Private local pharmacies in low- and middle-income countries: a review of interventions to enhance their role in public health.

OBJECTIVES: To review the evidence regarding the potential of pharmacy services to play an enhanced role in contributing to health care and policy initiatives in low- and middle-income countries.
METHODS: Literature search, using computer and hand searching, to identify original research reporting the results of interventions to improve services from private local pharmacies in low- and middle-income countries.
RESULTS: Eighteen studies were identified which spanned all regions: 12 evaluations of training initiatives, three studies evaluating the impact of policy of regulatory interventions, one regarding a collaboration of pharmacy services with a national TB programme, and two evaluating a pharmaceutical care initiative for patients with hypertension. A total of 14 studies used advice and recommendations to simulated clients as the primary outcome measures. Whilst most studies reported some improvements to practice, these were often small, limited to specific outcomes and believed to be short-lived.
CONCLUSION: The studies in this review demonstrate international interest in enhancing the place of pharmacy services in the provision and delivery of health care. But the small number of studies provides inadequate evidence on how to assure the quality of local pharmacy services can be assured, or how to develop them within a wider reform framework.