Barriers to and Facilitators of the Implementation of the Central Chronic Medicines Dispensing and Distribution Programme in South Africa: A Scoping Review

South Africa’s (SA) quadruple disease burden comprises communicable diseases such as HIV/AIDS, tuberculosis, maternal and child mortality, non-communicable diseases (NCDs), and injury and violence. Two of these components, HIV and NCDs, generate demand for long-term medicines and are the focus of the review. To improve access to chronic medicines and to alleviate the pressure on overburdened public health facilities, the National Department of Health launched the Central Chronic Medicines Dispensing and Distribution (CCMDD) programme. Stable, compliant patients were granted access to patient medicine parcels (PMPs) via decentralised community pick-up points (PUPs), thereby reducing clinic congestion and improving patient convenience. Despite considerable scale-up, implementation has been inconsistent among provinces. While regional syntheses of differentiated service delivery models exist, no synthesis has yet consolidated the barriers and facilitators specific to the CCMDD across the full decade of its implementation. To understand the barriers and facilitators, a scoping review was conducted for studies published in English between 2014 and 2024. The search was filtered primarily for duplicates, then title and abstract screening, of which 31 articles met the inclusion and exclusion criteria. Data were analysed using inductive thematic analysis; resulting themes were subsequently mapped to the Consolidated Framework for Implementation Research (CFIR) to contextualise findings within implementation science. A grey literature search was also conducted through Google Scholar and Sabinet. Key facilitators of implementation included decentralised service delivery and community-based distribution, reduced patient waiting times, enhanced treatment adherence, reduced patient-borne transport and time costs and improved access to medicines. Limited access to pick-up points in remote areas, miscommunication regarding pick-up dates and poor staff service were cited as barriers. The findings revealed a gap between planned activities and implementation and have significant implications for policy and practice. It further highlighted the need for ongoing optimisation strategies to enhance the programme.