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. 2024 May 21;12(Suppl 2):e2200225.
doi: 10.9745/GHSP-D-22-00225. Print 2024 May 21.

Improving Contraceptive Service Quality and Accessibility for Adolescents and Youth Through Proprietary Patent Medicine Vendors in Four Nigerian States

Dorcas Akila  1 , Oluwasegun Akinola  2 , Olukunle Omotoso  2 , Saori Ohkubo  3 , Adewale Adefila  2 , Philemon Yohanna  2 , Nwanne Ikodiya Kalu  2 , Adebusola Oyeyemi  2 , Olubunmi Ojelade  2 , Aisha Waziri  2 , Winifred Kwaknat  2 , Olusola Solanke  2 , Bernard Emonena  2 , Oluwafemi Rotimi  2 , Lisa Mwaikambo  3 , Victor Igharo  2 , Lekan Ajijola  2 , Krishna Bose  4
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Improving Contraceptive Service Quality and Accessibility for Adolescents and Youth Through Proprietary Patent Medicine Vendors in Four Nigerian States

Dorcas Akila et al. Glob Health Sci Pract. .

Abstract

Introduction: In Nigeria, health care services and commodities have increasingly been accessed through private sector entities, including retail pharmacies and drug shops (also called proprietary patent medicine vendors [PPMVs]). However, PPMVs cannot provide long-acting or permanent methods, and concerns have been raised about their quality of services and their need to better comply with government regulations. This article describes how The Challenge Initiative's (TCI) family planning program supported 4 state governments in Nigeria to develop a model to strengthen public-private partnerships between PPMVs and primary health centers (PHCs) to leverage PPMVs to provide adolescents and youth with high-quality contraceptive information, services, and referrals to PHCs.

Program description: The intervention implemented a hub-spoke model by strengthening the linkages between neighboring PPMVs and large PHCs for delivering contraceptive services to adolescents and youth. The steps in the implementation process included: (1) introducing the intervention to state governments, (2) selecting PPMVs as spokes and high-volume PHCs as hubs, (3) conducting whole-site orientations jointly with PPMV and PHC staff, (4) strengthening referral links between PPMVs and PHCs, (5) implementing supportive supervision and coaching, and (6) strengthening client data management. TCI worked with the state and local ministry of health to improve PPMV operators' knowledge, attitudes, and skills to deliver adolescent- and youth-friendly services.

Lessons learned and recommendations: Implementing the PPMV intervention with state governments and PHCs strengthened the public-private partnership. A functional referral system in Plateau State demonstrated significant success, enabling increased contraceptive choice and adherence to regulations for adolescents and youth. We recommend that the government strengthen the working relationship between PPMVs and PHCs, incorporate PPMVs into the routine supportive supervision of the state health system, and incorporate a referral linkage with PHCs into the design and implementation of PPMV programs.

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Figures

FIGURE 1
FIGURE 1
Map of Nigeria Showing Implementing States for the Adolescent and Youth Sexual and Reproductive Health Program
FIGURE 2
FIGURE 2
Front and Back of Go-Cards for Referral From Proprietary Patent Medicine Vendors to Primary Health Centers, Nigeria
FIGURE 3
FIGURE 3
Compliance Checklist Used During Supervision Visits to Proprietary Patent Medicine Vendors, Nigeria
FIGURE 4
FIGURE 4
Form to Collect Monthly Service Provision Data From Proprietary Patent Medicine Vendors, Nigeria
See this image and copyright information in PMC

References

    1. World Health Organization (WHO). Task Sharing to Improve Access To Family Planning/Contraception: Summary Brief. WHO; 2017. Accessed February 27, 2024. https://www.who.int/publications/i/item/WHO-RHR-17.20
    1. High-Impact Practices in Family Planning (HIP). Drug Shops and Pharmacies: Sources for Family Planning Commodities and Information. United States Agency for International Development; 2013. Accessed February 27, 2024. https://www.fphighimpactpractices.org/wp-content/uploads/2022/06/DrugSho...
    1. National Population Commission (NPC); ICF International. Nigeria Demographic and Health Survey 2013. NPC/ICF International; 2014. Accessed February 27, 2024. http://dhsprogram.com/pubs/pdf/FR293/FR293.pdf
    1. National Population Commission (NPC); ICF. Nigeria Demographic and Health Survey 2018. NPC/ICF; 2019. Accessed February 27, 2024. https://www.dhsprogram.com/pubs/pdf/FR359/FR359.pdf
    1. ACTWatch. Nigeria Outlet Survey Findings. Population Services International; 2013. Accessed February 27, 2024. https://marketbookshelf.com/wp-content/uploads/2017/05/Nigeria-2013-outl...

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