Universal health coverage in Nigeria: strategies for engagement of patent medicine vendors in rural communities

Abstract

Background: Universal health coverage has been touted as a key policy objective of most health systems the world over. However, to what extent it has been achieved across continents and countries varies widely, with sub-Saharan Africa faring the least while bearing the highest burden of disease. In these settings, much of the inhabitants are rural and access needed health care from untrained, often poorly regulated commercial drug shops, with concerns over products and service quality frequently expressed. The study undertook to critically explore and understand retail drug market interactions in a rural context with a focus on identifying scope for potential regulatory interventions that aim to improve retail drug market performance.
Methods: The study was underpinned on the neoclassical framework of Structure-Conduct-Performance Paradigm, and data was collected from a sample of patent medicine vendor outlets in Katsina-Ala Local Government Area of Benue State, north central Nigeria, between March and October of 2014. Data was triangulated using semi-structured questionnaires, indepth semi-structured interviews, structured observations, Key regulatory interviews and review of secondary documentary evidence.
Results: The study established patent medicine vendor outlets to be important sources of essential medicines for inhabitants of the local government area for ambulatory primary health care. Although drug shop retailers were acknowledged as offering reliable sources for a broad range of drugs at relatively more affordable prices, a number of market failures exist.
Conclusions: The study recommends a review of current stand-alone policies guiding the practice of patent medicine retailing in Nigeria to better align it with contextual realities.

Key words: Universal Health Coverage, patent medicine vendor, consumer, regulation, rural areas, Nigeria