Quality Assurance in Pharmacy Education in the East African Community: National Accreditation, Regional Harmonization, and Continuous Improvement

Abstract

Quality assurance (QA) in pharmacy education concerns both educational standards and the competence of graduates. This structured narrative review examines entry-to-practice pharmacy education in the eight East African Community (EAC) Partner States. The initial search focused on PubMed-indexed literature and official sources. During revision, the search was expanded to Scopus, PubMed, Google Scholar, and English- and French-language institutional sources, with final retrieval on October 4, 2026. Publications from 2015 onward were prioritized, with relevant earlier educational studies, legislation, and foundational frameworks also included. Selection focused on accreditation, competencies, curriculum, educational capacity, assessment, graduate outcomes, and continuous improvement. Evidence availability differs among Partner States. Institutional studies document curriculum reform, clinical training, assessment, and short-term learning outcomes, but evidence on graduate competence and the effects of QA systems remains limited. Shared core competencies, pharmacy-specific benchmarks, outcome monitoring, and documented improvement cycles are proposed within existing national and regional arrangements. The proposed framework is a conceptual synthesis requiring stakeholder validation and empirical pilot testing before operational use.

Introduction

The quality of pharmacy education has important implications for the competence of the pharmaceutical workforce and for the quality and safety of pharmaceutical services.^1,2 As pharmacists undertake increasingly diverse responsibilities across patient care, public health, regulation, supply systems, industry, research, and health-system management, entry-to-practice education needs to remain responsive to changing professional and population needs.^2,3 Quality assurance (QA) should therefore extend beyond confirming that programs possess curricula, academic staff, laboratories, and training sites; it should also examine whether educational processes produce graduates with the competencies required for practice.^1,2 The International Pharmaceutical Federation (FIP) conceptualizes QA in pharmacy education through the interrelated domains of context, structure, process, outcomes, and impact. Within this framework, accreditation is one component of a wider quality system rather than the endpoint of quality assurance.¹ FIP subsequently reinforced the importance of outcomes-based evaluation, institutional self-assessment, stakeholder participation, competency assessment, quality assurance of experiential education, and continuous quality improvement (CQI).²

These issues are particularly relevant to the East African Community (EAC), which currently comprises Burundi, the Democratic Republic of the Congo (DRC), Kenya, Rwanda, Somalia, South Sudan, Uganda, and Tanzania.⁴ Regional integration has progressively extended into higher education through harmonized regional frameworks coordinated by the Inter-University Council for East Africa (IUCEA).⁵ The EAC was declared a Common Higher Education Area on 20 May 2017, with the aim of supporting comparability, compatibility, recognition, and mobility within regional higher education.⁵ IUCEA has developed regional QA instruments to support this process, including standards and procedures for regional program accreditation.⁵

Pharmacy education has an explicit place in the regional policy agenda.⁶ The EAC Medicines and Health Technologies Policy identified inadequate numbers of trained pharmaceutical personnel, limited training capacity, and weak alignment between training and pharmaceutical-sector needs.⁶ It called for rationalization and harmonization of pharmacy and health-technology education and for establishment of a regional accreditation system for pharmacy and health-technology schools and universities in collaboration with IUCEA.⁶ The policy was developed before the DRC became a full EAC member in 2022 and Somalia became a full member in 2024.⁴ Regional program accreditation moved from framework development towards implementation when IUCEA invited higher-education institutions to submit programs for regional accreditation in 2023 and explicitly included Pharmacy and Pharmaceutical Sciences among the eligible discipline clusters.⁷ Under the IUCEA regional standards, accreditation is voluntary and complementary to national accreditation, and programs seeking it must first hold recognized national accreditation.⁵

At continental level, the QA environment is also evolving.⁸ In March 2026, the WHO Regional Office for Africa reported agreement on the Africa Health Professions Education Quality Standards (AHPEQS), comprising nine domains and 35 standards.⁸ Sheehy et al mapped pharmacy-education literature across sub-Saharan Africa and identified substantial gaps in country-specific documentation; their database searches ended in March 2024 and gray-literature searches in May 2024.⁹ Their scoping review describes the wider evidence landscape. The present review instead examines how the eight current EAC Partner States’ documented arrangements relate to IUCEA and pharmacy-specific guidance, incorporates later regional developments, and proposes priorities for continuous improvement; it does not repeat a comprehensive regional inventory. Here, entry-to-practice education means university-level education leading to eligibility to enter the pharmacist profession under the applicable national rules. Postgraduate education, pharmacy-technician training, continuing professional development, and other pathways are outside this review’s main scope. Regional harmonization refers to shared core competencies and minimum quality expectations, while allowing national variation in curricula and delivery. The review asks: What is documented about pharmacy-education QA across current EAC Partner States, where are the evidence gaps, and how might existing national and regional mechanisms support outcome-focused improvement?

The objectives are to distinguish documented mandates and standards from empirical findings about educational processes and outcomes; identify gaps in country-specific evidence; and propose feasible areas for regional alignment and future validation.

Methods: Structured Narrative Review

A structured narrative review was undertaken to examine quality assurance in entry-to-practice pharmacy education across the eight current EAC Partner States. The initial search focused on PubMed-indexed literature and targeted retrieval from official regional, national, professional, and international sources. During revision, the search was expanded to include Scopus, PubMed, Google Scholar, and English- and French-language regulatory, professional, university, and journal sources, with final retrieval on October 4, 2026. Publications from 2015 onward were prioritized. Earlier legislation and foundational QA frameworks were retained, and relevant earlier educational studies were added during revision.

Search concepts covered pharmacy or pharmaceutical education, quality assurance, accreditation, educational standards, competencies, curriculum, experiential education, assessment, program evaluation, graduate outcomes, and continuous improvement, alongside EAC and country terms. French-language queries included pharmacie, formation, assurance qualité, and accréditation. Supplementary Table S3 records the available search strings, interfaces, dates, and retrieval limits; Supplementary Table S2 identifies official and institutional sources. The Scopus, PubMed, and Google Scholar updates are provided in Supplementary File 1. Eligible sources addressed a review domain in an EAC setting or supplied a relevant regional or international QA framework. Studies of practicing pharmacists were eligible when they directly addressed preparation through entry-to-practice education. Other professions and regions were considered only for explicitly identified contextual comparisons. Postgraduate education, pharmacy-technician training, continuing professional development, and non-university pathways were outside the main scope. English-language sources and French-language material interpreted through AI-assisted translation were considered; other languages were outside the search scope.

Selection was purposive and based on relevance to the review question. Titles and available summaries were screened, followed by relevant full texts or official document passages before inclusion. Duplicate versions were treated as one source. Sources were organized by Partner State and QA domain. The synthesis cites 41 sources: 20 peer-reviewed publications and 21 legal, regulatory, policy, or institutional sources. These are counts of cited sources, not a systematic-review screening flow. Legislation and standards establish mandates and stated requirements; institutional reports describe reported activities; empirical studies support interpretations limited to their designs and settings; and commentaries identify perspectives or proposed priorities. Supplementary Table S1 maps country-specific sources and their evidentiary roles. This single-author narrative synthesis did not use duplicate screening, a formal risk-of-bias instrument, or quantitative pooling.

Relevant passages from three French-only institutional or official sources were translated into English using OpenAI ChatGPT. No independent bilingual verification was performed. Where an official English version was available, as in Rwanda’s multilingual 2021 ministerial order, the English text was used.

From Accreditation to Continuous Quality Improvement

Accreditation and QA are related but distinct.⁵ IUCEA defines accreditation as external verification or approval of an institution, QA agency, or academic program, normally for a limited period, whereas QA is a broader term encompassing internal and external procedures such as assessment, accreditation, evaluation, and audit.⁵ The FIP global framework is useful for distinguishing the components of educational quality.¹ Context concerns the health, professional, legal, social, and economic environment in which education occurs; structure encompasses the curriculum, organization, academic staff, resources, and practice-learning facilities; process includes curriculum development, teaching, assessment, policies, planning, and development of academic staff and preceptors; outcomes concern what graduates and programs achieve; and impact considers wider contributions to the profession, health services, and society.¹ Structural requirements remain necessary, because pharmacy programs require appropriate academic staff, infrastructure, curricula, learning resources, and experiential opportunities to deliver education effectively.^1,2 However, structural compliance alone does not demonstrate that students achieve the competencies expected of pharmacists.^1,2

FIP’s later policy statement recommends outcomes-based evaluation alongside consideration of structures and processes and emphasizes institutional self-assessment, stakeholder involvement, experiential-site quality, competency assessment, and a culture of continuous improvement.² FIP’s Global Competency Framework provides a reference for foundation and early-career pharmacist competencies and is intended to support adaptation to professional and contextual needs.³ CQI adds another dimension by requiring evaluation findings to inform subsequent action.^1,2,5 In this review, the CQI cycle is conceptualized as measurement, identification of a quality gap, intervention, reassessment, and documented improvement or further action, consistent with the self-assessment and cyclic-review principles described by FIP and IUCEA.^1,2,5 This principle is already evident within IUCEA’s regional standards.⁵ Program development and review are expected to be systematic and cyclic, with contributions from relevant stakeholders and attention to societal and labor-market needs.⁵ The regional framework also includes program review, tracer studies, employer and alumni information, and use of such information for curriculum and program enhancement.⁵ Accordingly, the central QA question is not simply whether programs are accredited, but whether standards are linked to educational experiences, competency attainment, graduate relevance, and continuing improvement.

Regional Architecture for Pharmacy-Education Quality Assurance

The EAC has an established regional higher-education QA architecture through the Common Higher Education Area and IUCEA’s harmonization mandate.⁵ IUCEA has developed program-accreditation standards, guidelines, procedures, and assessment mechanisms intended to support regional comparability and quality.⁵ IUCEA’s regional program accreditation is voluntary and complementary to national accreditation.⁵ Programs must first demonstrate recognized national accreditation, and involvement of relevant professional bodies is expected where applicable.⁵ The standards address curriculum development, learning outcomes, staffing, program leadership, infrastructure, learning resources, student support, assessment, internal QA, program evaluation, and stakeholder engagement.⁵

The framework also includes elements relevant to outcomes and CQI.⁵ IUCEA’s standards refer to periodic and cyclic program review, collection and use of student, alumni, and employer information, graduate tracer studies, and curriculum enhancement based on evidence.⁵ These elements provide an existing regional basis for moving beyond structural accreditation towards continuous improvement.⁵ The 2018 EAC medicines policy provides a pharmacy-specific policy foundation by calling for harmonization of pharmacy education and a regional accreditation system for pharmacy and health-technology schools and universities.⁶ A 2020 FIP report on pharmacy education in sub-Saharan Africa devoted a section to the then six-member EAC and noted that Burundi and South Sudan were excluded from detailed country analysis because few or no pharmacy-education data were available.¹⁰ The sources reviewed provide clearer evidence on the existence and development of regional accreditation mechanisms than on pharmacy-specific uptake or educational impact.^5,9 Evidence evaluating how regional QA mechanisms affect pharmacy programs, graduate competence, or other outcomes therefore remains an important research need.

National Evidence Across EAC Partner States

National accreditation and professional regulation remain central because pharmacy programs operate within country-specific higher-education and professional-regulatory systems.^5,9 Table 1 separates documented requirements and examples from the review’s interpretation of the limited available material; Supplementary Table S1 identifies the country-specific sources cited. Coverage differs among Partner States and should not be read as equivalent national assessment. In Kenya, legislation gives the Pharmacy and Poisons Board responsibilities for qualification requirements, examinations, and approval of pharmacist-training institutions.¹¹ A separate case study describes competency-based curriculum reform and stakeholder participation in a Kenyan setting.¹² Neither source establishes the effectiveness of QA nationally.

Table 1.

Illustrative Pharmacy-Education QA Evidence Identified Across Current EAC Partner States

Partner State	Evidence Identified in This Review	Review interpretation
Kenya	Pharmacy and Poisons Board statutory role; competency-based curriculum-reform evidence; recent program-level evidence on the transition to clinical education.11–13 Pharmacist survey of perceived undergraduate preparation.14 Supervised clinical-learning partnership and a multicountry student knowledge survey.15,16	Cited sources document a legal mandate and selected program experiences; they do not establish national QA effectiveness.
Rwanda	Statutory pharmacy-education role; higher-education accreditation and audit requirements; pharmacy student indexing.17–19 Pre-service supply-management curriculum development and a physiology teaching-modality evaluation.20,21	Institutional curriculum and assessment evidence complements stated oversight mechanisms; effects of national pharmacy QA remain untested.
Tanzania	Statutory Pharmacy Council role in approval of institutions and curricula, supplemented by descriptive evidence on education and practice models.22,23 Feedback-informed BPharm reform, a student knowledge survey, and a course-level pre–post evaluation.16,24,25	Selected curriculum and learning-outcome evidence complements the legal mandate; national QA effectiveness remains unevaluated.
Uganda	Detailed pharmacy-specific national minimum standards with explicit monitoring, feedback, assessment, and program-review provisions; recent institution-specific evidence on clinical/interprofessional training needs.26,27 Curriculum review, joint experiential programs, OSCE/OSPE implementation, and a student knowledge survey.16,28–30	Detailed standards and institutional educational studies are available; their presence does not establish consistent national implementation.
Democratic Republic of the Congo	University of Kinshasa curriculum-development example; ANAQ-ESU institutional QA training; Université Catholique du Graben pharmacy curriculum.31–33	Reported reform and QA activity, with a local example of intended training; no evaluation of national pharmacy QA effectiveness.
Somalia	Health-professions regulatory evidence, new national higher-education regulatory and QA structure, and a pharmacy-specific commentary on educational/regulatory gaps.34–36	Evolving regulatory environment; pharmacy-specific empirical QA and outcome evidence remains limited.
South Sudan	The General Medical Council regulates the pharmaceutical profession and reports education-related functions including contribution to curricula and inspection of training institutions.37,38	Formal professional oversight is documented; detailed pharmacy-program QA evaluation remains sparse in the sources reviewed.
Burundi	FIP documentation gap; ministry report of completed evaluation of 39 higher-education institutions.10,39	Reported general higher-education QA implementation; pharmacy-specific outcomes are not separately assessed.

Notes: This table summarizes only the publicly accessible sources cited here. A law or standard documents a stated requirement, whereas an institutional account or study describes a specific setting; neither demonstrates national effectiveness. Country rows are not rankings or claims of equal evidence coverage.

Abbreviations: EAC, East African Community; QA, quality assurance; CQI, continuous quality improvement.

Uganda has detailed publicly available pharmacy-specific program standards.²⁶ The Minimum Standards for the Bachelor of Pharmacy and Pharmaceutical Science Education in Uganda address governance, staffing, infrastructure, curriculum and expected competencies, assessment, monitoring, and program quality.²⁶ The standards include requirements for QA processes involving monitoring, evaluation, student feedback, program review, self-assessment, annual monitoring and evaluation, course evaluation, and use of course-evaluation feedback in decision-making.²⁶ They also recognize assessment approaches including written examinations, objective structured practical examinations, objective structured clinical examinations, logbooks, case presentations, practical assessments, and clinical assessments.²⁶

Tanzania gives the Pharmacy Council a formal role in pharmacy education and training.²² The Pharmacy Council has authority to approve or disapprove institutions and curricula for pharmacy education and, in collaboration with national education authorities, to evaluate academic and practical qualifications for pharmacy personnel.²² A descriptive report of pharmacy education and practice at three Tanzanian institutions describes academic, practical, hospital, community, and clinical learning experiences, although the study was not an evaluation of national QA effectiveness.²³ An earlier MUHAS report describes graduate and employer feedback informing a revised BPharm curriculum introduced in 2011, with greater clinical and experiential emphasis.²⁴

Rwanda’s pharmacy legislation assigns the National Council Board a role in university-level pharmacy standards and minimum pharmacist knowledge and skills.¹⁷ The 2021 ministerial order on education standards links higher-education accreditation to institutional audit or physical assessment and specifies institutional self-assessment one year after accreditation, followed by regulatory audit.¹⁸ The National Pharmacy Council also describes mandatory student indexing, which links learners, training institutions, and the Council and supports internship planning.¹⁹ These documents identify oversight requirements and mechanisms; they do not establish their consistent implementation or effects on graduate competence. The limited Rwanda-specific evidence in the earlier scoping review should therefore be interpreted in relation to that review’s eligibility criteria and search period.⁹ Earlier regional collaboration also supported incorporation of pharmaceutical supply management into pre-service pharmacy curricula at the National University of Rwanda and Makerere University.²⁰

The DRC provides a documented institutional example of pharmacy curriculum improvement. Within a pharmaceutical-systems strengthening initiative, the Accreditation Council for Pharmacy Education reviewed the University of Kinshasa pharmacy curriculum and supported development of a roadmap for curriculum revision. Subsequent work supported strategic planning and development of a competency framework addressing areas relevant to national pharmaceutical and public-health priorities. This example illustrates an external-review process linked to curriculum and institutional development, but it should not be interpreted as evidence of a comprehensive national QA system.³¹ A French-language report from the national higher-education QA agency, ANAQ-ESU, documents training in institutional self-assessment and student evaluation of teaching at the Université Protestante au Congo in June 2026.³² This provides additional evidence of higher-education QA activity, without establishing pharmacy-specific implementation or outcomes. A French-language curriculum published by the Université Catholique du Graben specifies practical teaching and placements in community, hospital, clinical, and industrial settings.³³ This provides a further local example of intended pharmacy training, without demonstrating placement quality, learner attainment, or national implementation.

Somalia’s higher-education and health-professions regulatory environment has changed in recent years.^34–36 An independent 2024 mixed-methods study described the growth of health-professions schools and regulatory gaps at the time of its data collection.³⁴ The National Commission for Higher Education states that it was established under the Higher Education Law signed on December 4, 2024 and describes its higher-education QA remit.³⁵ A 2026 pharmacy commentary by Sabrie proposes curriculum standardization and stronger oversight.³⁶ The commentary is used to identify proposed priorities, not as evidence of implementation. Pharmacy-specific implementation and outcome evidence remains limited in the sources reviewed.

South Sudan has formal professional oversight of the pharmaceutical profession.^37,38 The General Medical Council Act 2014 establishes the South Sudan General Medical Council as the regulator of medical, dental, and pharmaceutical professions.³⁷ Current official council information states that, in consultation with the authority responsible for higher education, the Council contributes to curricula for pharmaceutical colleges, while its Medical Education and Examination Committee advises on curricula and inspects training institutions.³⁸ Detailed publicly accessible evaluations of pharmacy-program QA were not identified in the sources reviewed.

For Burundi, FIP’s 2020 report identified limited pharmacy-education documentation.¹⁰ A French-language ministry report published in May 2026 describes completed institutional evaluations of 39 public and private higher-education institutions, combining self-evaluation and external evaluation. It reports gaps in qualified permanent teaching staff, infrastructure, information systems, and internal QA mechanisms.³⁹ This documents reported higher-education QA implementation, but does not separately assess pharmacy programs or graduate outcomes. The pharmacy-specific evidence gap therefore remains distinct from the existence of national QA activity. Table 1 and Supplementary Table S1 summarize the cited material and its limits.

Key Domains and Persistent Gaps

Competency and Curriculum Alignment

A contemporary pharmacy-education QA system should examine whether curricula are aligned with the competencies expected of graduates.^1,2 FIP’s Global Competency Framework provides an international reference for foundation and early-career pharmacist competencies.³ The Kenyan reform experience illustrates the relevance of this approach.¹² Ruparelia et al¹² described competency-based curriculum reform involving multiple educational, regulatory, professional, student, and employer stakeholders and emphasized alignment with country-wide health needs. For regional harmonization, these principles support focusing on comparable core competencies rather than identical curricula, while retaining national and institutional flexibility in how competencies are taught and assessed.^2,3,5 In Uganda, a curriculum review and stakeholder study found that BPharm programs had broader pharmacovigilance coverage than other health programs, while identifying gaps in practical content and dedicated instruction.²⁸ This provides a curriculum-level basis for reviewing how stated competencies are taught and assessed.

Academic and Preceptor Capacity

Curriculum standards cannot be separated from the capacity to deliver them.^1,2 FIP’s sub-Saharan Africa report identified academic capacity, including staff availability and staff-to-student ratios, as an important issue in pharmacy-education development in participating countries.¹⁰ FIP’s QA policy also emphasizes adequate educational capacity and support for those involved in experiential education.² Accordingly, QA should examine not only academic qualifications but also whether staffing profiles are appropriate to program size and curriculum requirements, whether faculty development occurs, and whether sufficient trained practice educators and preceptors are available.^2,10

Experiential Education

Experiential education requires quality assurance beyond confirmation that placements occur.² Attendance at hospitals, community pharmacies, industry, or other sites does not by itself establish the quality of supervision, learning opportunities, feedback, or assessment.² FIP therefore recommends explicit QA mechanisms for experiential education and practice sites.² Recent institution-specific evidence illustrates the type of issues that program-level QA can identify.^13,27 At Jomo Kenyatta University of Agriculture and Technology in Kenya, Mayoka et al¹³ surveyed 120 pharmacy students and reported that 60.8% perceived the transition from preclinical to clinical education as challenging and 67.5% felt unprepared for medical technical skills. At Mbarara University of Science and Technology in Uganda, Kyomya et al²⁷ interviewed 14 fourth-year pharmacy students and three faculty members and identified limited clinical-training exposure, preceptor shortages, siloed learning, and limited simulation capacity among barriers to clinical and interprofessional learning. Because both studies were institution-specific, they should not be generalized to entire national systems; rather, they illustrate the value of program-level evidence on students’ clinical preparation and learning environments.^13,27 QA of experiential education should therefore address intended placement outcomes, site selection and review, preceptor preparation, supervision, student feedback, and assessment of performance rather than placement duration alone.² Earlier collaborations provide examples of delivery: a Kenyan partnership offered supervised clinical learning for Kenyan and US pharmacy students, while Ugandan partnerships linked Makerere and Mbarara with four US schools through joint ward activities, case presentations, skills laboratories, and faculty facilitation.^15,29 These descriptive accounts identify approaches to experiential teaching and supervision.

Assessment of Competence

Assessment is central to determining whether intended competencies have been attained.^1,2 Because pharmacy competency frameworks encompass knowledge, skills, behaviors, communication, professional practice, and other performance domains, program assessment needs to use methods appropriate to the competencies being assessed.^1–3 Uganda’s national standards recognize multiple assessment approaches, including objective structured practical examinations, objective structured clinical examinations, logbooks, case presentations, practical assessments, and clinical assessments.²⁶ IUCEA likewise requires assessment approaches to be linked to intended learning outcomes and places assessment within its regional QA framework.⁵ A stronger regional approach would therefore require programs to demonstrate explicit alignment between major graduate competencies, the educational experiences through which they are developed, and the methods by which attainment is assessed.^1,2,5

Institutional evaluations provide examples of assessment in practice. At Makerere, a 10-station OSCE/OSPE was implemented for 25 third-year pharmacy students following faculty and standardized-patient preparation.³⁰ A survey of 328 final-year medical and pharmacy students, including 132 pharmacy students, across universities in Kenya, Uganda, and Tanzania identified antibiotic and resistance knowledge gaps.¹⁶ At MUHAS, a dedicated course on substandard and falsified medicines involving 50 third-year pharmacy students was associated with a mean increase of 5.3 points on a 20-point knowledge test (95% CI, 2.9–7.7).²⁵ The uncontrolled pre–post design measured immediate knowledge rather than retention or practice. A Rwandan study comparing physiology examination results found no statistically significant difference between online and face-to-face teaching among pharmacy students; its observational design does not establish equivalence.²¹ These examples support evaluation at course and program level, while leaving the effects of accreditation untested.

Graduate Outcomes and Workforce Relevance

Graduate and employer information is explicitly included within IUCEA’s regional QA approach through tracer studies, stakeholder information, and use of findings for program and curriculum enhancement.⁵ However, the wider sub-Saharan African literature contains substantially more description of educational structures and models than evaluation of accreditation and educational outcomes.⁹ Ruparelia et al¹² also highlighted the value of understanding graduate destinations and employer needs in the Kenyan competency-reform context. A similar outcome-level limitation has been reported more broadly in sub-Saharan African health-professions education. In a systematic review of interprofessional education and interprofessional continuous education, Kitema et al⁴⁰ found that reported outcomes commonly concerned changes in attitudes and perceptions towards collaborative practice and acquisition of knowledge and skills, whereas few studies assessed outcomes related to healthcare practice. This evidence is not pharmacy-specific but supports the need for stronger evaluation of downstream educational outcomes. Relevant outcome information can include professional registration outcomes where applicable, sectors and locations of employment, employer perceptions of graduate preparedness, graduate-reported gaps in preparation, and progression into further training.⁵ Such indicators should be interpreted alongside labor-market context rather than treated as stand-alone measures of educational quality, because the purpose of graduate and employer data is to inform program relevance and improvement.⁵ A Kenyan cross-sectional survey of 118 pharmacists found that 55 (46.6%) disagreed that undergraduate training adequately prepared pharmacists to provide medication therapy management.¹⁴ This illustrates the potential value of practitioner feedback for curriculum review, but the purposive and snowball sample and self-reported responses limit generalizability and do not measure competence objectively.

Closing the Quality Loop

The defining feature of CQI is that quality information is used to inform and reassess change rather than being collected only for compliance purposes.^1,2,5 Student evaluations, external reviews, assessment results, tracer studies, and employer feedback are most useful when programs can document how findings influenced subsequent action and reassessment. Uganda’s standards explicitly require course-evaluation feedback to be used in decision-making.²⁶ FIP promotes institutional self-assessment and CQI, while IUCEA expects program review and stakeholder information to contribute to program enhancement.^2,5 On that basis, this review proposes a closed-loop sequence of problem identification, supporting evidence, corrective action, implementation, reassessment, and documented result.^1,2,5 The MUHAS reform illustrates graduate and employer feedback leading to curricular change, but reassessment of subsequent graduates was planned rather than demonstrated in that report.²⁴ It therefore documents part of the improvement cycle.

Discussion: Priorities for Regional Harmonization and Continuous Improvement

The available documents show regional and national accreditation arrangements more clearly than they show implementation and outcomes.^5,9 The priorities below are the author’s proposals drawn from this uneven evidence and existing FIP and IUCEA guidance; they have not been evaluated as an EAC intervention. Evidence from another region helps explain why accreditation status and outcome-oriented QA merit separate attention: a 2026 Eastern Mediterranean survey of 61 pharmacy-school leaders reported periodic accreditation in 82%, but enrollment planning based on workforce needs in 51% and teacher-practitioner capacity building in 47%.⁴¹ These findings cannot be generalized to EAC countries.

Implementation would require agreement among national regulators, universities, IUCEA, and professional bodies on authority and responsibilities. Programs also differ in staff time, preceptor capacity, information systems, and access to reliable graduate and employer data. The proposed benchmarks and indicators should therefore be tested for cost, acceptability, and feasibility before regional expansion.

Agree on Core Entry-to-Practice Pharmacy Competencies

Regional stakeholders could develop a common core of competencies expected of entry-to-practice pharmacists while retaining country-specific additions. FIP’s Global Competency Framework provides an international reference for competency development, and FIP recommends stakeholder involvement and needs-based adaptation in pharmacy education and QA.^2,3 The proposed EAC process should therefore involve regulators, universities, practicing pharmacists, employers, students, and health-system stakeholders.^2,5

Develop Pharmacy-Specific Regional QA Benchmarks

IUCEA’s regional accreditation standards are cross-disciplinary and provide generic program-level requirements rather than a pharmacy-specific benchmark.⁵ Pharmacy-specific benchmarks could therefore complement, rather than replace, the IUCEA framework by addressing profession-specific areas such as experiential learning, preceptor preparation, practice-based assessment, pharmaceutical-science facilities, medicines-information resources, and regulatory and supply-system competencies.^1,2,5 This is a proposed next step rather than an existing EAC requirement. Pharmacy and Pharmaceutical Sciences are already eligible for IUCEA regional accreditation,⁷ but no pharmacy-specific EAC benchmark document was identified in the publicly accessible IUCEA materials examined for this review.

Strengthen Experiential-Education QA

Regional expectations could define minimum principles for selection and review of experiential sites, preceptor preparation, supervision, feedback, student assessment, and action when sites do not meet educational expectations.² This would shift emphasis from documenting the amount of experiential exposure towards demonstrating its educational quality.²

Increase Attention to Outcomes

Accreditation should continue to examine curriculum, staffing, governance, resources, and educational processes while progressively incorporating evidence of competency attainment, program completion, graduate outcomes, employer feedback, and documented improvement.^1,2,5

Establish a Regional QA Dataset

This review proposes a small, feasible shared dataset that would help programs compare and improve practice. Candidate measures include accreditation status, enrollment and staff capacity, experiential-site capacity, progression and completion, selected competency assessments, graduate destinations, employer feedback, and documented improvement actions.^1,2,5 Regulators and programs would need to agree on definitions, data ownership, privacy safeguards, collection burden, and how results would be interpreted before using any indicator across countries. A staged pilot could begin with a few willing programs rather than assuming that all national systems can collect identical data immediately.

Require Evidence of Closed-Loop Improvement

Rather than asking only whether a program has a QA policy, program review should examine evidence that evaluation findings generated change and that the effect of the change was subsequently reassessed.^1,2,5 Uganda’s requirement that course-evaluation feedback be used in decision-making provides one national example of this principle.²⁶

Proposed EAC Pharmacy Education Quality Assurance and Continuous Improvement Framework

Figure 1 integrates existing ideas rather than presenting a new accreditation standard. FIP supplies the context–structure–process–outcome perspective and competency guidance; IUCEA supplies regional program-review and stakeholder-feedback mechanisms; EAC policy provides the pharmacy-education harmonization mandate; and AHPEQS adds a continental health-professions reference.^1–3,5,6,8 The proposed contribution is to connect these elements in an EAC pharmacy-specific improvement sequence: health-system and workforce needs, agreed entry-to-practice competencies, curriculum and experiential learning, assessment, graduate outcomes, stakeholder feedback, corrective action, and reassessment. Governance, accountability, and quality data run across the sequence. The framework is a conceptual synthesis, not a validated accreditation or assessment instrument. A multicountry panel of students, educators, preceptors, employers, professional regulators, and QA agencies should first assess the relevance and feasibility of its components. Willing programs in differently resourced settings could then pilot a small set of indicators, document the resources required, examine whether findings lead to action and reassessment, and revise the framework before wider use.

Figure 1.

Proposed EAC pharmacy education QA and continuous improvement framework. Conceptual synthesis informed by FIP, IUCEA, EAC, and WHO guidance.^1–3,5,6,8 Arrows indicate a proposed sequence for feedback and reassessment; the framework has not been validated as an accreditation instrument.

Strengths and Limitations

A strength of this review is its integration of peer-reviewed literature with primary regulatory and policy documents, allowing national and regional quality-assurance arrangements to be considered alongside published evidence. It also distinguishes formal standards and reported activities from evidence of implementation and educational outcomes.

As a narrative review, the search and purposive selection may have missed relevant sources, and no duplicate screening or formal risk-of-bias appraisal was undertaken. Supplementary searches broadened coverage, but database, language, and availability limitations remain. French-language passages were translated with AI assistance without independent bilingual verification. Evidence was uneven across EAC Partner States and predominantly descriptive, limiting conclusions about the effectiveness of quality-assurance mechanisms. Limited retrieved evidence should therefore not be interpreted as an absence of QA activity. The findings reflect the sources available at the time of retrieval, and regulatory arrangements may subsequently change.

Conclusion

Pharmacy education quality assurance in the EAC operates within national, regional, and continental frameworks, but publicly accessible pharmacy-specific evidence remains uneven across Partner States. Outcome-oriented quality assurance is a regional priority, with greater attention needed to graduate competence, experiential learning, workforce relevance, and continuous program improvement. Regional harmonization does not require identical curricula. Shared entry-to-practice competencies and pharmacy-specific quality expectations could support comparability while allowing adaptation to national health-system needs. The proposed framework provides a conceptual starting point. Multicountry stakeholder validation and pilot testing in differently resourced programs should assess feasibility, data quality, and whether feedback leads to documented improvement before wider adoption.

Funding Statement

This article was supported by SIMAD University.

Generative AI Use Declaration

OpenAI ChatGPT (GPT-5.6 SoL; web-based application; used August–October 2026) assisted with language refinement, manuscript organization, structural editing, revision-stage source organization, and English translation of relevant French-language passages. The author takes responsibility for the submitted text, the use and interpretation of sources, and the accuracy and integrity of the manuscript.

Disclosure

The author declares no competing interests in this work.