Magreth Bugalama Sumira is a retired nurse who opened an accredited drug dispensing outlet (ADDO) with her daughter in Nyamagana District, Mwanza region, in Tanzania on the shores of Lake Victoria. After decades of serving her community as a medical professional, she now serves the needs of her neighbors as a dispenser at the ADDO her daughter owns.
“After retiring, I thought it would be a good thing to use my already gained experience and open a small business,” Sumira explained. “That is when I opened a drug dispensing outlet.”
ADDO owner, Mariam Derick Lima, shares a similar calling to serve her community.
“I have always had a passion for helping the community,” says Lima, who also works at a local school in the district. “I was moved to open this outlet based on the fact that there are very few in the community and it is a service greatly needed by the people.”
According to SHOPS Plus Tanzania chief of party, Maureen Ogada-Ndekana, 39% of ADDO owners and 90% of medicine dispensers at the retail outlets are women. The World Bank estimates that women like Sumira and Lima make up 40% of the world’s workforce and that many of the sectors that are critical for economic growth in some of the poorest countries rely heavily on women.
Increasing access to women and girls
ADDOs, also called duka la dawa muhimu, are small pharmaceutical outlets located in rural and semi-urban settings in Tanzania. They are the first entry point into the health system for 75% of the country’s rural population. With limited resources in the public sector, the private sector plays a critical role in increasing access to health services in the country. In fact, among Tanzanian caregivers who seek care for sick children, 51% use the private sector, and 85% of private sector care seekers access a non-clinical source, like these outlets.
Drug dispensing outlets increase access to health services for women and girls.
“Every Tanzanian woman and girl lives five kilometers from an ADDO,” Ogada-Ndekana says. “These platforms have moved health commodities and services closer to women in Tanzania allowing them to access information, services and referral for primary health care.”
SHOPS Plus is working to strengthen the sustainability of ADDOs by building the capacity of their owners and dispensers, and by facilitating access to finance, one of their biggest challenges, so that they can expand and improve their services. The project does this by providing business and finance training, and helping these outlets secure loans. Owners and dispensers who complete the training course are eligible for continued support through coaching.
Building a sustainable and resilient business
By providing training and tools to ADDO owners and dispensers, SHOPS Plus is helping them develop businesses that are sustainable and able to withstand setbacks and emergencies. With support from SHOPS Plus, Sumira and Lima have been able to elevate the quality of their outlets and the services they provide.
“The sessions were eye opening and I was able to get books like this,” Sumira explained as she held up her stock card. “This book allows for me to write down all the commodities I buy. SHOPS Plus helped me understand that I need to have a system for book keeping. I will continue to use the business tools shared by the project as they have truly taken me from one stage to another. I am thankful to the project for imparting this knowledge on me.”
Lima echoes her thoughts about the SHOPS Plus training and tools.
“They [SHOPS Plus] helped us see the business opportunity available even when serving your community by providing us with the necessary tools to record our stock and sales,” said Lima. “For this I am very grateful, and request that the project continues to scale up in order for more ADDO business owners and dispensers to benefit.”
Organizing the private sector
SHOPS Plus also helps strengthen ADDO associations as a platform for accessing financing and the pooled procurement of commodities. As a result of her success and determination, Lima was selected by her peers to become the secretary of the Nyamagana Health Support Foundation, the first officially registered ADDO association in Nyamagana District. Through the association, ADDOs can address common issues and raise their concerns to the Pharmacy Council.
Lima believes that as a group they can influence change.
“The point of the association is to have one voice, as we are stronger together and can influence changes compared to an every man for himself approach,” she says. “I continue to urge SHOPS Plus to continue with business strengthening training for ADDOs and for the pharmacy council to work hand-in-hand with us. Only this way will we be able to give the best services to our communities.”
Lima hopes that through her position in the association she can one day be the voice for ADDOs at high level meetings. Ultimately, her goal is to develop initiatives that would will improve the quality and performance of ADDOS in her district and beyond.
About the Project
Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is USAID’s flagship initiative in private sector health. The project seeks to harness the full potential of the private sector and catalyze public-private engagement to improve health outcomes in family planning, HIV, child health, and other health areas. SHOPS Plus supports the achievement of US government priorities, including ending preventable child and maternal deaths, an AIDS-free generation, and FP2020. SHOPS Plus improves the equity and quality of the total health system, accelerating progress toward universal health coverage.
Credits:
Photos by Christina Kramer and Farhan Yusuf | SHOPS Plus.