Bringing the marginalized drug seller into mainstream pharmaceutical services delivery: Experiences from three developing countries using three models

APHA Scientific Session and Event Listing

Keith Johnson, MS, Center for Pharmaceutical Management, Management Sciences for Health, 4301 North Fairfax Drive, Arlington, VA 22203, 703-524-6575, kjohnson@msh.org

In developing countries, up to 40–60% of people use local drug sellers as primary sources of medicines, particularly in underserved, rural areas. However, shop attendants have minimal drug dispensing training, and governments rarely provide adequate oversight. Because of drug shops' important role in health care delivery, the Strategies for Enhancing Access to Medicines (SEAM) Program implemented two public-private sector models and provided assistance to a third to improve pharmaceutical services in retail drug outlets.

In Ghana, SEAM helped set up the CAREshop franchise for essential medicines by converting selected chemical seller shops. The franchiser controls the quality of services and products sold by the outlets, as well as the prices.

In Tanzania, SEAM helped the government create a new category of accredited, private drug dispensing outlets, sustained by both commercial incentives and local enforcement. Most new shops were converted from existing drug shops.

In Kenya, SEAM supported the Sustainable Healthcare Enterprise Foundation to strengthen their franchises of essential drug shops and health clinics operated by community health workers and nurses.

SEAM has proven the feasibility of using retail drug sellers to enhance access to quality medicines and pharmaceutical services at affordable prices: • Key stakeholders in all countries committed to an expanded role for private-sector drug sellers, including approval to sell certain prescription drugs in accredited outlets in Tanzania, where assessments showed they were dispensed responsibly. • Assessments showed improvements in product and service quality and increased consumer satisfaction in all three models, while medicine prices remained relatively stable.

Learning Objectives: At the conclusion of the session, participants will be able to

Describe the role that retail drug sellers play in health care delivery in developing countries.
Evaluate the strengths and weaknesses of the three models implemented in Ghana, Tanzania, and Kenya to improve access to and quality of pharmaceutical products and services in retail drug outlets.
Identify additional roles that retail drug outlets can play in improving public health in underserved areas.
Discuss the challenges of scaling-up and sustaining retail drug seller initiatives in resource-limited settings.

Keywords: Public/Private Partnerships, Pharmacies

Presenting author's disclosure statement:

Any relevant financial relationships? No

Improving Quality! Practical Models that Work

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA