Should medicines be distributed by health services or pharmacies? A preliminary evaluation of the Boulgou project in Burkina Faso

Drug distribution by pharmacies is fraught with difficulties in Africa. These include: improper use of medication by health professionals; by-passing health services leading to irrational self-medication; the inevitable fee-for-service payment scheme; and finally inadequate management. In this article, a health centre in Burkina Faso is evaluated for these problems using quantitative and qualitative methods. The reality of the problems justifies consideration of an alternative drug distribution arrangement, perhaps via the health service.