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BACKGROUND: Medicine retailers, considered here as any person or setting dedicated to the sale of retail medicines, fill an important gap in terms of access to healthcare in areas where population are not covered by universal healthcare schemes. In Goma in the Democratic Republic of the Congo, such retailers have proliferated and are consulted as the first port of call by more than half of the population, playing therefore a key role as an alternative source of healthcare for any type of health condition. The objective of this study is to understand people of Goma's rationale for using the medicine retailers over the formal healthcare system. METHODS: Twelve focus groups, gathering 147 participants in total, were conducted in four worship communities, covering the most common faiths practised in Goma. Three focus group discussions were organised per worship community: one with fathers, another with mothers, and another with chronic patients and/or highly vulnerable people. We used a qualitative and inductive approach to analyse the participants' practices and perceptions in terms of their use of medicine retailers. We identified central categories explaining the reasons for using medicine retailers and the choice of a specific medicine retailer. RESULTS: When facing a health problem, most of the participants in our study tended to first buy medicines at medicine retailers because it was cheap, quick, and easily accessible. Most were aware of the risks and limitations of such practices and had developed a number of mitigation strategies in order to reduce those risks: evaluating medicine retailers' expertise; developing a "medical expertise"; and seeking proactively out empathetic care. CONCLUSIONS: People in Goma make a conscious and rational choice when resorting to medicine retailers as it is seen as the least-worst option in a complex situation. In order to reduce the risks, they have developed a number of mitigation strategies. Future research should focus on the organisation of medicine retailers as a professional group to improve their supervision in a sensitive context such as Goma and on modalities to articulate them to the formal health system to guarantee a financial accessibility to healthcare for all.

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Objectives: Belgium enacted a coronavirus disease 2019 (COVID-19) pass - the 'COVID Safe Ticket' (CST) - in October 2021. This study aimed to understand the expectations and reasons given by those supporting this policy measure. Methods: This mixed methods study was based on a voluntary online survey among 9444 French-speaking residents in Belgium. Results: Most respondents were not very supportive of the CST, with only 617 respondents (7%) being pro-CST. Compared with other respondents, the pro-CST sample comprised more males, older people, people scared of COVID-19, people who had confidence in the COVID-19 vaccines, and highly educated people. A qualitative analysis was undertaken to identify the reasons why respondents supported the CST. Two lines of argument were related to personal comfort (individual protection and means of 'recovering freedom'), and two other lines were related to collective protection (controlling the pandemic and incentivizing vaccination). Pro-CST respondents also indicated some limitations of the CST. Conclusions: The expectations regarding the CST were high, diverse and not entirely rational. Some contradictions and frustration emerged from the respondents' comments. The CST may have exacerbated the social divide in society. The high expectations risk leading to comparably high levels of disappointment, resulting in potential distrust towards future public health interventions.

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This cross-sectional study examines why people in French-speaking regions of Belgium who initially resisted getting the COVID-19 vaccine eventually chose to get vaccinated.

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OBJECTIVES: In Sub-Saharan Africa (SSA), private medicine retailers have become the first entry point to health systems, irrespective of their level of accreditation. This review aims to map the main trends in research about formal and informal medicine retailers in SSA over the past 20 years. Such an overview offers a valuable resource to understand their role and develop inclusive interventions to improve accessibility to health care in line with people's health-seeking behaviours. This review followed the steps recommended by the Joanna Briggs Institute. Four electronic databases were searched and complemented by manual web researches. KEY FINDINGS: A total of 293 publications from 23 countries met our inclusion criteria, 79% of which relate to six countries. The number of publications has been growing since 2010. Medicine retailers are distributed among three professional groups based on their accreditation level. Most studies used quantitative methods. Three topics - service provision; knowledge, attitudes and practices; and the expanding role of medicine retailers in the health system - accounted for 67% of included studies. Most studies focus on a specific health condition, of which malaria (26%) and sexual/reproductive health (13%) are the most common. SUMMARY: This review reveals increasing interest in medicine retailers in SSA and increasing expectations as stakeholders within health systems. This review suggests that new research and interventions should focus on: moving beyond a disease-based approach; using qualitative methods; and understudied countries, rural areas and informal medicine retailers. A more dynamic, relational and interactive approach could help better understand the sector.

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