Abstract
BackgroundThe emergency response phase to HIV epidemic in Nigeria and other countries saw to the deployment of donors’ resources with little consideration for country ownership (CO) and sustainability. The progress that has been made in the fight against the pandemic has however precipitated a paradigm shift towards CO and sustainability. With the decline in donors’ funding, countries must continually evaluate their readiness to own and sustain their HIV response especially the supply chain system (SCS) and bridge any observed gaps. This study assessed the current understanding of CO and sustainability of Nigeria’s HIV/AIDS SCS, established progress that has been made, identified challenges that may be hampering CO and possible recommendations to address these challenges. It also explored opportunities that the country can leverage on.MethodsWe conducted a cross sectional descriptive study through semi-structured interview of twelve purposefully selected key informants involved in HIV/AIDS supply chain management. Transcribed qualitative data were analyzed using a thematic approach.ResultsAmong other submissions, respondents acknowledged that CO involves non-government stakeholders. Key CO and sustainability achievements were: development of national strategic plans and policy documents, establishment of coordinating structures, allocation of funds for some logistics activities at the state level and payment of salaries of government staff, institution of pre-service training, use of logistics data for decision making and the unification of the hitherto parallel HIV/AIDS supply chains. Challenges included: inadequate domestic funding, bureaucratic bottlenecks and inadequate manpower at the health facility level. Respondents recommended more political commitment and increased government funding, exploration of alternative sources of funding, improved accountability, effective healthcare workforce planning and local manufacture of HIV commodities. Existing structures and programmes that the country can leverage on included: Nigeria Supply Chain Integration Project, National Health Insurance Scheme and the private sector.ConclusionsNigeria has made some progress towards achieving CO and sustainability. The country however needs to address financial and human resource gaps through innovative resource mobilization and effective workforce planning. As other countries plan for CO and sustainability, it is important to secure political buy-in and adopt a working definition for CO and sustainability while resource mobilization and workforce planning should be prioritized.
Highlights
The emergency response phase to Human immunodeficiency virus (HIV) epidemic in Nigeria and other countries saw to the deployment of donors’ resources with little consideration for country ownership (CO) and sustainability
It is important to explore the current understanding of CO and sustainability, document the most updated progress that has been made in Nigeria, identify challenges that may be hampering CO as well as potential recommendations and opportunities that the country can leverage on. This study examined these issues as it relates to HIV/Acquired immunodeficiency syndrome (AIDS) Supply Chain System
Twelve purposefully selected key informants (KIs) involved in supply chain management (SCM) of HIV/AIDS products were interviewed using an interview guide that comprised of 7 broad questions
Summary
The emergency response phase to HIV epidemic in Nigeria and other countries saw to the deployment of donors’ resources with little consideration for country ownership (CO) and sustainability. Seventy percent of the 37 million people that were globally infected as of 2015 were from Sub-Saharan Africa [1] with Nigeria ranking as the country with the second highest number of infected people and the highest number of infected children [2,3,4,5] These alarming statistics make HIV/AIDS a disease of public health importance. In order to curb the scourge of this epidemic, a lot of research and investment had gone into fighting the pandemic [6] These efforts have yielded positive results as the number of AIDS-related deaths and new infections has consistently reduced over the last decade [7]. The numbers of new HIV infections and AIDS-related deaths have decreased by 21% and 6% respectively since 2010 treatment gap still stands at 70% [12]
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