Sari-sari stores may bridge medicine gaps in remote Philippine communities
· Medical Xpressby Danika Geronimo, Ateneo de Manila University
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Medicine should never feel out of reach. Yet for many Filipinos, a trip to the pharmacy can mean literally crossing mountains and streams for a handful of tablets. In a remote location in Barangay Kalawakan, Bulacan, getting to the nearest pharmacy can mean traveling almost a dozen kilometers without public transportation. A single trip to town can cost more than ₱400—almost an entire day's minimum wage. For some, the only alternative is more than an hour's walk, even in good weather.
A new study by Ateneo de Manila University researchers explores small sari-sari stores as potential points of access to medicine and health care, leveraging their ubiquity and accessibility within local communities.
The findings are published in the journal Acta Medica Philippina.
Most of the medicines sold by the tinderas, or sari-sari store owners, in the study were for what they considered common illnesses: headaches, diarrhea, fever, colds and stomachaches. These included familiar over-the-counter medicines like paracetamol, mefenamic acid, ibuprofen and loperamide. They generally stocked nonprescription medicines, often selling them in small quantities.
Such a scene is ordinary enough to be almost invisible: A neighbor walks up to the nearest sari-sari store, asks the tindera for a few tablets, purchases them piecemeal or tingi-tingi, then goes home. Yet behind this familiar transaction is a larger story of proximity, affordability and the gaps between communities and formal health care.
"The sari-sari store, as a venue to observe interactions between the consumers, the government, and the medical and pharmaceutical world, shows us its social, political, and economic relevance," the researchers write.
The study draws on ethnographic insights from interviews with 14 sari-sari store tinderas. The findings show that distance is a major factor in why some store owners choose to sell medicines: In communities without nearby pharmacies, keeping common medicines within reach can save residents the cost and time of traveling to town.
The same is true of store hours: One tindera said they kept the store open until midnight, making medicines available even after a nearby pharmacy had closed for the day.
Tinderas, serving as the eyes and ears of their communities, repeatedly encounter people in those communities. They learn which medicines people ask for, what they can afford and what their neighborhoods tend to need. Some began selling medicines after noticing demand from the people around them. They adapt to the communities they serve.
"Sari-sari stores bring valued 'things' in close proximity to the people who look to them for healing and comfort," the researchers explained.
This is where the sari-sari store becomes more than just a place to buy medicine. Embedded in everyday Filipino life, sari-sari stores reveal how people rely on informal systems of care alongside formal institutions.
Yet the study also reveals the boundaries of the services these sari-sari stores offer. Tinderas do not see themselves as doctors or pharmacists; 11 of the 14 simply refuse to sell antibiotics and other prescription medicines, advising customers to seek care directly from health care professionals when necessary.
Viewed through the lens of sari-sari stores as a community "myopticon"—a place where a neighborhood's health needs become visible through everyday interactions—the study raises questions about who is close enough to notice when people need medicine, who can make it available and who is there when formal health care is beyond reach.
"Strictly speaking, the sale of pharmaceuticals through sari-sari stores is illegal, unless the outlet is duly licensed by the Food and Drug Administration (FDA). There are, however, layers of liminalities, such as due considerations for geographically isolated and disadvantaged areas (GIDAs) and medicines not captured in the FDA circular," the researchers clarify.
The researchers approach the issue through a medical anthropology lens and recommend against blanket prohibitions and punitive measures. They argue that policies should account for the economic and geographic barriers that shape access to medicine.
"We see the value in recognizing the role of sari-sari stores in the health system, as well as in accounting for economic and geographic barriers before imposing top-down prohibitions," the researchers say.
Sari-sari stores are neither replacements for pharmacies nor substitutes for the country's health care system. The sari-sari store does not stand outside or simply beside the health care system: It occupies an ambiguous but necessary liminal space between the household and formal institutions—a place shaped by poverty, distance, convenience, trust and necessity.
Perhaps sari-sari stores tell us what happens when the system is too far away, too costly or simply unavailable to those who need it.
More information
Melissa Louise M. Prieto et al, Sari-sari Stores as Community Pharmacies? A Qualitative Exploration of Sari-sari Stores Selling Medicines in the Philippines, Acta Medica Philippina (2026). DOI: 10.47895/amp.v60i15.13577
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