Introduction: Innovative private pharmacy distribution channels, including delivery services, telepharmacy, and e-pharmacies, have emerged as potential solutions to improve access to quality-assured medicine and pharmacy services in Zambia, but limited evidence exists regarding their impact on medicine quality and safety. This qualitative study provides the first comprehensive investigation of stakeholder perspectives on these channels, examining their implications for pharmaceutical quality assurance and distribution in Zambia's health care system.
Methods: A purposive sample of 15 stakeholders participated in the study, selected to represent key sectors of the pharmaceutical supply chain, including wholesalers, innovators, retailers, national medicine supply agencies, national medicine regulators, professional pharmacy bodies, and supply chain experts. Semi-structured interviews were conducted until data saturation was achieved. Interviews were recorded and transcribed, and a bottom-up thematic analysis was employed to derive themes directly from the data.
Results: Themes that emerged from the analysis fell into 4 interconnected categories of issues: (1) current challenges in the pharmaceutical supply chain (including affordability barriers, transportation limitations, and regulatory constraints) affecting both traditional and innovative pharmacy services, (2) potential benefits of the innovative pharmacy approaches (such as enhanced traceability and improved quality assurance), (3) limitations and shortcomings (including technical and behavioral challenges), and (4) recommendations for improvement. Stakeholder perspectives varied notably by role, with regulators emphasizing quality control and innovators focusing on accessibility and efficiency.
Conclusion: The findings suggest that innovative pharmacy distribution approaches will be constrained by some of the same regulatory and structural issues faced by traditional pharmacy systems, and thus cannot fully circumvent existing challenges of access to quality pharmacy services and medicines in Zambia and other countries. To successfully realize the potential of pharmacy innovations to improve accessibility to good-quality medicines, balanced attention is required to technological advancement, regulatory compliance, and the local context. These insights offer actionable guidance for policymakers and stakeholders seeking to strengthen medicine distribution systems, enriching the broader narrative of health care delivery in resource-limited settings.
© Matafwali et al.