Replicating Pharmaceutical Policy Research in Egypt: An African Perspective from

Pharmaceutical policy research is important for improving medicine access and regulation in Africa. Findings from studies conducted in high-income countries may not account for the distinct socio-economic and regulatory environments found in African settings like Egypt. Replication studies are needed to verify the applicability of such research and to inform local policy. This study replicated a seminal pharmaceutical policy analysis within Egypt. Its objective was to test the transferability of the original findings on policy drivers and barriers, and to generate evidence relevant to African obstetric and gynaecological care. This qualitative replication used a similar policy analysis framework to the original research. Data were collected through semi-structured interviews with a purposive sample of key stakeholders, including policymakers, hospital pharmacists, and obstetrics and gynaecology clinicians. Documentary analysis of national policy texts was also performed. The replication confirmed the original finding that centralised medicine procurement acts as a barrier to access. However, it identified a more prominent theme regarding the impact of informal patient payments on equity, which was not a major finding in the original study. A large majority of interviewees cited this as a critical, under-reported challenge. While core policy mechanisms may be consistent, this replication highlights distinctive systemic pressures in Egypt, particularly informal payments, which disproportionately affect women's access to essential medicines. This underscores the need to contextualise international policy research within specific African health systems. Egyptian pharmaceutical policy reform should explicitly seek to mitigate informal payment structures within the medicine supply chain. Further replication studies across different African regions are recommended to build a continent-specific evidence base for medicine policy in obstetrics and gynaecology. pharmaceutical policy, replication study, access to medicines, Egypt, obstetrics, gynaecology, qualitative research, Africa This study provides a contextualised African perspective on a replicated pharmaceutical policy analysis, highlighting informal payments as a key equity issue in Egypt's obstetric and gynaecological medicine access.