This qualitative study used individual, in-depth, semi-structured interviews to explore pharmacy academics’ perceptions of public health and pharmacists’ public health roles. Data were analysed using reflexive thematic analysis [14–16], and reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ) [17].

Participants were pharmacy academics working at Faculties of Pharmacy in Istanbul. Purposive maximum-variation sampling sought diversity in academic rank, disciplinary background, and involvement in public health-related teaching or research. Eligibility required current employment at an Istanbul Faculty of Pharmacy, involvement in pharmacy education, at least 4 years of academic experience, and willingness to participate online. Sixteen academics were approached; 15 interviews were scheduled, and recruitment ended after 11 interviews when the research team judged that sufficient information power had been reached and substantively new codes were diminishing.

The 11 participants represented eight universities (four public and four private). Seven were female and four male; mean age was 38 years (range 29–52). Two were professors, three associate professors, and six assistant professors. Their fields were clinical pharmacy (n = 4), pharmacognosy (n = 3), pharmaceutical technology (n = 3), and pharmaceutical toxicology (n = 1). Participant characteristics are presented in Annex Table 1.

Data were collected between November 2024 and January 2025 through Zoom or Google Meet. A semi-structured interview guide was developed from the study aim and relevant literature and policy documents. Following review by a public health academic, a pharmacy academic, and a public health specialist, and two pilot interviews, an 11-question guide was finalised. Interviews lasted approximately 40 min. With permission, interviews were audio-recorded and the researcher took notes during and after interviews.

Recordings were transcribed verbatim, checked against the audio, and anonymised by removing names and institutional identifiers. Participants were assigned identifiers S1–S11; transcripts were not returned for correction. Interviews were conducted by SH, an MD and PhD candidate with qualitative interviewing and analysis experience who had a prior professional relationship with participants. Participants were informed of the study purpose. Reflexive journaling and analytic memos documented assumptions, contextual influences, and interpretive decisions.

Data management and coding were conducted in MAXQDA 2024 Pro. SH repeatedly read the transcripts and conducted inductive line-by-line coding. Codes were mapped and clustered into candidate domains, which the research team refined through peer-debriefing meetings. The final framework comprised 15 codes organised into four domains under one overarching theme, “The Strategic Role and Perceptions of Pharmacists in Public Health”: (i) conceptual and definitional approaches to public health; (ii) emphasis on preventive healthcare; (iii) individual and societal awareness elements; and (iv) intersections between community pharmacy and public health. Coding was led by SH, with HHE and MÖ acting as reflexive “critical friends”; disagreements were resolved through discussion focused on analytic richness rather than agreement metrics. Credibility was supported through iterative engagement, peer debriefing, and verbatim quotations, while an audit trail and reflexive journaling supported dependability and confirmability.

The studies involving human participants were reviewed and approved by the Hamidiye Scientific Research Ethics Committee of the University of Health Sciences (approval date: September 2, 2022; decision no. 20/7; project registration no. 22/430). Participants received study information and provided written informed consent, including consent for recording. Data were anonymised and stored on a password-protected institutional hard drive accessible only to the research team. The study was conducted in accordance with the 1964 Declaration of Helsinki and its later amendments.

The findings obtained within the scope of this theme reveal how the conceptual boundaries of public health are defined in the context of pharmacy practice and how individual-community approaches to this field are shaped. This theme is concentrated in the following 4 categories and their 15 sub-codes:

Emphasis on Preventive Healthcare

The topics most intensively addressed at the code level are shown in Figure 1 in the Code Matrix.

Perceptions of public health are defined in academics’ discourses as a protective, preventive and multidimensional area. Participants see public health as a concept that is not limited to individual health but also encompasses social welfare. In this context, the code “Taking precautions before diseases occur” stands out as the most intensively discussed topic in the interviews. Academics emphasize that one of the basic functions of public health is to prevent diseases before they occur; they state that this approach has strategic importance at the individual and social level. For example, one participant expressed this view as follows:

This statement shows that public health is perceived as a multi-stakeholder area of responsibility and that the role of pharmacists in this process is increasingly recognized.

In addition, the code “Need to raise public awareness” is frequently included in the participants’ statements. Increasing health literacy is considered as an element that directly affects the effectiveness of public health services. Participants state that pharmacists should undertake an informative and guiding role in order to raise public awareness:

This quote reveals that the perception that health literacy is low in Türkiye is widespread among academics and that this reduces the impact of public health services.

In the participants’ opinions, public health is defined as a multidimensional field that brings together different disciplines and encompasses both individual and community health. This structure, in which individuals, institutions, and health professionals interact, reveals the breadth of the field and the need for a holistic approach. In this category, the following topics stood out in the participants’ opinions: The perception of public health as a multidimensional field, the inclusion of psychological health within public health, the definition of public health as a multidisciplinary structure, and the diversity of practices included within the scope of public health.

Public health is defined by academics as a multidimensional and multidisciplinary field. Participants state that this concept goes beyond individual health and also includes improving social conditions:

This quote shows that public health has an inclusive framework and that the principle of equality has an important place in this field. The inclusion of psychological health in public health is also noteworthy. Participants argue that addressing physical and mental health in a balanced way increases social wellbeing:

This view reveals that public health is not limited to physical diseases only, and the psychological dimension is also becoming increasingly important.

The multidisciplinary structure of public health requires cooperation between different professional groups:

This quote shows that public health education should be enriched with an interdisciplinary approach and that this approach can increase the effectiveness of practices.

The points where public health services intersect with pharmaceutical practice are becoming increasingly visible. Interviews highlight that pharmacies are no longer merely places for obtaining medication; they are now taking on critical roles in counseling, guidance, and preventive health practices. It is understood that community pharmacy, particularly through its direct contact with individuals, contributes significantly to the healthcare system. In daily practice, the function of pharmacists in the field of public health is less about diagnosis and more about forming the first link in the chain of referral, information, and monitoring mechanisms, thus alleviating the systemic burden. Participants’ opinions on the points of contact between public health and community pharmacy focused on topics such as first aid, immunization, and health counseling; contributions to public health through pharmacy consultations; and the role of community pharmacists in the context of chronic disease monitoring and medication management.

This statement shows that pharmacists play a multifaceted role in public health services and that this role is gradually expanding. Pharmacy consultancy is considered an important tool in contributing to public health. Participants state that pharmacies support the health system with services such as vaccination, screening and information:

This quote suggests that pharmacies have become a part of public health services in international examples and that this model is also applicable in Türkiye.

Participants’ emphasis on preventing disease before it occurs is consistent with the broader public health focus on organised efforts to protect population health [17]. Their accounts position pharmacists within a shared-responsibility model involving health professionals, institutions, government, and individuals. Evidence from other settings also shows increasing pharmacist involvement in preventive services, including vaccination [21]. Pharmacies’ accessibility and repeated contact with individuals therefore create opportunities for early intervention, counselling, and appropriate referral.

Participants described pharmacies as counselling and monitoring settings beyond medicine supply, particularly highlighting chronic disease monitoring, medication management, screening, vaccination, and health counselling [22-29]. This is consistent with literature describing expanding pharmacy roles in primary healthcare and contributions to chronic disease management through education and follow-up [22–24]. Such functions may support health systems by improving access to preventive advice and directing individuals to appropriate services.

Health literacy emerged as a central factor affecting the effectiveness of public health services. Participants linked low awareness and reliance on unreliable information with reduced effectiveness of preventive interventions, consistent with evidence of health-literacy challenges in Türkiye [25]. Community pharmacists may help bridge this gap because of their accessibility and capacity to provide reliable, repeated counselling [26-29]. However, participants stressed that this potential depends on strengthening public health competencies within pharmacy education. Public health content should therefore be more clearly integrated into undergraduate curricula and supported through postgraduate and continuing professional development.

This study contributes an academic perspective on pharmacists’ public health roles in Türkiye and provides qualitative insight into prevention, health literacy, education, and community pharmacy’s position within the health system. The findings may inform educational reforms and policies that formally recognise pharmacists as contributors to preventive services and population health.

Several limitations should be acknowledged. Participants were pharmacy academics from Faculties of Pharmacy in Istanbul, which may limit transferability to other regions of Türkiye. Community pharmacists and other healthcare professionals were not included, so the findings predominantly reflect an academic perspective. Future studies should include geographically diverse participants and additional professional groups and examine how proposed roles can be operationalised and evaluated in practice.