy maker, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(2) \u003cb\u003eLimited and inconsistent institutional support compounded by HR constraints\u003c/b\u003e: Institutional support for DI services has been weak and inconsistent. Leadership changes often disrupted continuity. HR constraints further compounded the problem. Facilities often lacked the staff needed to maintain a consistent DI service, with recruitment challenges cited as a major issue. Respondents mentioned:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"The one who was in charge, once the person left, nobody took it over,\"\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Development partner]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\"Recruitment is one\u0026hellip;. we are not getting recruitment from the Ministry of Finance for HR to directly recruit new people into the facilities\u0026hellip;\"\u003c/em\u003e \u003cb\u003e[Pharmacist, Policy maker, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(3) \u003cb\u003eLimited technical capacity\u003c/b\u003e: There is also a clear gap in technical capacity. Effective DI service requires skills in information retrieval, appraisal, and communication that are not widespread among available personnel. As a respondent noted,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"It takes a bit of skill and somebody with the know-how to interpret whatever you are getting.\"\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Development partner]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(4) \u003cb\u003eLimited visibility and awareness\u003c/b\u003e: Another persistent weakness is the limited visibility and lack of awareness of DI services, both within institutions and nationally. Many healthcare providers are unaware that DICs exist or that they can access these services easily. As one respondent shared:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"Health professionals not knowing that there's an institutionalized drug information unit or centres in their hospitals or nationally\u0026hellip; that's a major barrier.\"\u003c/em\u003e \u003cb\u003e[Policy maker, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(5) \u003cb\u003ePerception of DI as a project rather than a core health system function\u003c/b\u003e: Finally, the perception of DI services as a secondary or project-based activity, rather than an integral part of routine clinical care, continues to undermine its value. This view limits the institutional ownership and sustainability of DI efforts. A participant explained,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;I realized that people saw DI like a project, and though they embrace the concept all right, they saw it like somebody's job. Yeah. And they separated it from the routine work of the facility\u0026rdquo;\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Development partner]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eBarriers to functional and institutionalised information dissemination\u003c/h2\u003e \u003cp\u003eIn addition to the strengths and weaknesses of the DI system in Ghana, participants highlighted key barriers to functional and institutionalised DI services from the study. These include: weak and inconsistent institutional support compounded by HR constraints; inadequate funding and budgetary allocation; infrastructural and logistical challenges, including inadequate communication infrastructure and internet, and inadequate human resources; limited access to reference materials and alternative information sources; limited HR technical capacity to man DICs; limited visibility and lack of awareness of DI with subsequent under-utilisation of services; continuous shift to digital and self-sourced information; as well as poor stakeholder engagement. Among these, weak and inconsistent institutional support compounded by HR constraints, limited HR technical capacity to man DICs, as well as limited visibility and lack of awareness of DI with subsequent under-utilisation of services, were identified as weaknesses which were also barriers to DI services.\u003c/p\u003e \u003cp\u003e(1) \u003cb\u003eWeak institutional support, compounded by HR constraints and weak governance systems\u003c/b\u003e: The absence of institutional or consistent management support was also identified as a barrier to the effective dissemination of information on health technologies. Aside from weak institutional management, weak governance oversight of the DI system was also identified as a barrier. It was highlighted that there was a need to ensure people are held responsible to ensure accountability, so that the centres serve the needs of the facility. Participants noted:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;\u003cem\u003eDealing with management, there are some things that you make a case for, but you keep on making the case, but you're not getting the support. So, sometimes it leads to even fatigue on your side. So, you just decide to make do with what you have in the best way possible\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Pharmacist, DI practitioner, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u0026ldquo;\u0026hellip;\u003cem\u003ePeople are held responsible, make sure that people report on whatever it does, and the centre is serving the needs of the facility; otherwise it will be a white horse\u0026rdquo;\u0026hellip;..\u003c/em\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\"Since I transitioned and moved out of that place, I have not seen any national action to sustain what was started.\"\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Development partner]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(2) \u003cb\u003eInadequate funding and budgetary allocation\u003c/b\u003e: Funding and budgeting issues were also identified. It was noted that DI services often do not have any budget lines for their set-up and operations. One participant said,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;\u003cem\u003eOne of the structural barriers is funding. With less funding, definitely, things are going to be at a standstill. So, I would suggest in this case that the Health Information Department make a strong case for the PPME to include it in their subsequent budgets\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Pharmacist, Policy makers, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(3) \u003cb\u003eInfrastructural and logistical constraints, including inadequate communication infrastructure and internet\u003c/b\u003e: Structural and logistical barriers were widely reported, including inadequate space, weak communication infrastructure, lack of functioning telephones and intercom systems, and unreliable internet access. Some staff are reported to have attempted to fix these challenges on their own initiative. These challenges limited providers\u0026rsquo; ability to reach DI pharmacists and access or disseminate health technology information effectively. Participants responded:\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eWith structural barriers, the first thing that comes to my mind is a place reserved for drug information. There should be a very good place for the drug information service so that people who work there would work with convenience\u0026rdquo;.\u003c/em\u003e\u003cb\u003e[Policy implementer, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eSo, with the barriers, I'll categorize them. So, let's say the first one has to do with the resources and then the structure\u0026rdquo;. \u0026hellip;\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cem\u003e\"At some point there were technical challenges across the whole institution, so the phones were not working at all\u0026hellip; it went on for a very long time.\"...\u003c/em\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;Some staff had to find a way to fix these telephones by themselves\u003c/em\u003e. \u003cem\u003eAt some point there was some technical challenges which was across the whole institution, so the phones were not working at all I mean it went on for a very long time.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Pharmacist, DI practitioner, Public sector]\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eBut in present times, we have a lot of information, but you need internet access\u0026ldquo;\u003c/em\u003e, said one respondent. \u003cb\u003e[Policy implementer, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u0026hellip; \u003cem\u003eSo, wherever you are, so far as you have internet access, which has improved compared to years back, I think yes, that structure is not an issue now\u003c/em\u003e.\u003cem\u003e\u0026rdquo;\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e \u003cp\u003eWhere the information is available or accessible, the absence of appropriate digital technologies to facilitate the effective dissemination of health technologies was identified as a challenge. One respondent said,\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;So, the structural barriers include the absence of a digital platform which will be well known to professionals or care providers that if they need information on certain medicines, they can easily go to and have themselves updated on the current technologies available in the system\u0026rdquo;.\u003c/em\u003e \u003cspan type=\"BoldItalicUnderline\" class=\"BoldItalicUnderline\" name=\"Emphasis\"\u003e[Policy maker, Pharmacist, Public sector]\u003c/span\u003e\u003c/p\u003e \u003cp\u003e(4) \u003cb\u003eLimited access to reference materials\u003c/b\u003e: Limited access to current reference materials, journals, and affordable subscriptions was identified as a key barrier to effective DI. Although online information is widely available, outdated resources and concerns about reliability often leave professionals unable to find or verify needed information. Participants added that:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;Okay, so the resources I'm talking about are reference materials and specifically online reference materials, so access to journals, access to published work, and all that\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Pharmacist, DI practitioner, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(5) \u003cb\u003elimited technical capacity, to man DICs\u003c/b\u003e: A notable barrier also identified was staff challenges. Most facilities needed human resources to man DI units. However, the Ministry of Finance is unable to provide clearance for the recruitment of personnel. With a lack of recruitment, there will be fewer staff to effectively execute DI work. Participants indicated,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;Personnel, which can also be a barrier, affects effective DI services\u0026rdquo;\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Development partner]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;\u0026hellip;it takes a bit of skill, and it takes a bit of somebody with the know-how to interpret whatever you are getting.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Development partner]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(6) \u003cb\u003eLimited of visibility and limited awareness of DI with subsequent under-utilisation of services\u003c/b\u003e: Structural and institutional shifts have reduced the visibility and functionality of DI units. The relocation of the DI secretariat, though intended to strengthen DI, did not improve its visibility or use. Many facilities, especially private ones, lack formal DI units due to limited awareness of their role and resource needs. Even where DI units exist, services are often underutilised, with few formal email requests and most enquiries handled informally by phone calls or occasional walk-ins. This suggests that, beyond larger public institutions, DI services remain poorly integrated into routine healthcare delivery. Respondents mentioned,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"Yes, so currently I would say that it's not serving the purpose for which it was established because even the location in the past, it has moved from the premises of the Pharmacy Council to the current position of the Ministry of Health itself and that's what informed the development of the new Ministry of Health organizational manual that this unit should be now housed at the Pharmacy Directorate of the Ministry of Health.\"\u0026hellip;\u003c/em\u003e \u003c/p\u003e\u003cp\u003e\u0026ldquo;\u003cem\u003eAnother one is the health professional not knowing that there's an institutionalised drug information unit or centres in their hospitals or nationally for them to quickly access the information that they need on health technologies\u0026rdquo;\u003c/em\u003e \u0026hellip;\u003c/p\u003e\u003cp\u003e\u0026ldquo;\u003cem\u003e\u0026hellip;updating or informing other healthcare providers that there is this service on drug information in the system. It's one of the policy barriers that we can look at\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Policy maker, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\"I don't have such a thing in my facility\u0026hellip; most of them may not even have any idea what you are talking about\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Doctor, Private sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\"Patronage has gone down drastically when it comes to passive drug information delivery where you receive a drug-related question and then generate a response.\"\u003c/em\u003e \u003cb\u003e[Pharmacist, DI practitioner, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(7) \u003cb\u003eContinuous shift to digital through self-sourced information\u003c/b\u003e: The widespread shift to digital tools has become a barrier to facility-based DI services. Increased use of smartphones, apps, and internet resources has changed how health professionals seek drug information, often bypassing institutional DI units. While digital access enables quicker information retrieval, it also increases reliance on self-sourced information unless users are guided to reliable, up-to-date sources. Participants stated that:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"Currently it looks like almost every healthcare professional has one or two apps or even more installed on their smartphones. So mostly whenever they are looking for information, they resort to these apps that they have. Or even they will go on to the internet, try to get information\u0026rdquo;.\u003c/em\u003e \u003cb\u003e[Pharmacist, DI practitioner, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\"\u0026hellip;Even the handset that we use\u0026hellip; our mobile phones, can equally provide that.\" \u0026hellip;\u003c/em\u003e \u003c/p\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;\u0026hellip; the era that we find ourselves in now has made it much easier, and it's even getting much easier for people to look for information by themselves\u0026rdquo; \u0026hellip;\u003c/em\u003e \u003c/p\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;So, they only contact you when probably what they are looking for, they were not able, or they are not able to get it from the internet or from the app.\"\u003c/em\u003e \u003cb\u003e[Pharmacist, DI practitioner, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e(6) \u003cb\u003eWeak stakeholder engagement\u003c/b\u003e: Respondents noted that, in terms of DI services, many stakeholders have been left out. They added that non-engagement of stakeholders in the institutionalisation of DI services had been a major obstacle. A respondent stated that,\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u0026hellip; \u003cem\u003eAnd then set up the drug information in the hospitals, so that all stakeholders are engaged to know that there is a service like this else it will not work.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Policy maker, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eEnablers to functional and institutionalised information dissemination\u003c/h2\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e(1) Recognition of the importance of accurate, effective and timely Information Dissemination on New Technologies:\u003c/h2\u003e \u003cp\u003eRespondents underscored that effective dissemination of information is essential for the successful rollout and proper use of new health technologies in Ghana. The overarching message was that without adequate drug information, healthcare professionals and patients may misuse or underutilise these technologies. Respondents pointed out that clear, accurate, and timely information helps improve not only the adoption of technologies but also their lifespan and value. Participants explained,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"It's very, very important because, I mean, in the healthcare system, those who matter, the key stakeholders, those who are the healthcare professionals should be well-versed with any new medical technology which is being, which is going to be rolled out. So, I think that one is very, very crucial and very, very important.\"\u003c/em\u003e \u003cb\u003e[Pharmacist, DI practitioner, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\"If we have the right information on such things, it will even improve the longevity of these equipment and then of the technology and then we'll be able to make better use of them.\"\u003c/em\u003e \u003cb\u003e[Policy implementer, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\"The fact that there's a new technology means that there should be somebody there disseminating information on the new technology to targeted populations... because you come to realize that most times it is lack of information that makes us do things in a way that we shouldn't do.\"\u003c/em\u003e \u003cb\u003e[Policy implementer, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eSeveral respondents emphasised that the impact of information extends directly to patient outcomes. Noting that the accuracy of information contributes to patients\u0026rsquo; treatment outcomes. Respondents also pointed to national-level interventions, such as the rapid dissemination of information during the COVID-19 pandemic. Respondents said,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\"Yeah, to me, I think it's very, very important because when the information that you give out is not accurate, it goes a long way to actually impact on treatment, patient treatment outcome.\"\u003c/em\u003e\u003cb\u003e[DI practitioner, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Where good information dissemination has made a difference, let me say COVID. When the COVID vaccines came into being and we quickly developed a standard treatment guideline for COVID treatment or management, this information was quickly shared on platforms.\u0026rdquo;\u003c/em\u003e\u003cb\u003e[Policy maker, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThe importance of timely and effective information dissemination was also linked to ensuring broad access to new treatments. One respondent noted that without it, many people may miss out on new treatments.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"Without effective information on this new intervention, a lot of people are going to lose out on new treatments. Whereas in developed countries, they will benefit.\"\u003c/em\u003e \u003cb\u003e[Pharmacist, Policy makers, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e(2) Recognition of the linkage between DI and broader system and policy context:\u003c/h2\u003e \u003cp\u003e Several respondents linked drug information with broader system functions like guidelines, formularies, and national adoption of technology. Others stressed the policy-level significance. Respondents noted,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\"Yes, so it's very, very important. Sometimes when new medicines are added to the national standard treatment guideline and essential medicine list, we need this information to. be disseminated properly so that the medicines are properly used at the facility level.\"\u003c/em\u003e\u003cb\u003e[Policy maker, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"Drug information or information sharing on technologies, including medicines, are very crucial and well-acknowledged by the policy documents in the Ministry of Health.\"-\u003c/em\u003e\u003cb\u003e[Policy maker, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e(3) Recognition of the impact of strong information dissemination on health outcomes:\u003c/h2\u003e \u003cp\u003eRespondents shared specific examples where strong information dissemination had clear, positive outcomes. One respondent described a case involving methylated spirit that had caused adverse reactions among ward staff due to improper handling and the use of chlorhexidine for umbilical cord care. The DI unit intervened:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThere was a case I think was it last year?, there was a case of adverse reaction with handling of methylated spirit at the ward level... so the drug information was tasked to bring out\u0026hellip; material like the currency of print regards to safety handling of methylated spirit. So, we broke it down to the level where the orderlies and all those ward assistants could also [understand]. So, I mean, it worked very, very well. Since then, the incidence of mishandling of these methylated spirits also went down.\u003c/p\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;There was also an incident with the use of chlorhexidine in the management or treatment of the umbilical cord. That one too, there was an education to that effect on the proper handling or the proper use of the chlorhexidine.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Pharmacist, DI practitioner, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eDespite systemic limitations, some DI initiatives in Ghana have shown promise. Respondents referenced a range of facility-level interventions that improved access to information. For instance, one respondent described efforts to share information with prescribers and staff: It was recommended that education on DI should be added to continuous professional development sources for doctors. Collaboration with drugs and therapeutic committees (DTCs) and clinical staff was also identified as key.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;We also do CPDs for the prescribers, the doctors. Yes. We also have health staff meetings. So sometimes we get the opportunity to educate them. So, we join the DTCs and the MTCs and then we also work with the clinicians in the facilities.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eSolutions and Strategies for Improvement\u003c/h2\u003e \u003cp\u003eStakeholders across all interviews offered concrete proposals for how the DI system in Ghana could be revitalised. Their ideas, drawn from experience and a clear sense of what is practical, can be organised across three implementation phases.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e(1) Evaluation of the current situation of DICs and DI system\u003c/h2\u003e \u003cp\u003eThe first step proposed by participants is a situational analysis, which could inform a new strategy and manual. This includes mapping all existing DI units, evaluating their performance, and identifying gaps in infrastructure and human resources. A retired policy advisor emphasised,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\"First of all, we need to know what we have. These assessments. What is there? Now, when we know that, then we take our policies, and we compare what is there with what should be there...\"\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;So, we need to go back and do a needs assessment... Know your gaps. Know your requirements. Then you do the plus or minus. Then you\u0026rsquo;ll be fine.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Policy implementer, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e(2) Active engagement of stakeholders, including the media and general public\u003c/h2\u003e \u003cp\u003eParticipants underscored the active participation of stakeholders as part of the solution. Healthcare professionals were identified as the frontline communicators. The general public is important as a user of accurate information. Some selected quotes:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;When we do community-based programs, we also take the opportunity to educate the public on drug safety and how to use their medicines well.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Pharmacist, Policy makers, Public sector]\u003c/b\u003e\u003c/p\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;Ideally, these things should be disseminated, not just to health professionals, but the public as well.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Doctor, Private sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e(3) Re-introduction of the drug information newsletter into DI operations\u003c/h2\u003e \u003cp\u003eParticipants recommended the re-establishment of known information dissemination platforms, such as the previous periodic DI newsletter, possibly via a digital platform. This was seen as a basic and standard dissemination platform which should exist to retain the visibility and relevance. As one participant put it,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;We should have a standard newsletter that could be sent to every region... Even if it is quarterly.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[Pharmacist, Policy maker, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e(4) Re-establishment of the National Drug Information Resource Centre (NDIRC)\u003c/h2\u003e \u003cp\u003eParticipants also alluded to the re-establishment of the NDIRC as foundational. A participant noted,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;It has been a challenge even sustaining that place\u0026hellip; I\u0026rsquo;ve not seen any other national action to sustain what was started.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Development partner]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e(5) Continuous training for DI practitioners\u003c/h2\u003e \u003cp\u003eAdditionally, stakeholders emphasised the need to train pharmacists using continuous training models in order to sustain the skills to manage DI centres. One participant said,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003e\u0026ldquo;You need to do continuous training for them to get the needed skills to manage these centres.\u0026rdquo;\u003c/em\u003e \u003cb\u003e[DI practitioner, Pharmacist, Public sector]\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThese efforts, though described informally, reflect the beginnings of localised solutions such as bulletins, education sessions, and committee involvement. However, such successes remain fragmented and unevenly distributed across the country.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eDue to the time lapse between the period of functional DICs and the time of the assessment, responses could be affected by recall bias, especially those respondents who worked within the DI system. To reduce this, respondents selected were a mix of those currently working in the few DI systems and previous staff, to recollect institutional memory.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study provides critical insights into the state of Ghana\u0026rsquo;s DI system and highlights both enabling factors and significant obstacles that must be addressed to enhance information dissemination and utilisation. Our findings corroborate the importance of policy frameworks such as the National Medicines Policy (2017\u0026ndash;2021) (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) and the establishment of the Drug Information Research Monitoring and Evaluation Unit (DIRMEU) and Health Technology Assessment (HTA) secretariat (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)in creating an enabling environment for DI activities. However, although these structures exist, the absence of a clear national DI strategy, weak institutional support, and limited technical capacity undermine their potential impact.\u003c/p\u003e \u003cp\u003eDespite the reported formal incorporation of DI roles into curricula in pharmacy schools and the willingness among pharmacists to integrate DI into clinical rounds, day-to-day service, utilisation has waned. Our study identified key strengths, residual experienced personnel, curricular integration, and pockets of sustained DI services in major teaching hospitals, which can serve as anchors for revitalisation efforts. Yet, weaknesses such as inconsistent leadership continuity, inadequate recruitment, and the perception of DI as a project rather than a routine practice have eroded institutional ownership and visibility of DI units.\u003c/p\u003e \u003cp\u003eMapping these weaknesses onto the nine primary barriers elucidated by the participants reveals a complex interplay of factors: Shift to digital/self-sourced information reduces reliance on formal DI units and emphasises the need for official, up-to-date digital platforms.\u003c/p\u003e \u003cp\u003eLimited awareness and visibility of DI services lead to underutilization, particularly in private facilities where units are often unknown. Restricted access to reference materials, both paid subscriptions and current online databases- hampers evidence retrieval and appraisal. Infrastructural/logistical constraints, including broken telecommunication systems, a lack of dedicated DI spaces, and unreliable internet connectivity, impede timely responses. Inadequate human resources and technical skills limit the ability of the remaining staff to retrieve, interpret, and communicate drug information effectively. Weak governance and management support create accountability gaps, such that DI units lack champions to sustain operations through leadership transitions. Insufficient funding and budget allocations prevent the expansion of services or the procurement of essential resources.\u003c/p\u003e \u003cp\u003ePoor stakeholder engagement, with clinicians, administrators, and information and communications technology (ICT) partners not fully mobilised around DI objectives. Loss of institutional oversight arising from the physical relocation of DI secretariats further dilutes service awareness.\u003c/p\u003e \u003cp\u003eThese barriers not only echo challenges observed in other LMIC settings(27\u0026ndash;29) but also point to unique institutional gaps within Ghana\u0026rsquo;s health system. For instance, while the DIRMEU was conceived to serve as a hub for accurate, timely drug information, it has struggled to maintain visibility and stakeholder buy-in, highlighting the disconnect between policy intent and operational reality.\u003c/p\u003e \u003cp\u003eGoing forward, strengthening Ghana\u0026rsquo;s DI system will require a multi-phase approach leveraging the IR model (\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Phase 1 should include a comprehensive situational analysis to map existing DI units, assess infrastructure and staffing levels, and benchmark against international guidelines. Phase 2 must institutionalise DI services by securing dedicated budget lines, assigning physical space in all major hospitals, and deploying a centralised digital platform accessible via web and mobile. Phase 3 will focus on capacity building, embedding DI competencies into continuous professional development, leveraging experienced personnel as trainers, and establishing performance indicators tied to DI outputs such as bulletins and query response times.\u003c/p\u003e \u003cp\u003eA sustained stakeholder engagement strategy is essential: clinical staff, pharmacists, policy makers, academia, media, and the public must be mobilised to demand and participate in robust DI services. Ultimately, translating Ghana\u0026rsquo;s policy frameworks into effective practice hinges on bridging the gap between institutional mandates and on-the-ground operations, an endeavour anchored by the empirical findings of this study and informed by global best practices in DI service delivery.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eWe highlight key weaknesses and barriers to functional and institutionalised DI dissemination in Ghana, while also identifying residual strengths, including existing HR capacity, sustained clinical demand, and DI in training curricula. Functional DI services are essential for evidence-based care, rational medicine use, and patient safety, but remain constrained by weak institutional support, inadequate funding, infrastructural and communication challenges, limited access to reference materials, low technical capacity, poor visibility, growing reliance on self-sourced digital information, and weak stakeholder engagement. Proposed solutions included evaluating the DI system, engaging stakeholders and the public, re-establishing the National Drug Information Resource Centre, reintroducing the DI newsletter, and strengthening continuous training. These findings call for sustained institutional commitment and coordinated investment to build visible, well-resourced, and sustainable DI services in Ghana.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eADP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAccess and Delivery Partnership\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOVID-19\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCoronavirus Disease 2019\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCPDs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eContinuous Professional Development\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDrug Information\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDICs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDrug Information Centres\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDIRMEU\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDrug Information Research Monitoring and Evaluation Unit\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDTCs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDrugs and Therapeutic Committees\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEDCTP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEuropean and Developing Countries Clinical Trials Partnership\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFDA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGhana Food and Drugs Authority\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGHS-ERC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGhana Health Service Ethical Review Committee\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGHS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGhana Health Service\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHuman resource\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHTA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHealth Technology Assessment\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIDIs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIn-depth interviews\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInformation and Communications Technology\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eImplementation Research\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLMICs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLow- and middle-income countries\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMoH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMinistry of Health\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMTCs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMedicines and Therapeutic Committees\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNDIRC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNational Drug Information Resource Centre\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNMP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNational Medicines Policy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePATH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eProgramme for Appropriate Technology in Health\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePPME\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePolicy Planning Monitoring and Evaluation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSAVING\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSustainable Access and Delivery of New Vaccines in Ghana\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSwissTPH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSwiss Tropical and Public Health Institute\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTDR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSpecial Programme for Research and Training in Tropical Diseases\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUHAS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eUniversity of Health and Allied Sciences\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Ghana Health Service Ethical Review Committee (GHS-ERC 003/05/22) and the Ethical Review Committee of the University of Health and Allied Sciences (UHAS-REC A.9[1] 21-22). All participants provided informed consent before participating in the study. Participants were assured of their right to withdraw from the study at any time without any negative consequences. Confidentiality was maintained by anonymising the data and storing it securely.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data and materials underlying the analysis are available, provided it does not breach ethical confidentiality clauses for best research practices. Where the sources are articles or documents, these are cited, and references are provided to the source articles.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe conduct of this study was made possible through funding from the European and Developing Countries Clinical Trials Partnership (EDCTP), project (Grant number CSA2018HS-2528), implemented by the SAVING Consortium in Ghana. \u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBAA prepared the initial draft of the manuscript. MG, EA, AH, TO, and OO provided leadership and guided the design of the study. EA, IA, DDO and BAA collected data for the study. DDO, SKY, JA, MAD, MI, MA, AA, JNT, and MAA reviewed the draft manuscript, providing inputs and perspectives. SKY and JA provided policy perspectives to the analysis. BAA, EA, JNT and MA edited the manuscript. All authors reviewed the manuscript. \u003c/p\u003e\n\u003cp\u003eAcknowledgement\u003c/p\u003e\n\u003cp\u003eThis study was made possible through funding from the European and Developing Countries Clinical Trials Partnership (EDCTP), through the SAVING Consortium. The Access and Delivery Partnership (ADP) is acknowledged for the various roles it has played in this study. We also thank the study participants for their participation in providing vital information.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBrian Adu Asare, Ministry of Health, Ghana and SAVING Consortium \u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eEmmanuella Abassah-Konadu, Ministry of Health, Ghana and SAVING Consortium\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eIvy Amankwah, Ministry of Health, Ghana. \u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eJustice Naa Tabariyeng, Ministry of Health, Ghana.\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eAgneta Afriyie-Twumasi, Ministry of Health, Ghana.\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eMichael Adu, Ministry of Health, Ghana.\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eDesmond Dzidzornu Otoo, University of Ghana, Ghana. \u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eSaviour Kwame Yevutsey, Ministry of Health, Ghana and SAVING Consortium\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eMaxwell Ayindenaba Dalaba, University of Health and Allied Sciences, Ghana and SAVING Consortium\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eMustapha Immurana, University of Health and Allied Sciences, Ghana and SAVING Consortium\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eMatilda Aberese-Ako, University of Health and Allied Sciences, Ghana and SAVING Consortium\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eJoycelyn Azeez, SAVING Consortium\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eEvelyn Ansah, University of Health and Allied Sciences and SAVING Consortium\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eTuoyo Okorosobo, SAVING Consortium \u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eOlumide Ogundahunsi, SAVING Consortium\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eAbraham Hodgson, SAVING Consortium \u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003eMargaret Gyapong, University of Health and Allied Sciences and SAVING Consortium\u003c/p\u003e\n\u003cp\u003eEmail: [email protected]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBrian Adu Asare, Ministry of Health, Ghana and SAVING Consortium\u003c/p\u003e\n\u003cp\[email protected]\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWHO. Everybody\u0026rsquo;s business -- strengthening health systems to improve health outcomes: WHO\u0026rsquo;s framework for action [Internet]. Geneva: World Health Organization. 2007. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://apps.who.int/iris/handle/10665/43918\u003c/span\u003e\u003cspan address=\"https://apps.who.int/iris/handle/10665/43918\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. Monitoring the building blocks of health systems. 2010.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. 2010.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHtaGlossary.net. HtaGlossary.net | health technology [Internet]. 2021 [cited 2021 Aug 24]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://htaglossary.net/health-technology\u003c/span\u003e\u003cspan address=\"http://htaglossary.net/health-technology\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJamal A, Vaccines. Advancements, Impact, and the Road Ahead in Medicine. BULLET: Jurnal Multidisiplin Ilmu. 2023;2(5):1047\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmerson AB. Drug Information Centers: An Overview. Drug Inf J. 1986;20(2):173\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInamdar SZ, Londhe SK, Kategri S, Kulkarni R, Badiger S, Biradar S. Evaluation of Drug Information Services in a Tertiary Care Hospital. Indian J Pharm Pract. 2023;16(4):349\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCardoni AA, Thompson TJ. Impact of drug information services on patient care. Am J Hosp Pharm. 1978;35(10):1233\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO, Joint. FIP/WHO guidelines on good pharmacy practice: standards for quality of pharmacy services. Geneva; 2011. (WHO Technical Report Series). Report No.: No. 961.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMinistry of Health. National Medicines Policy, 3rd Edition. Vol. 3rd edition, NMP. Ministry of Health; 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eParliament of Ghana. Pharmacy Act \u0026ndash; 1994 (Act 489). Accra; 1994.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGovernment of Ghana. Ghana Public Health Law Act, 851. 2nd Editio. Accra, Ghana: Ghana Publishing Corporation; 2012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMinistry of Health Ghana. Ghana National Drug Policy (Second Edition) [Internet]. 2nd Editio. Accra, Ghana: Yamens Press, Ministry of Health, Ghana National Drugs Programme. 2004. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.ghndp.org\u003c/span\u003e\u003cspan address=\"http://www.ghndp.org\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGhana National Drugs Programme, Ministry of Health. National Drug Policy. Ministry of Health (GNDP) Ghana; 2004.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHogerzeil H, Mac\u0026eacute; C, Annan EA. Assessment of the implementation of the Ghana National Drug Policy 2004\u0026ndash;2013, and Proposed policy directions for 2014\u0026ndash;2020. Accra, Ghana; 2014.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAccess and Delivery Partnership. Framework for Strengthening Health Technology Access and Delivery in LMICs. 2018 [cited 2024 Oct 30]; Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://adp.health.org\u003c/span\u003e\u003cspan address=\"https://adp.health.org\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFixsen DL, Naoom SF, Blase KA, Friedman RM, Wallace F, Implementation Research. A Synthesis of the Literature. Tampa, FL, University of South Florida. Louis de la Parte Florida Mental Health Institute: The National Implementation Research Network (FMHI Publication #231).; 2005.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTheobald S, Brandes N, Gyapong M, El-Saharty S, Proctor E, Diaz T, et al. Implementation research: new imperatives and opportunities in global health. Lancet. 2018;392(10160):2214\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeters DH, Adam T, Alonge O, Agyepong IA, Tran N. Republished research: Implementation research: what it is and how to do it. Br J Sports Med. 2014;48(8):731\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSavings Consortium [Internet]. [cited 2025 Feb 12]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://savingconsortium.org/\u003c/span\u003e\u003cspan address=\"https://savingconsortium.org/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmundstuen Reppe L, Spigset O, Schj\\o{}tt J. Drug Information Services Today: Current Role and Future Perspectives in Rational Drug Therapy. Clin Ther. 2016;38(2):414\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShrestha S, Khatiwada AP, Gyawali S, Shankar PR, Palaian S. Overview, Challenges and Future Prospects of Drug Information Services in Nepal: A Reflective CommentaryJ Multidiscip Healthc. 2020;Volume 13:287\u0026ndash;95.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVasileiou K, Barnett J, Thorpe S, Young T. Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period. BMC Med Res Methodol. 2018;18(1):148.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eATLAS.ti Scientific Software Development GmbH. ATLAS.ti Web. ATLAS.ti Scientific Software Development GmbH; 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3:77\u0026ndash;101.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGhana Ministry of Health. Terms of Reference and meeting norms for the Ghana HTA governance structures. 1st edition. MOH, editor. Accra: MOH; 2019.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Drug Information Services, Implementation Research, Barriers, Enablers, Drug Information Unit, Health Systems, Ghana","lastPublishedDoi":"10.21203/rs.3.rs-9012942/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9012942/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Drug Information (DI) services are essential for safe and rational use of health technologies by providing timely, unbiased information to health professionals, policymakers, and the public. In Ghana, DI dissemination remains poorly institutionalised. Implementation Research (IR) offers a structured approach for identifying context-specific bottlenecks and practical strategies for integrating DI services into routine healthcare delivery. We explored the strengths, weaknesses, barriers, enablers, and strategies for strengthening DI services.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e We conducted a qualitative exploratory study using purposive sampling of eight (n=8) key stakeholders involved in DI service delivery and use, including hospital pharmacists, a medical doctor, and Ministry of Health officials. In-depth interviews were conducted to elicit experiences and perceptions regarding DI systems. Interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis to identify key strengths, weaknesses, barriers, enablers, and recommended implementation strategies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Participants identified important strengths within Ghana’s DI landscape, including residual human resource (HR) capacity supporting services, sustained demand for DI in clinical practice, and updated curricula incorporating DI. These strengths were undermined by weaknesses, including the absence of a clear national drug information strategy, limited and inconsistent institutional management support compounded by HR constraints, limited technical capacity, limited visibility and awareness, and the perception of DI as a project rather than a core health system function.\u003c/p\u003e\n\u003cp\u003eKey barriers included weak institutional support, inadequate-funding, infrastructural and logistical constraints, limited-access to reference materials, limited technical capacity, limited visibility/awareness with under-utilisation of services, continuous shift to digital through self-sourced information and weak stakeholder engagement.\u003cstrong\u003e \u003c/strong\u003eEnablers included recognition of the importance of timely and accurate information dissemination, its linkage to the wider health system and policy context, and its impact on health outcomes. Suggested strategies to address the identified barriers included evaluating the DI system to inform a new strategy and manual, active stakeholder engagement, reintroducing the DI newsletter via the digital DI platform, re-establishing the National Drug Information Resource Centre, and providing continuous training.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Functional DI services are critical to evidence-based care and safe medicine use. Strengthening the system will require coordinated reforms to move DI from a fragmented to a sustainable health system function.\u003c/p\u003e","manuscriptTitle":"Institutional Drug Information Dissemination in Ghana: Barriers, Enablers, and System-Level insights","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-30 02:07:39","doi":"10.21203/rs.3.rs-9012942/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"264300654298527451752943207981327286895","date":"2026-03-31T09:38:01+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-26T09:06:35+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-05T06:05:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-04T07:01:25+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-04T06:56:14+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2026-03-02T18:08:45+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5e12f764-178c-4fc4-a801-285b53c76567","owner":[],"postedDate":"March 30th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-30T02:07:39+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-30 02:07:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9012942","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9012942","identity":"rs-9012942","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}