Medicine retailers in Goma, the “white coats of the pharmacy”: unity among diversity

In the Democratic Republic of Congo, medicine retailers play a central role in access to medicines and, more broadly, to primary healthcare, within a fragmented health system marked by weak regulation. In the city of Goma, they constitute the first port of call with the health system for more than half of the population. Despite their rapid expansion, little is known about their everyday practices, professional trajectories, and modes of organisation. This qualitative study draws on 24 semi-structured interviews conducted with medicine retailers in Goma. An inductive analytical approach, informed by the sociology of professions, was used. Data were analysed using descriptive and process coding and organised using Evetts’ framework to examine medicine retailers as a professional group in the making. Despite substantial heterogeneity in profiles, training backgrounds, and trajectories, medicine retailers share a set of common characteristics that support their analysis as a professional group. These include partially shared pathways into the activity, overlapping ethical orientations, fluid and negotiated professional identities, a shared understanding of their role in improving access to healthcare, relational practices structured by users’ trust and perceived expertise, and similar experiences of economic pressure and weak institutional regulation. Rather than revealing a clear opposition between commercial imperatives and healthcare motives, the findings highlight how these logics are pragmatically articulated in everyday practice. By offering a profession-centred analysis of medicine retailers in a fragile and underregulated urban context, this study contributes to a more nuanced understanding of how access to medicines and care is effectively produced in plural health systems. Conceptualising medicine retailers as a professional group in the making helps move beyond binary distinctions between formality and informality and invites reflection on regulatory and policy approaches that engage with existing practices and local forms of legitimacy.