Adaptive professionalism among rural primary care pharmacists: A qualitative study of stunting prevention practice in eastern Indonesia.

BACKGROUND

In rural primary care, pharmacists are increasingly expected to support preventive and public health activities, yet their role adaptation in under-resourced systems remains insufficiently understood. In Eastern Indonesia, stunting prevention provides a relevant context for examining pharmacists' expanded responsibilities in medicine and micronutrient supply, counseling support for mothers and children, and community-based preventive services.

OBJECTIVE

This study examined how rural primary care pharmacists in East Nusa Tenggara adapt their professional roles in stunting prevention practice, using adaptive professionalism as an analytic lens.

METHODS

A qualitative case study was conducted in Ngada and East Manggarai districts. All eligible pharmacists working in Puskesmas in the selected districts were invited to participate, resulting in a final sample of ten participants. Semi-structured interviews were conducted between April and July 2024. Data were analyzed inductively using Braun and Clarke's thematic approach, supported by OpenCode version 4.03.

RESULTS

Five themes were identified: expanding professional boundaries, adapting to logistical and workforce constraints, negotiating interprofessional collaboration, responding to institutional dynamics, and sustaining community-oriented professional values. Pharmacists described roles in micronutrient and medicine supply coordination, posyandu outreach, counseling support, and maintaining program continuity when service gaps emerged.

CONCLUSION

Adaptive professionalism was enacted through everyday adjustments to service needs, interprofessional expectations, and resource limitations. Pharmacists' adaptive practices reflected a negotiated response to the practical demands of stunting prevention in rural primary care. Clearer role recognition, institutional support, and integration into preventive health programs are needed to sustain these contributions.