Integrating Pharmacy-Based Primary Health Care Model: A Practical Approach for Expanding Healthcare Access in Low-and Middle-Income Countries, Kenyan Example

Abstract

Purpose: The paper examines the integration of a pharmacy-based primary health care (PHC) model as a practical strategy for expanding healthcare access in low- and middle-income countries (LMICs), with a particular focus on Kenya. It assesses how pharmacies already widely utilized as first points of care can be systematically incorporated into formal PHC systems to improve access, efficiency, and health outcomes.

Methodology: The study adopts a secondary data research design, drawing on global databases (WHO, World Bank, UN), national health data from Kenya, peer-reviewed literature, and policy documents. A mixed-methods approach combining quantitative trend analysis and qualitative policy analysis is used, alongside comparative analysis of LMICs and high-income countries with established pharmacy-based PHC models such as the United Kingdom, Canada, and Australia.

Findings: Findings indicate that community pharmacies play a significant yet underutilized role in healthcare delivery in LMICs, accounting for a substantial proportion of first-contact care (40–60%), particularly for minor ailments, chronic medication refills, and preventive services. Comparative evidence demonstrates that countries with integrated pharmacy-based PHC models achieve improved access, reduced facility congestion, shorter waiting times, and enhanced system efficiency through structured reimbursement, defined scopes of practice, and strong governance frameworks. In Kenya, the presence of approximately 8,000 community pharmacies presents a scalable and cost-effective opportunity to expand PHC coverage and support Universal Health Coverage (UHC) goals.

Unique Contribution to Theory, Practice and Policy: The study contributes to theory by advancing a health systems strengthening perspective that positions community pharmacies as strategic primary care actors within integrated service delivery networks. Practically, it provides an implementation-oriented framework outlining service packages, workforce competencies, referral pathways, and digital integration mechanisms necessary for operationalizing pharmacy-based PHC. From a policy perspective, it offers evidence-based recommendations for legal and regulatory reform, financing through health insurance schemes, public-private partnerships, and the establishment of quality assurance and governance structures. The study further recommends that formal integration of community pharmacies into PHC systems represents a viable, scalable, and high-impact intervention for improving equitable access to healthcare in Kenya and similar LMIC contexts.