Pharmacies and Drug Shops: Expanding contraceptive choice and access in the private sector

Expanding access to contraceptive methods through the private sector and community-based sources—which includes task sharing—is an important strategy to help achieve national family planning and development goals and, in particular, aims to reduce barriers to access for youth, lower-income, and other marginalized groups. Private sector pharmacies and drug shops are often the first line of health care in low- and middle-income countries, particularly for many underserved populations and especially in rural areas that have very few private or public clinics. While there are differences between pharmacies and drug shops, there are also common issues around implementation and impact. For both, training and support can improve and expand the range and quality of services they offer and thereby increase access and choice for women.

Pharmacies are generally larger than drug shops, are staffed by a licensed pharmacist, and carry a wider range of products. Like pharmacies, many drug shops also sell over-the-counter family planning methods, especially condoms, oral contraceptives, and emergency contraception. Drug shops typically have storefronts, product displays, and a counter. Many have a small room in the back, separated by a curtain or door, for examinations and treatment. The owners of these shops may or may not have some type of retail license, and frontline staff may or may not have family planning training, or health accreditation such as training as a nurse, nursing assistant, pharmacy assistant, or traditional medicine practitioner.

Pharmacies and drug shops, with their convenience, anonymity, and cost savings (compared to private physicians), are an essential source of health services, products, and information that is particularly important in the context of “high maternal mortality and morbidity, poorly stocked clinics, high unmet need for family planning” and critical health-worker shortages. In recent years, drug shops and pharmacies have been recognized in many countries for their potential to improve health across a wide area of diseases and health issues. Despite their popularity and potential, pharmacies and drug shops have often not been considered part of the larger health system; they are typically missing from countries’ health strategies, policies and regulation, and monitoring. A regulatory scan of 32 countries found that there has been more official recognition for drug retail outlets in recent years(e.g., in the form of licensure), with increasing awareness that these sources are responsible for a substantial share of modern family planning services.

Evidence shows that with training and support, pharmacy and drug shop staff can facilitate the use of a broad range of modern contraception, especially in areas where the unmet need is high, access to family planning services is poor, and health worker shortages and other barriers prevent women, men, and youth from accessing family planning services. Access to contraceptives through pharmacies and drug shops can also be critical during emergency situations when there is added stress on the health care system and restricted mobility for many people. This brief describes the importance of these outlets for providing commodities and information, and outlines key issues for planning and implementing programs to support pharmacy and drug shop staff. While many pharmacies and drug shops already provide family planning, this high-impact practice focuses on how to strengthen and improve these services and their impact.