Private sector availability and affordability of under 5 malaria health commodities in selected states in Nigeria and the Federal Capital Territory

ABSTRACT

Background

To guarantee uninterrupted service delivery, quality-assured products must be affordable and continuously available across all sectors, including the private sector, which provides more than 60% of healthcare services in Nigeria. We investigated the private sector availability and affordability of under 5 malaria commodities to establish the level of access in this sector.

Methods

We surveyed patent medicine and pharmacy stores across seven states in Nigeria and the Federal Capital Territory to establish the availability and affordability of selected malaria commodities for children under 5 years. Availability was measured as the percentage of visited outlets with the product of interest on the day of visit, while affordability was assessed by establishing if it cost more than a day’s wage for the least-paid government worker to purchase a full course of malaria diagnostic test and/or medication.

Results

Artemisinin-based antimalarials for uncomplicated and severe malaria were the most available commodities. SPAQ1 and SPAQ2 used for seasonal malaria chemoprevention campaign were surprisingly also available in some outlets. However, only about half (48.3% and 53.3%) of the surveyed outlets had stock of artemether/lumefantrine (AL1) and artesunate injection, respectively. The median price of surveyed products ranged from USD (United States Dollars) 0.38 to USD 2.17 per treatment/test. Except for amodiaquine tablet and artemether injection, which cost less, all other originator brands cost the same or more than the lowest-priced generic. Antimalarial products were affordable as their median prices were not more than a day’s wage for the least-paid government worker. However, when the cost of testing and treatment with artemisinin-based combination therapies (ACTs) was assessed, testing and treatment with dihydroartemisinin/piperaquine were unaffordable as the they cost more than 1.5 times the daily wage of the least-paid government worker.

Conclusion

The overall private sector availability of under-five malaria commodities in surveyed locations was suboptimal. Also, testing and treatment with recommended ACTs were not affordable for all surveyed products. These findings suggest the need for interventions to improve access to affordable under-five malaria commodities.

KEYWORDS:

• Access to medicines
• availability
• affordability
• antimalarial commodities
• pharmaceutical policy

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Malaria Consortium.

Notes on contributors

Kunle Rotimi

Kunle Rotimi is a public health specialist and pharmacist currently working as country health systems supply chain manager with malaria consortium. He is passionate about access to medicines and global health. Kunle holds a Bachelor of Pharmacy degree from Ahmadu Bello University, Master of Science Degree in Pharmacology from University of Lagos, Nigeria, Master of Science Degree in Public Health from University of South Wales, UK, an MBA degree from the University of East London, UK and a fellowship in Public Health Pharmacy from West African Postgraduate College of Pharmacists. His experiences and research interests include, Pharmacovigilance and medicines safety, implementation science, pharmaceutical and health policy evaluation, procurement and supply chain management of health commodities and global health.

Babatunde Fagbemi

Babatunde Fagbemi is a pharmacist and a public health supply chain professional with over 12 years of experience working with in the health sector in Nigeria. He holds a Master’s Degree in Business Administration, Bachelor of Pharmacy degree, Diploma in Project Management and a Diploma in Procurement and Supply Management. His experience cuts across Clinical Pharmacy practice, Pharmacovigilance, Medicine Quality Control and Quality assurance, Public Health Pharmacy Practice, Health Product procurement and Supply Chain management across HIV/AIDs, TB, Family planning, Malaria and Maternal, Newborn, and Child Health (MNCH) program implementation.

Ademola Joshua Itiola

Ademola Joshua Itiola is currently enrolled in the PhD programme in Health Services and Policy Research at the School of Public Health, University of Alberta, Canada. He holds a Bachelor of Pharmacy Degree (with distinctions) from the University of Ibadan, Nigeria, coupled with a Master of Science Degree in Population and Public Health from The University of British Columbia, Canada, a Master of Public Health Degree from the University of the Western Cape, South Africa, and a fellowship in Public Health Pharmacy from West African Postgraduate College of Pharmacists. His research interests include the application of patient-reported outcome measures in improving quality of care, pharmaceutical and health policy evaluation, supply chain management and global health.

Taiwo Ibinaiye

Taiwo Ibinaiye has a BSc and Master degrees in Demography and Social Statistics from Obafemi Awolowo University Ile-Ife, Nigeria. Taiwo has experience in Data Management and impact analysis, using suitable statistical modeling techniques to generate evidence of the programme effectiveness of various initiatives. His diverse skill set in data management includes a high level of analytical thinking, which allows him to interpret data in ways that drive actionable insights and improvements. With a career spanning a decade, Taiwo has consistently demonstrated his commitment to driving positive change through his work with Malaria Consortium and African Field Epidemiology Network. He currently works with United Nation Population Fund (UNFPA) as Data for Development Analyst.

Adaeze Aidenagbon

Adaeze Aidenagbon currently serves as the Project Director for the Global Fund Malaria Project at Malaria Consortium in Nigeria. She has over a decade of experience in the management of large-scale malaria interventions and has expertise in project management, mass campaigns, advocacy and communications.

Chrysantus Dabes

Chrysantus Dabes is a pharmacist with over 10 years of experience in procurement and supply chain management of health commodities. Chrysantus is one of the names to reckon with when it comes to supply chain management. With a passion in ensuring effective and efficient distribution of essential commodities from where they are produced to where they are needed, he enrolled in Kaduna state University to study procurement and Supply chain management and eventually graduated with a master’s degree. Before then, he had undertaken some certificate courses in advocacy and policy in public health, leadership, and management in health amongst others. He is currently a senior supply chain officer with malaria consortium in Abuja and has strong interest in research with a view to proffering solutions to public health challenges. His ultimate goal is to see that the less privileged have access to essential commodities whenever and wherever they need them.

Ahmed Aminu Biambo

Ahmed Aminu Biambo is a pharmacist with over a decade of working experience in different areas of practice, in the Nigerian health sector. He is a public health and operational research specialist. He is also a Supply Chain specialist with experience in managing malaria, HIV, vaccines and reproductive health commodities. Currently, he is one of the Supply Chain Officers of Malaria Consortium in Nigeria.

Azuka Iwegbu

Azuka Iwegbu is a Nigerian with 15 years of experience in the public health space. Azuka Iwegbu has a Bachelor and Master degree in Statistics, Masters of science in Health Science. He is currently working with Malaria Consortium office as the M&E manager.

Sarah Onabajo

Sarah Onabajo is a senior regulatory officer with the National Agency for Food and Drug Administration and Control (NAFDAC), Lagos State, Nigeria. She received a Bachelor of Pharmacy degree (with distinction in clinical and administrative pharmacy) from the University of Ibadan, Nigeria. She is passionate about public health with special interest in health promotion and health policy.

Chibuzo Oguoma

Dr Chibuzo Oguoma is a Public Health Physician with over 20 years experience in implementing and managing public health programmes in Nigeria. He currently works as Project Director for Malaria Consortium in Nigeria.

Olusola Oresanya

Dr. Olusola Oresanya is a public health specialist with a strong base in epidemiology and over 20 years’ experience as a medical doctor. As the organisation’s Country Technical Coordinator in Nigeria, she provides technical oversight for projects and programmes and support with large-scale surveys, implementation research and other monitoring and impact evaluation surveys.