Table 1 Six-district study [13]

The study included 60 medicine shops and 24 government health posts, drawn from six districts selected to be representative of the diverse geographies in Nepal. It found that the profile of health worker credentials was essentially the same in medicine shops and government health posts (mainly CMAs, plus other trained paramedical workers) but medicine shop providers, on average, had more years of professional experience. A small proportion of health workers served in both medicine shops and government clinics. Opening hours and availability of health workers were considerably greater in medicine shops than in public health posts, making the shops a more convenient source of care. Approximately half the medicine shops reported, over the previous 3 months, having treated one or more cases of potentially severe infection, among young infants, using injectable antibiotics. By contrast, only three of the 24 public sector health posts reported having treated any such cases. In most respects, there were no differences in quality of care between medicine-shop and health post practitioners. Health workers in medicine shops considered the Ministry of Health a highly credible source for clinical guidelines (and rated pharmaceutical company detailers poorly in this regard) and expressed interest in using such guidelines, if they were made available to them. Similarly, most of those interviewed in private medicine shops indicated interest in participating in a social-franchising network, providing care for sick infants and children, if one were developed.