The study, authored by Melissa Louise M. Prieto, Gamaliel P. Galigao, Ana Rica S. Navarra-Cruz, Louise Gabriel R. Jimenez, and Gideon Lasco, was published in the August 2026 issue of the journal Acta Medica Philippina under the title “Sari-sari Stores as Community Pharmacies? A Qualitative Exploration of Sari-sari Stores Selling Medicines in the Philippines.” Drawing on ethnographic interviews with fourteen sari-sari store owners, known locally as tinderas, the researchers set out to understand why these small shops sell medicines, what they sell, to whom, and where their informal role in community health begins and ends. The result is a portrait of an informal care network that operates in the shadows of the formal health system, shaped by poverty, distance, convenience, trust, and necessity.

The medicines that tinderas reported selling were overwhelmingly those associated with what they considered common illnesses: headaches, diarrhea, fever, colds, and stomachaches. The inventory consisted almost entirely of familiar over-the-counter products such as paracetamol, mefenamic acid, ibuprofen, and loperamide. Crucially, the stores generally stocked non-prescription medicines and frequently sold them in very small quantities, a practice known in the Philippines as tingi-tingi, in which goods are purchased piecemeal in amounts matched to what a customer can afford at that moment. This retail logic, in which a customer might buy two tablets rather than a full box, mirrors the broader economics of the communities these stores serve, where household budgets are often stretched across days and small expenditures must be timed to daily cash flow.

What emerges from the interviews is that proximity is not an incidental feature of these transactions but their defining rationale. Distance was a major factor in why store owners chose to sell medicines at all: in communities without a nearby pharmacy, keeping common medicines within reach can spare residents the considerable cost and time of traveling to town. Store hours extend the same logic into the temporal dimension. One tindera reported keeping her store open until midnight, which means that medicines remain available even after a nearby pharmacy has closed for the day. In effect, the sari-sari store functions as a form of after-hours, last-mile pharmaceutical access that no formal institution in these areas currently provides, filling gaps that are both geographic and temporal.

The researchers argue that tinderas also occupy a distinctive informational position within their neighborhoods. Serving as what they describe as the eyes and ears of their communities, store owners repeatedly encounter the same people day after day. Through these repeated interactions they learn which medicines people ask for, what customers can afford, and what their neighborhoods tend to need. Some of the tinderas interviewed began selling medicines only after noticing demand from the people around them, which suggests that the supply of medicines through these channels is not imposed from above but grows organically out of observed community need. The store adapts to the community rather than the other way around, a dynamic that stands in sharp contrast to the standardized protocols of formal pharmaceutical retail.

This adaptability has limits, and the study is careful to map them. The tinderas do not see themselves as doctors or pharmacists, and this self-understanding translates into concrete boundaries of practice. Eleven of the fourteen store owners interviewed simply refuse to sell antibiotics and other prescription medicines, instead advising customers to seek care directly from healthcare professionals when their conditions appear to require it. This finding complicates any simplistic narrative of informal medicine sales as inherently dangerous. The tinderas in the study appear to operate according to an implicit triage system, offering remedies for minor, self-limiting complaints while recognizing and referring conditions that exceed their competence. The researchers describe the sari-sari store as a kind of community myopticon, a vantage point from which the health needs of a neighborhood become visible through everyday interactions, raising questions about who is close enough to notice when people need medicine, who can make it available, and who is present when formal healthcare is beyond reach.

There is, however, another boundary that cannot be negotiated by custom or goodwill: the law. Strictly speaking, the sale of pharmaceuticals through sari-sari stores is illegal in the Philippines unless the outlet is duly licensed by the Food and Drug Administration. The researchers note, though, that the regulatory landscape contains layers of liminality, including special considerations for geographically isolated and disadvantaged areas, known as GIDAs, and categories of medicines not captured in the relevant FDA circular. In other words, the practice occupies an ambiguous legal zone in which the letter of the law, the realities of rural access, and the limits of regulatory coverage do not fully align. It is precisely this ambiguity, the researchers suggest, that policy must confront rather than ignore.

Approaching the issue through the lens of medical anthropology, the authors recommend against blanket prohibitions and punitive enforcement measures. They argue that policies should take into account the economic and geographical barriers that shape access to medicine before imposing top-down restrictions on the only accessible source of relief available to many communities. In their view, there is genuine value in recognizing the role of sari-sari stores within the health system, and in accounting for the structural conditions, poverty, remoteness, and the cost of travel, that make these informal channels necessary in the first place. A regulatory response that simply criminalizes the practice would, on this reading, remove a functioning safety net without replacing it, leaving residents with nothing between their symptoms and a costly, hours-long journey to town.

The researchers are explicit that sari-sari stores are neither replacements for pharmacies nor substitutes for the country’s healthcare system. Instead, they argue, the sari-sari store occupies an ambiguous but necessary liminal space between the household and formal institutions, a space produced by the interaction of poverty, distance, convenience, trust, and necessity. It does not stand outside the healthcare system, nor simply beside it, but in an in-between zone where informal and formal systems of care meet, overlap, and compensate for one another’s gaps. The study’s contribution lies in making this zone visible, documenting through careful qualitative work a form of healthcare delivery that has been so embedded in everyday Filipino life as to become almost invisible.

Perhaps the most provocative implication of the research is what it reveals about the formal system itself. The familiar scene the researchers describe, a neighbor walking to the nearest sari-sari store, asking the tindera for a few tablets, paying piecemeal, and walking home, is ordinary enough to escape notice, yet behind it lies a larger story about proximity, affordability, and the distance between communities and institutional healthcare. The sari-sari store, as a venue for observing interactions among consumers, government, and the medical and pharmaceutical worlds, carries social, political, and economic relevance that extends far beyond its small storefront. Sari-sari stores, the study suggests, show what happens when the system is too far away, too costly, or simply unavailable to those who need it, and any serious effort to improve access to medicine in the Philippines will have to reckon with the informal infrastructures that communities have already built for themselves.

Subject of Research: The role of sari-sari stores as informal community pharmacies and their implications for medicine access in the Philippines

Article Title: The anthropological dimensions of sari-sari stores as liminal community pharmacies

Article References: The anthropological dimensions of sari-sari stores as liminal community pharmacies. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: sari-sari stores, Philippines, medical anthropology, medicine access, informal healthcare, community pharmacies, Ateneo de Manila University, Acta Medica Philippina, tingi-tingi, geographically isolated areas, pharmaceutical regulation, tinderas