The place of the “pharmacy” and “drug sellers” in LMICs: a scoping review

Introduction: Faced with numerous barriers reducing access to formal health systems, many people in low- and middle-income countries (LMICs) turn themselves to "pharmacies" and other drug sellers. After having been neglected for a long time in health system policies, these stakeholders are progressively taken into account. This slow recognition is sustained by two main interconnected elements: an inability of public health systems to take charge efficiently of endemic and emerging non-communicable diseases; and the increasing importance of self-medication as first therapeutic resort of a large portion of people across the world, both in urban and rural settings. Thus "pharmacies" seem to have become unavoidable in the health-seeking behaviours of populations in LMICs, and now play an essential role in the health system.
Aim: This study aims to identify existing knowledge and clarify key concepts related to the "pharmacy" and its connected professional groups, so as to better understand their place and role in the broader context of changing health systems.
Methods: We use the scoping review method which has been structured around a three-step search strategy. The inclusion criteria were developed on the basis of the PCC model: Public – Concept – Context. Different types of sources have been searched (primary, secondary and others which includes grey literature). Among the primary sources, the following databases have been selected for the review: Medline (via PubMed), Sociological Abstracts, Psychinfo (via Proquest) and Scopus.
Results: After applying our extraction framework, the results will be presented in a search and selection decision flowchart, following the PRISMA mode. Results will be presented around following themes: professional groups' categories, articulation to health systems, role in care delivery, relations to other healthcare professionals.
Conclusion: By establishing a cartography of existing knowledge and key concepts underlying the topic, this scoping review aims to better understand the state of the art on the place of the "pharmacy" in a changing health system in LMICs. This will allow to clearly identify the areas that need to be further investigated by public health researchers in order to nurture the reflections around the reorganisation of care provision in those settings.