Despite policies that recommend parasitological testing before treatment for malaria, presumptive treatment remains widespread in Nigeria. Poorer individuals seeking care at PPMVs were more likely to receive inappropriate malaria treatment when compared to those who go to pharmacies. Increasing accessibility to reliable diagnosis should be explored to reduce malaria over-treatment.

There is growing interest in franchising as a model that can be applied to reach social, as well as commercial gains, particularly in global health. Tiendas de Salud is a rural pharmacy franchise that brings essential medicines to rural villages in Guatemala, which was incubated through donor-funding but has transitioned to commercial ownership. This case study examines the community effects of the franchise program through qualitative interviews, observation, and analysis of store records.