A cross-sectional study to identify the distribution and characteristics of licensed and unlicensed private drug shops in rural Eastern Uganda to inform an iCCM intervention to improve health outcomes for children under five years

PLoS One. 2019 Jan 9;14(1):e0209641. doi: 10.1371/journal.pone.0209641. eCollection 2019.


Introduction: Malaria, pneumonia and diarrhea are leading causes of death in young children in Uganda. Between 50-60% of sick children receive treatment from the private sector, especially drug shops. There is an urgent need to improve quality of care and regulation of private drug shops in Uganda. This study was conducted to determine the distribution, the licensing status and characteristics of drug shops in four sub-districts of Kamuli district.

Methods: This study was part of a pre-post cross sectional study that examined the implementation of an integrated Community Case Management (iCCM) intervention for common childhood illness in rural private drug shops in Kamuli District in Eastern Uganda. This mapping exercise used a snowball sampling technique to identify licensed and unlicensed drug shops and collect information about their characteristics. Data were collected using a questionnaire. GPS data were collected for all drug shops.

Analysis: Quantitative data were analyzed using SPSS for descriptive statistics. Open ended questions were entered into NVivo 10 and analyzed using thematic analysis strategies.

Results: In total, 215 drug shops in 284 villages were located. Of these, 123 (57%) were open and consented to an interview. Only 12 (10%) drug shops were licensed, 93 (76%) were unlicensed, and the licensing status of 18 (15%) was unknown. Most respondents were the owner of the drug shop (88%); most drug sellers reported their qualification as nursing assistants (70%). Drug sellers reported licensing fees and costs of contracting an "in-charge" as barriers to licensing. Nearly all drug shops sold drugs for malaria (91%) and antibiotics (79%).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Antidiarrheals / therapeutic use*
  • Antimalarials / therapeutic use*
  • Child, Preschool
  • Cross-Sectional Studies
  • Diarrhea / drug therapy
  • Female
  • Humans
  • Malaria / drug therapy
  • Male
  • Pharmacies / legislation & jurisprudence*
  • Pneumonia / drug therapy
  • Uganda


  • Anti-Bacterial Agents
  • Antidiarrheals
  • Antimalarials

Grants and funding

This work is supported by Grand Challenges Canada Stars in Global Health Round Six (#0492-01-10), http://www.grandchallenges.ca/programs/stars-in-global-health/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.