Table 1 Description of country context and initiative

Bangladesh

Nizame et al.

Drug shops are a major source of healthcare for poor and disadvantaged populations in Bangladesh. Antibiotic stewardship is a challenge associated with antimicrobial resistance. Unregulated antibiotic sales by drug shops, therefore, contributes to this problem

To prohibit the sale and distribution of antibiotics without a prescription

Government of Bangladesh developed a National Drug Policy to lay out guidelines for appropriate sale and dispensing of antibiotics

Research group explored attitudes towards this policy through qualitative interviews towards informing the development of social and behavioral communication change materials

Indonesia

Ferdiana et al.

Indonesia has the second highest number of malaria cases in South East Asia. Private health providers are often the first port of call for antimalarials, due to access factors, but they are unregulated and do not necessarily comply with standardized treatment guidelines, potentially increasing resistance

To implement a public–private partnership to increase access to quality antimalarials for patients, and increase adherence to guidelines for pharmacies

District health office provides free antimalarials to drug shops, ensuring quality and stock of guideline-adherent therapy. Drug shops are permitted to dispense these only with prescription and laboratory confirmation of malaria

Research group analyzed secondary data on malaria cases and the use of antimalarials by drug shops, as well as conducted interviews and focus group discussions on the acceptability of the partnership among key stakeholders

Myanmar

Thein et al.

TB and malaria are important causes of morbidity and mortality in Myanmar. Drug shops are the first or only port of call for many people, especially for those in urban slums, for their healthcare needs

To integrate drug sellers into the healthcare system, enabling them to provide TB and malaria screening, testing, case notification and referral according to national guidelines

PSI/Myanmar provided training on guidelines and appointed one field supervisor per township to support drug sellers and patients with these services

Research group conducted a mixed-method study involving a quantitative survey and qualitative interviews to understand the barriers to service provision by drug shops currently engaged in the program

Nigeria

Oluwasanu et al.

Injectable contraception is a popular family planning choice for Nigerian women but can’t be legally provided by PPMVs. PPMVs are the primary source of contraception due to geographical, financial and sociocultural factors. PPMVs have been providing injectable contraception regardless to meet customer demand

Training of PPMVs to deliver injectable contraception and to regulate this currently unregulated market. Initiative was introduced as a pilot program

Training on injectable contraception, as well as monitoring and follow-up at 3, 6 and 9 months. This was accompanied by a time-bound policy change allowing PPMVs to provide injectable contraceptives for the duration of the pilot

Research group conducted a mixed-methods study involving quantitative questionnaires and qualitative interviews to elucidate the processes through which this intervention influenced women’s utilization of injectable contraception

Nigeria

Uneke et al.

PPMVs are often the first and only point of care for family planning, treatment of childhood illnesses, antibiotic prescribing and malaria care. They remain somewhat unregulated

Given the role of PPMVs in providing healthcare to large sections of the population, the aim is to integrate and regulate their operations to help contribute to moving towards UHC

Implementation of National Drug Policy on appropriate family planning services, malaria care and antibiotic dispensing by PPMVs

Research group conducted a self-administered questionnaire for PPMV staff, nursing mothers and young people to understand PPMVs knowledge of National drug policy and subsequent behaviours, as well as nursing mothers and young people’s access to and views on these services

Tanzania

Shekalaghe et al.

Many patients seek healthcare from Accredited Drug Dispensing Outlets (ADDOs). These outlets are part of a public–private partnership using an accreditation approach to improve access to quality medicines rurally. However, poor communication between ADDOs, community health workers and health facilities may be associated with inadequate referral and integration of care

To better integrate ADDOs into the system by increasing communication pathways and referral between these three groups

A training initiative to educate each of these groups on the roles and responsibilities of the others and informally convene ADDOs, Community health workers and health facilities

Research group used in-depth interviews to understand relationships between these three groups, as well as barriers and facilitators to their linkage

Zambia

Zulu et al.

There is inadequate access to quality medicines in rural Zambia, and especially for family planning. Specific issues include lack of skilled personnel, limited adherence to treatment protocols and dispensing drugs without prescriptions

To better regulate drug shops to increase the quality of their service provision and to increase access and quality of medication for vulnerable populations

Guidelines on operating Health Shops developed by Zambian Medicines Regulatory authority (ZAMRA), outlining key standards such as personnel requirements, medication supply, and record keeping. Guideline training also conducted

Research group conducted documentary review and qualitative interviews to understand the current acceptability of these guidelines among key stakeholders