The GMSN Medication Safety Framework: Integrating Core Safety Rights, Process Continuum, and Systems-Based Pyramid for Safer Medication Use in Low-Resource Settings

Medication-related harm remains a significant global patient safety challenge, particularly in low-resource and humanitarian settings. This paper presents the GMSN Medication Safety Framework, a systems-based model developed from over a decade of clinical pharmacy practice across Nigeria, South Sudan, and Sierra Leone. The framework integrates three components:(1) the expanded “5 + 1” Rights of Medication Safety, incorporating patient education as a core safety principle;(2) the Medication Safety Continuum, mapping risks across prescribing, dispensing, administration, and patient use; and(3) the Medication Safety Pyramid, linking patient, health worker, and system-level interventions. The model provides a practical and scalable approach to improving medication safety, particularly in contexts where patients serve as the final safety barrier.