Abstract
BackgroundIn Nigeria and elsewhere, informal drug sellers, or patent and proprietary medicine vendors (PPMVs), are a common source of care for children with malaria, diarrhoea, and pneumonia. However, their knowledge and stocking of recommended treatments for these common childhood illnesses are not well understood.MethodsA census of PPMV shops was conducted in Kogi and Kwara states. A shop survey was conducted on a subset of 250 shops. Multivariate regression analysis was used to assess associations between shop worker characteristics and (1) knowledge of optimal treatments for malaria, diarrhoea, and pneumonia, and (2) stocking of essential medicines to treat these illnesses.ResultsFrom the census, 89.9 % of shops stocked oral rehydration solution (ORS), while 61.1 % of shops stocked artemisinin-based combination therapies and 72.2 % of shops stocked amoxicillin. Stocking patterns varied by state, urban/rural location, and according to whether or not the shop was headed by someone with formal health training (e.g. having a professional health education degree). In multivariate analyses, selling drugs wholesale and participating in any training in the past year was associated with a higher likelihood of naming the correct treatment for malaria, and having formal health training was associated with stocking ORS. However, few other PPMV characteristics were predictive of correct knowledge of optimal treatments and stocking behaviour.ConclusionMany PPMVs lack the knowledge and tools to properly treat common childhood illnesses. PPMV knowledge and selling of essential medicines for these illnesses should be strengthened to improve child health in Nigeria.
Highlights
In Nigeria and elsewhere, informal drug sellers, or patent and proprietary medicine vendors (PPMVs), are a common source of care for children with malaria, diarrhoea, and pneumonia
Kogi and Kwara states were chosen to represent Nigeria’s central region, with mixed populations by religion, socio-economic status, ethnicity, and mix of urban, peri-urban, and rural areas, in comparison to southern Nigeria, where a majority of studies in Nigeria are concentrated [24]. This census listing produced a database of 2,083 shops (1,088 in Kogi, 995 in Kwara), and collected limited information on shop owner and worker characteristics, and the types, doses, and brands of medicines stocked for malaria, pneumonia, and diarrhoea
Stocking patterns from the PPMV shop census A total of 1,088 PPMV shops in Kogi and 995 in Kwara were identified during the census. 33.3 % of Kogi shops and 12.2 % of Kwara shops participated in the Affordable Medicines Facility-malaria (AMFm) programme
Summary
In Nigeria and elsewhere, informal drug sellers, or patent and proprietary medicine vendors (PPMVs), are a common source of care for children with malaria, diarrhoea, and pneumonia. Their knowledge and stocking of recommended treatments for these common childhood illnesses are not well understood. Diarrhoea, and malaria are the leading causes of child mortality in Nigeria, from which over one million children under five are estimated to die each year [1] These conditions contribute 16.4, 18.7, and 20.1 % of the total burden of disease, respectively [1]; ensuring prompt and proper diagnosis and treatment for these illnesses is essential for reducing childhood morbidity and mortality [2]. Providers eligible to deliver iCCM include for-profit drug retailers, or patent and proprietary
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