A literature search (computer and hand searches) was undertaken to identify all studies which included
an assessment of the quality of some aspect of private pharmacy services in low and middle income
countries. Results 30 studies were identified which spanned all regions in the developing world. These
included 9 which examined the scope and/or quality of a range of professional services, 14 which
assessed the quality of advice provided in response to specific symptoms and 7 which investigated the
supply of medicines without a prescription. A range of methods were employed, in particular,
questionnaire surveys with staff and/or clients and assessment of practice using simulated client
methodology. Whilst many authors identified a potential for pharmacies to contribute more effectively
to primary health care, virtually all studies identified deficiencies in the quality of current professional
practice. In particular authors highlighted the lack of presence of pharmacists or other trained
personnel, the provision of advice for common symptoms which was not in accordance with guidelines
and the inappropriate supply of medicines.
Smith, F. The quality of private pharmacy services in low and middle-income countries: A systematic
review. Pharm World Sci 31, 351–361 (2009). https://doi.org/10.1007/s11096-009-9294-z
A cross-sectional study was conducted on 287 patients, who were served in five pharmacies of Gondar
University Hospital in May 2015. Data regarding socio-demographic characteristics and parameters that
measure patients' expectation and satisfaction were collected through interview using the Amharic
version of the questionnaire. Among 287 respondents involved in the study, 149 (51.9%) claimed to be
satisfied with the pharmacy service and setting. Two hundred and twenty-nine (79.4%) respondents
have high expectation toward gaining good services. Even though significant association was observed
between the pharmacy type and patients level of satisfaction, sociodemographic characteristics of a
patient were not found to predict the level of satisfaction.
yalew MB, Taye K, Asfaw D, Lemma B, Dadi F, Solomon H, Tazeze H, Tsega B. Patients'/Clients'
Expectation Toward and Satisfaction from Pharmacy Services. J Res Pharm Pract. 2017 Jan-Mar;6(1):21-
26. doi: 10.4103/2279-042X.200995. PMID: 28331862; PMCID: PMC5348852.
An institution-based cross-sectional study was conducted involving 400 clients who had
prescriptions/orders filled at the outpatient pharmacy of the hospital during the period of 5th to 25th of
November 2013. The data on the level of satisfaction of clients with the services of the outpatient
pharmacy in the hospital was collected using a structured interview guide adopted from an instrument
translated into Amharic and validated. The overall mean score the respondents gave to satisfaction with
the pharmaceutical services was 2.48 out of a maximum of 5.00 score. The mean scores for all the
individual parameters rated were less than 3.00. Maximum mean scores were given for parameters
asking about the promptness of prescription medication service (2.99), and professionalism of the
pharmacy staff (2.96) with the lowest being scored for information given to clients about the storage of
medication (1.25), and explanations of possible side effects (1.27).
Surur AS, Teni FS, Girmay G, Moges E, Tesfa M, Abraha M. Satisfaction of clients with the
services of an outpatient pharmacy at a university hospital in northwestern Ethiopia: a cross-
sectional study. BMC Health Serv Res. 2015 Jun 11;15:229. doi: 10.1186/s12913-015-0900-6.
PMID: 26062912; PMCID: PMC4464722.
A cross-sectional study design was employed from March 8 to 24, 2016. A semistructured questionnaire
was used to assess clients' perception and satisfaction toward service provided by pharmacy
professionals. Among 384 respondents, 53.1% were male. Of the total participants, 63.8% had good
perception and 36.2% had poor perception toward pharmacy services. With regard to satisfaction,
52.6% of the respondents were satisfied and 47.4% were unsatisfied by the pharmaceutical services.
Sociodemographic variables such as educational level (p=0.000), occupation (p=0.031), payment for
service (p=0.002), and reasons the respondents seek service (p=0.001) showed statistically significant
association with the level of perception. Clients' satisfaction was found to be significantly associated
with educational level (p=0.002) and reason for seeking service (p=0.016).
Teshome Kefale A, Hagos Atsebah G, Ayele Mega T. Clients' perception and satisfaction toward
service provided by pharmacy professionals at a teaching hospital in Ethiopia. Integr Pharm Res
Pract. 2016 Nov 14;5:85-94. doi: 10.2147/IPRP.S118657. PMID: 29354544; PMCID:
PMC5741042.
An institutions-based cross-sectional study was conducted from April 20 to May 5, 2014, by sampling
five pharmacies and eight drug stores through simple random sampling. Clients, 424, who came to the
MROs during the study period were included in the study. Data were collected using structured
questionnaires measuring expectations and satisfaction of clients using a Likert scale of 1-5 through
face-to-face interviews. Out of the total 424 interview encounters, 422 (99.5% response rate)
questionnaires were included in the analysis, of which 61.1% were of males. The overall mean
expectation of respondents toward MRO setting and services was 3.82 and that of satisfaction of the
respondents was 3.02. More than three-quarters (76.8%) of the respondents expected medicines in
affordable prices from MROs, but nearly half (44.8%) were not satisfied with it. Much more than half
(58.5%) of the respondents were dissatisfied with the comfort and convenience of private counseling
area. Also, nearly half (47.6%) of the respondents claimed that pharmacy professionals did not provide
information regarding the storage condition of medications. There was statistically significant difference
in overall expectation (t=2.707, P=0.007) and satisfaction (t=2.260, P=0.024) with the setting and
services of MROs between respondents who claimed to know the difference between a pharmacy and a
drug store and those who claimed they did not.
Workye M, Admasu S, Abura T, Belete Y, Getaye Y, Teni FS, Surur AS. Clients' expectations
from and satisfaction with medicine retail outlets in Gondar town, northwestern Ethiopia: a
cross-sectional study. Integr Pharm Res Pract. 2015 Jan 28;4:1-12. doi: 10.2147/IPRP.S75819.
PMID: 29354515; PMCID: PMC5741013.
A cross-sectional design, using an interview-administered questionnaire, was employed in this study.
Data were analyzed in SPSS, continuous and categorical data were computed descriptively. Main
outcome measure Patients satisfaction with pharmaceutical services provided in public hospitals in
Sierra Leone. Results Overall, 797 questionnaires were analyzed. The majority of patients seeking free
pharmaceutical services were satisfied (n = 470, 56%) or very satisfied (n = 229, 28.7%) with the services
they received. Pharmacy staff which includes pharmacists and pharmacy techincians demonstrated good
communication skills while delivering services, but lacked technical details like; how to handle (n = 187,
23.5%) and store (n = 135, 16.9%) drugs and their potential side effects (n = 253, 31.8%). Low
satisfaction was observed with the lack of private area for patients counseling (n = 474, 60.1%), and a
convenient waiting area (n = 229, 28.7%). Respondents also thought the pharmacy was too small (n =
191, 24.6%) and with less than optimal lighting system (n = 120, 15.0%). Dissatisfaction was associated
with college/university students or graduates [AOR: 0.211 (0.083-0.537), p = 0.001] and those with
household incomes less than SLL 1,000,000 [AOR: 0.391 (0.155-0.987) p = 0.047].
Kabba JA, Bah AJ, James PB, Chang J, Kitchen C, Jiang M, Zhao M, Fang Y. Patients
satisfaction with free healthcare pharmaceutical services in Sierra Leone: a national cross-
sectional study. Int J Clin Pharm. 2021 Jun;43(3):556-565. doi: 10.1007/s11096-020-01163-5.
Epub 2020 Oct 6. PMID: 33025447.
