Skip to main content
Top
Published in: BMC Health Services Research 1/2020

Open Access 01-12-2020 | Research article

The potential role of patent and proprietary medicine vendors’ associations in improving the quality of services in Nigeria’s drug shops

Authors: Abisoye S. Oyeyemi, Oladimeji Oladepo, Adedayo O. Adeyemi, Musibau A. Titiloye, Sarah M. Burnett, Iorwakwagh Apera

Published in: BMC Health Services Research | Issue 1/2020

Login to get access

Abstract

Background

Patent and Proprietary Medicine Vendors (PPMVs) play a major role in Nigeria’s health care delivery but regulation and monitoring of their practice needs appreciable improvement to ensure they deliver quality services. Most PPMVs belong to associations which may be useful in improving their regulation. However, little is known about how the PPMV associations function and how they can partner with relevant regulatory agencies to ensure members’ compliance and observance of good practice. This study sought to describe the PPMV associations’ structure and operations and the regulatory environment in which PPMVs function. With this information we explore ways in which the associations could help improve the coverage of Nigeria’s population with basic quality health care services.

Methods

A mixed methods study was conducted across four rural local government areas (LGAs) (districts) in two Nigerian states of Bayelsa and Oyo. The study comprises a quantitative data collection of 160 randomly selected PPMVs and their shops, eight PPMV focus group discussions, in-depth interviews with 26 PPMV association executives and eight regulatory agency representatives overseeing PPMVs’ practice.

Results

The majority of the PPMVs in the four LGAs belonged to the local chapters of National Association of Patent and Proprietary Medicine Dealers (NAPPMED). The associations were led by executive members and had regular monthly meetings. NAPPMED monitored members’ activities, provided professional and social support, and offered protection from regulatory agencies. More than 80% of PPMVs received at least one monitoring visit in the previous 6 months and local NAPPMED was the organization that monitored PPMVs the most, having visited 68.8% of respondents. The three major regulators, who reached 30.0–36.3% of PPMVs reported lack of human and financial resources as the main challenge they faced in regulation.

Conclusions

Quality services at drug shops would benefit from stronger monitoring and regulation. The PPMV associations already play a role in monitoring their members. Regulatory agencies and other organizations could partner with the PPMV associations to strengthen the regulatory environment and expand access to basic quality health services at PPMV shops in Nigeria.
Appendix
Available only for authorised users
Literature
1.
go back to reference World Health Organization. The world health report: health systems financing: the path to universal coverage. 2010. World Health Organization. The world health report: health systems financing: the path to universal coverage. 2010.
2.
go back to reference World Health Organization. Health in 2015: from MDGs, Millennium Development Goals to SDGs, Sustainable Development Goals. 2015. World Health Organization. Health in 2015: from MDGs, Millennium Development Goals to SDGs, Sustainable Development Goals. 2015.
3.
go back to reference National Population Commission (NPC) [Nigeria] and ICF. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland: NPC and ICF.; 2019. National Population Commission (NPC) [Nigeria] and ICF. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland: NPC and ICF.; 2019.
4.
go back to reference Brieger WR, Osamor PE, Salami KK, Oladepo O, Otusanya SA. Interactions between patent medicine vendors and customers in urban and rural Nigeria. Health Policy Plan. 2004 May;19(3):177–82.PubMedCrossRef Brieger WR, Osamor PE, Salami KK, Oladepo O, Otusanya SA. Interactions between patent medicine vendors and customers in urban and rural Nigeria. Health Policy Plan. 2004 May;19(3):177–82.PubMedCrossRef
5.
go back to reference Bames J, Chandani T, Feeley R. Nigeria Private Sector Health Assessment-Private sector partnership one project; 2008. Bames J, Chandani T, Feeley R. Nigeria Private Sector Health Assessment-Private sector partnership one project; 2008.
6.
go back to reference Liu J, Prach LM, Treleaven E, Hansen M, Anyanti J, Jagha T, et al. The role of drug vendors in improving basic health-care services in Nigeria. Bull World Health Organ. 2016;94(4):267–75. Liu J, Prach LM, Treleaven E, Hansen M, Anyanti J, Jagha T, et al. The role of drug vendors in improving basic health-care services in Nigeria. Bull World Health Organ. 2016;94(4):267–75.
7.
go back to reference Okeke TA, Uzochukwu BSC, Okafor HU. An in-depth study of patent medicine sellers’ perspectives on malaria in a rural Nigerian community. Malar J. 2006;5:1–7.CrossRef Okeke TA, Uzochukwu BSC, Okafor HU. An in-depth study of patent medicine sellers’ perspectives on malaria in a rural Nigerian community. Malar J. 2006;5:1–7.CrossRef
8.
go back to reference Prach LM, Treleaven E, Isiguzo C, Liu J. Care-seeking at patent and proprietary medicine vendors in Nigeria Health systems and services in low and middle income settings. BMC Health Serv Res. 2015;15:231. Prach LM, Treleaven E, Isiguzo C, Liu J. Care-seeking at patent and proprietary medicine vendors in Nigeria Health systems and services in low and middle income settings. BMC Health Serv Res. 2015;15:231.
9.
go back to reference Oye-Adeniran BA, Adewole IF, Umoh AV, Oladokun A, Gbadegesin A, Odeyemi KA, et al. Sources of contraceptive commodities for users in Nigeria. PLoS Med. 2005;2(11):1145–51.CrossRef Oye-Adeniran BA, Adewole IF, Umoh AV, Oladokun A, Gbadegesin A, Odeyemi KA, et al. Sources of contraceptive commodities for users in Nigeria. PLoS Med. 2005;2(11):1145–51.CrossRef
10.
go back to reference Coroon M, Kebede E, Spektor G, Speizer I. Key Role of Drug Shops and Pharmacies for Family; 2016. p. 1–16. Coroon M, Kebede E, Spektor G, Speizer I. Key Role of Drug Shops and Pharmacies for Family; 2016. p. 1–16.
11.
go back to reference Aguwa EN, Aniebue PN, Obi IE. Management of childhood diarrhea by patent medicine vendors in Enugu north local government area, south- East Nigeria. Int J Med Med Sci. 2010;2(3):88–93. Aguwa EN, Aniebue PN, Obi IE. Management of childhood diarrhea by patent medicine vendors in Enugu north local government area, south- East Nigeria. Int J Med Med Sci. 2010;2(3):88–93.
12.
go back to reference Okonkwo AD, Okonkwo UP. Patent medicine vendors, community pharmacists and STI management in Abuja, Nigeria. Afr Health Sci. 2010;10(3):253–65.PubMedPubMedCentral Okonkwo AD, Okonkwo UP. Patent medicine vendors, community pharmacists and STI management in Abuja, Nigeria. Afr Health Sci. 2010;10(3):253–65.PubMedPubMedCentral
13.
go back to reference Onwujekwe O, Hanson K, Uzochukwu B. Do poor people use poor quality providers? Evidence from the treatment of presumptive malaria in Nigeria. Trop Med Int Heal. 2011;16(9):1087–98.CrossRef Onwujekwe O, Hanson K, Uzochukwu B. Do poor people use poor quality providers? Evidence from the treatment of presumptive malaria in Nigeria. Trop Med Int Heal. 2011;16(9):1087–98.CrossRef
14.
go back to reference Onwujekwe O, Onoka C, Uzochukwu B, Hanson K. Constraints to universal coverage: inequities in health service use and expenditures for different health conditions and providers. Int J Equity Health. 2011;10:1–9.CrossRef Onwujekwe O, Onoka C, Uzochukwu B, Hanson K. Constraints to universal coverage: inequities in health service use and expenditures for different health conditions and providers. Int J Equity Health. 2011;10:1–9.CrossRef
15.
go back to reference Basu S, Andrews J, Kishore S, Panjabi R, Stuckler D. Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review. PLoS Med. 2012;9(6):e1001244. Basu S, Andrews J, Kishore S, Panjabi R, Stuckler D. Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review. PLoS Med. 2012;9(6):e1001244.
16.
go back to reference Morgan R, Ensor T, Waters H. UHC : markets , profi t , and the public good 2 Performance of private sector health care : implications for universal health coverage. Lancet. 2016;388(10044):606–12.PubMedCrossRef Morgan R, Ensor T, Waters H. UHC : markets , profi t , and the public good 2 Performance of private sector health care : implications for universal health coverage. Lancet. 2016;388(10044):606–12.PubMedCrossRef
17.
go back to reference Unicef WHO. Integrated Community Case Management, An equity-focused strategy to improve access to essential treatment services for children. World Heal Organ Jt Statement. 2012;(iCCM). Unicef WHO. Integrated Community Case Management, An equity-focused strategy to improve access to essential treatment services for children. World Heal Organ Jt Statement. 2012;(iCCM).
18.
go back to reference Barnes, Jeff; Chandani, Taara;Feeley R. Nigeria Private Sector Health Assessment. Bethesda, MD; 2008. Barnes, Jeff; Chandani, Taara;Feeley R. Nigeria Private Sector Health Assessment. Bethesda, MD; 2008.
20.
go back to reference Oyeyemi AS, Ogunnowo BE, Odukoya OO. Patent Medicine Vendors in Rural Areas of Lagos Nigeria : Compliance with Regulatory Guidelines and Implications for Malaria Control 2014;13(January):163–169. Oyeyemi AS, Ogunnowo BE, Odukoya OO. Patent Medicine Vendors in Rural Areas of Lagos Nigeria : Compliance with Regulatory Guidelines and Implications for Malaria Control 2014;13(January):163–169.
21.
go back to reference Beyeler N, Liu J, Sieverding M. A systematic review of the role of proprietary and patent medicine vendors in healthcare provision in Nigeria. PLoS One. 2015;10(1):1–21.CrossRef Beyeler N, Liu J, Sieverding M. A systematic review of the role of proprietary and patent medicine vendors in healthcare provision in Nigeria. PLoS One. 2015;10(1):1–21.CrossRef
22.
go back to reference Berendes S, Adeyemi O, Oladele EA, Oresanya OB. Are Patent Medicine Vendors Effective Agents in Malaria Control ? Using Lot Quality Assurance Sampling to Assess Quality of Practice in Jigawa , Nigeria. PLoS One. 2012;7(9):e44775. Berendes S, Adeyemi O, Oladele EA, Oresanya OB. Are Patent Medicine Vendors Effective Agents in Malaria Control ? Using Lot Quality Assurance Sampling to Assess Quality of Practice in Jigawa , Nigeria. PLoS One. 2012;7(9):e44775.
23.
go back to reference Akuse RM, Eseigbe EE, Ahmed A, Brieger WR. Patent medicine sellers: how can they help control childhood malaria? Malar Res Treat. 2010;2010:1–7.CrossRef Akuse RM, Eseigbe EE, Ahmed A, Brieger WR. Patent medicine sellers: how can they help control childhood malaria? Malar Res Treat. 2010;2010:1–7.CrossRef
24.
go back to reference Treleaven E, Liu J, Prach LM, Isiguzo C. Management of paediatric illnesses by patent and proprietary medicine vendors in Nigeria. Malar J. 2015;14(1):1–9.CrossRef Treleaven E, Liu J, Prach LM, Isiguzo C. Management of paediatric illnesses by patent and proprietary medicine vendors in Nigeria. Malar J. 2015;14(1):1–9.CrossRef
25.
go back to reference Prach LM, Treleaven E, Isiguzo C, Liu J. Care-seeking at patent and proprietary medicine vendors in Nigeria health systems and services in low and middle income settings. BMC Health Serv Res. 2015;15(1):1–12.CrossRef Prach LM, Treleaven E, Isiguzo C, Liu J. Care-seeking at patent and proprietary medicine vendors in Nigeria health systems and services in low and middle income settings. BMC Health Serv Res. 2015;15(1):1–12.CrossRef
26.
go back to reference Oladepo O, Oyeyemi AS, Titiloye MA, Adeyemi AO, Burnett SM, Apera I, et al. Malaria testing and treatment knowledge among selected rural patent and proprietary medicine vendors (PPMV) in Nigeria. Malar J. 2019;18(1):1–8.CrossRef Oladepo O, Oyeyemi AS, Titiloye MA, Adeyemi AO, Burnett SM, Apera I, et al. Malaria testing and treatment knowledge among selected rural patent and proprietary medicine vendors (PPMV) in Nigeria. Malar J. 2019;18(1):1–8.CrossRef
27.
go back to reference Adeboye, BW; Bloom, G; Peters, DH; Brieger, WR; Lawal, A; Ogunbemi, O; Oladepo, M; Oladepo, O; Oshiname, F; Ofi, B; Salami K. Malaria treatment and policy in three regions in Nigeria: The role of patent medicine vendors. 2007;(September):1–10. Adeboye, BW; Bloom, G; Peters, DH; Brieger, WR; Lawal, A; Ogunbemi, O; Oladepo, M; Oladepo, O; Oshiname, F; Ofi, B; Salami K. Malaria treatment and policy in three regions in Nigeria: The role of patent medicine vendors. 2007;(September):1–10.
28.
go back to reference Sieverding M, Liu J, Beyeler N. Social support in the practices of informal providers: the case of patent and proprietary medicine vendors in Nigeria. Soc Sci Med. 2015;143:17–25.PubMedCrossRef Sieverding M, Liu J, Beyeler N. Social support in the practices of informal providers: the case of patent and proprietary medicine vendors in Nigeria. Soc Sci Med. 2015;143:17–25.PubMedCrossRef
29.
go back to reference Montagu D, Goodman C. Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector? Lancet. 2016;388(10044):613–21.PubMedCrossRef Montagu D, Goodman C. Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector? Lancet. 2016;388(10044):613–21.PubMedCrossRef
30.
go back to reference Shah NM, Brieger WR, Peters DH. Can interventions improve health services from informal private providers in low and middle-income countries? A comprehensive review of the literature. Health Policy Plan. 2011;26(4):275–87.PubMedCrossRef Shah NM, Brieger WR, Peters DH. Can interventions improve health services from informal private providers in low and middle-income countries? A comprehensive review of the literature. Health Policy Plan. 2011;26(4):275–87.PubMedCrossRef
33.
go back to reference Federal Ministry of Health. National guideline for the implementation of integrated community case management of childhood illness in Nigeria. 2013. Federal Ministry of Health. National guideline for the implementation of integrated community case management of childhood illness in Nigeria. 2013.
34.
go back to reference Pacqué M, Gilroy, Kate. Findings from the Enhancing Quality iCCM through Proprietary and Patent Medical Vendors (PPMV) and Partnerships (EQuiPP) Approach. [cited 2020 Feb 25]. Available from: https://www.childhealthtaskforce.org/sites/default/files/2019-08/MCSP EQuiPP %28PSE Subgroup Meeting%29_07.30.2019.pdf. Pacqué M, Gilroy, Kate. Findings from the Enhancing Quality iCCM through Proprietary and Patent Medical Vendors (PPMV) and Partnerships (EQuiPP) Approach. [cited 2020 Feb 25]. Available from: https://​www.​childhealthtaskf​orce.​org/​sites/​default/​files/​2019-08/​MCSP EQuiPP %28PSE Subgroup Meeting%29_07.30.2019.pdf.
35.
go back to reference Uzochukwu BSC, Onwujekwe OE, Okwuosa C, Ibe OP. Patent Medicine Dealers and Irrational Use of Medicines in Children : The Economic Cost and Implications for Reducing Childhood Mortality in Southeast Nigeria 2014;9(3):1–5. Uzochukwu BSC, Onwujekwe OE, Okwuosa C, Ibe OP. Patent Medicine Dealers and Irrational Use of Medicines in Children : The Economic Cost and Implications for Reducing Childhood Mortality in Southeast Nigeria 2014;9(3):1–5.
36.
go back to reference Victor L, Onuoha OC, Dale M, Akin-Kolapo NB, Bell M. Greater impact at a lower cost: prioritizing support to patent and proprietary medicine vendors for increased quality fever case management in Ebonyi state, Nigeria. Am J Trop Med Hyg. 2015;93(4 Supplement):296. Victor L, Onuoha OC, Dale M, Akin-Kolapo NB, Bell M. Greater impact at a lower cost: prioritizing support to patent and proprietary medicine vendors for increased quality fever case management in Ebonyi state, Nigeria. Am J Trop Med Hyg. 2015;93(4 Supplement):296.
37.
go back to reference Oleribe OO, Udofia D, Oladipo O, Ishola TA, Taylor-Robinson SD. Healthcare workers ’ industrial action in Nigeria : a cross-sectional survey of Nigerian physicians; 2018. p. 1–10. Oleribe OO, Udofia D, Oladipo O, Ishola TA, Taylor-Robinson SD. Healthcare workers ’ industrial action in Nigeria : a cross-sectional survey of Nigerian physicians; 2018. p. 1–10.
38.
go back to reference Adeloye D, David RA, Olaogun AA, Auta A, Adesokan A, Gadanya M, et al. Health workforce and governance : the crisis in Nigeria; 2017. p. 1–8. Adeloye D, David RA, Olaogun AA, Auta A, Adesokan A, Gadanya M, et al. Health workforce and governance : the crisis in Nigeria; 2017. p. 1–8.
39.
go back to reference National Malaria Elimination Programme. National malaria policy. Abuja: Federal Ministry of Health; 2015. National Malaria Elimination Programme. National malaria policy. Abuja: Federal Ministry of Health; 2015.
40.
go back to reference De Jonge V, Sint Nicolaas J, Van Leerdam ME, Kuipers EJ. Overview of the quality assurance movement in health care. Best Pract Res Clin Gastroenterol. 2011;25(3):337–47.PubMedCrossRef De Jonge V, Sint Nicolaas J, Van Leerdam ME, Kuipers EJ. Overview of the quality assurance movement in health care. Best Pract Res Clin Gastroenterol. 2011;25(3):337–47.PubMedCrossRef
Metadata
Title
The potential role of patent and proprietary medicine vendors’ associations in improving the quality of services in Nigeria’s drug shops
Authors
Abisoye S. Oyeyemi
Oladimeji Oladepo
Adedayo O. Adeyemi
Musibau A. Titiloye
Sarah M. Burnett
Iorwakwagh Apera
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2020
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-020-05379-z

Other articles of this Issue 1/2020

BMC Health Services Research 1/2020 Go to the issue