MSH’s work over the years has demonstrated that private-sector drug seller initiatives based on an accreditation and regulation model are feasible and improve access to medicines, but lessons showed that countries need greater efficiencies in implementation and changes to the models to institutionalize, scale-up, and sustain the initiatives. Decentralized implementation decreases implementation costs and time because multiple implementations can occur simultaneously and localizing activities costs less.

Activities to enhance drug shop operations and promote sustainability include links to community-based health initiatives and the incorporation of information technology to improve information-sharing. For example, databases can help regulatory authorities track shops and mobile banking can facilitate fee collection. Short messaging services (SMS) can also be used to send information to shop owners and sellers.