Table. 2 Summary of key findings

1. Leadership and governance

GHS at the district and OTCMS at the district and regional levels: leadership structure of OTCMS and CHPS can support the dispensing of antibiotics

GHS and pharmacy council at regional and the national AMR platform: leadership and governance structure of OTCMS and CHPS cannot support the dispensing of antibiotics

2. Service delivery

OTCMS and GHS at the district level: OTCMS and CHPS could be trained to dispense antibiotic

GHS, pharmacy council at the regional level and the national AMR platform: allowing OTCMS and CHPS to dispense antibiotics could further dilute the system

3. Health workforce

OTCMS at the district and regional level: it is possible to train OTCMS to dispense antibiotics as they have extensive years of experience

GHS at the district level: it is feasible to train health workers in CHPS to dispense some antibiotics as they are already trained and doing similar activities

GHS and pharmacy council at the regional levels and national AMR platform: OTCMS cannot be trained to dispense antibiotics because their level of education is inadequate

4. Medical products

GHS at the district and regional levels: medical laboratory which is currently not part of CHPS with basic equipment may be required to do culture and sensitivity test

OTCMS at the regional level: there will be no need for such equipment as antibiotics would be dispensed with prescription from health professionals

OTCMS in district and regional levels: prices of antibiotics may increase if they would have to buy equipment, i.e. rapid diagnostic test kits

5. Health finance

OTCMS at the district and regional levels: there would be no major financial challenges with dispensing antibiotics as OTCMS could buy medicines on credit from the pharmaceutical companies and pay later

GHS and pharmacy council: financial implications—equipping and training staff could be challenging

6. Health information

OTCMS at the regional level: a manual/guideline with information on antibiotics dispensing will be required for reference

GHS participants at the district level: Beyond antibiotics dispensing guidelines, health information materials such as posters and reporting format for antibiotics dispensed will be required