Background: Achieving universal health coverage in poorly-resourced settings like Nigeria demands optimal mobilization of all healthcare resources including community pharmacists. Such efforts are hampered by insufficient data on primary healthcare (PHC) contributions by community pharmacists. The study aimed to identify PHC services offered by community pharmacists; assess impact of technologies on PHC service quality; and evaluate factors influencing management of PHC services in Nigeria. Methods: A descriptive cross-sectional survey of 321 community pharmacies and 642 clients was undertaken between April and August, 2019. Semi-structured pre-tested questionnaires were administered on randomly-selected community pharmacists and clients. Interviews were conducted with key informants. Data were summarized using frequency and percentages while weighted averages on 5-point ordinal scales and chi-square tests were used to identify weights and associations between variables respectively at P<.050. Results: Response rates of pharmacists and clients were 74.7% (N=321) and 100% (N=642); while their median ages were 39.41 and 51.20 years respectively. Community pharmacists offered services in all eight domains of PHC, especially supply of medicines for treating of endemic diseases (mean weighted average [MWA]=4.59), and disease prevention (4.54) but least of vaccine administration (2.39). Blood glucose screening devices were the most adopted technology with significant impact on service quality (χ2 6.86, P=.030). Major challenges to management of PHC services were poor awareness of pharmacists’ roles (4.31) and lack of integration with the PHC infrastructure (4.31). Capacity constraints in finances (4.11), technologies (4.09), and human resources (3.99) were significant. However, major facilitators were pharmacists’ managerial skills (4.35), and strong client relationships (4.27). Conclusion: In Nigeria, community pharmacists offered important PHC services. Deploying technologies were associated with improved service quality. If community pharmacists are integrated in the national PHC architecture and financial incentives are provided, their competences and goodwill would enhance the achievement of universal health coverage.
Background: There is a growing need to understand the determinants of service quality in community pharmacy from the viewpoint of customers. Objectives: The study explored customer perspectives of pharmacy services using quality indicators and proposed a path for quality improvement. Methods: A questionnaire-based cross-sectional survey was conducted on 704 conveniently selected customers of community pharmacies between August and October, 2019. The exit survey examined customer expectations compared to actual services received. Questionnaire items were drawn from service quality domains of reliability, assurance, tangibles, equity, and responsiveness. Descriptive statistics was used to summarize demographic characteristics of respondents. To explore gaps between expected and perceived service quality, each domain was subjected to a pairwise t-test. Results: Customers’ response rate was 91.2% (n = 642) while their mean age was 52.1±3.55 years. Majority 60% (n = 259) were females, 62.5% (n = 401) had spent five years or less as customers of individual pharmacies. There was significant gap between expected and perceived service quality (t =13.55, p = 0.047). Domains of responsiveness (t = 162.67, p = 0.004) and reliability (t = 27.96, p = 0.023) contributed significantly to this gap with responsiveness being disproportionately impactful. Conclusion: There was significant gap between customer expectations of responsiveness and reliability of pharmacy teams and service fulfilment. This demands improved willingness to prioritize customer needs, serving them promptly, accurately, and as promised.
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Background: Malaria infection remains one of the leading causes of death in sub-Saharan Africa. Over the years, several measures have been implemented for the prevention of malaria, including vector control with insecticide-treated nets, indoor residual spraying, and seasonal or traveling prophylactics. In 2021, the World Health Organization (WHO) approved the use of the malaria vaccine in children. We conducted a cross-sectional survey study in three sub-Saharan African countries—Uganda, Ghana, and Nigeria—to assess public awareness of the malaria vaccine among the residents of these countries. Method: A cross-sectional, web-based survey was conducted between time January 2022 and April 2022 using Qualtrics® software (Version number: April 2022; Qualtrics, Provo, UT, USA). A total of 3896 responses were analyzed using SAS OnDemand for Academics software. Linear regression model was used to assess the relationship between the demographic characteristics and awareness of the malaria vaccine, using a level of significance (alpha) of 0.05. Result: Overall, there was significant association between the level of education and public awareness of the malaria vaccine in each of the countries studied. Gender and place of residence were associated with awareness in Nigeria and Uganda, while younger respondents were more likely to be aware of the malaria vaccine in Ghana. Conclusion: Given the negative impact of lack of awareness and knowledge, misinformation and conspiracy theories on immunization programs, public health campaigns preceding the population-wide roll-out of the novel malaria vaccine should target the less-educated, and those residing in more rural areas, while assuring equitable access to the malaria vaccine across sub-Saharan Africa.
Background Although generic medicines are used extensively in Nigeria information from community pharmacists about these drugs are scanty and therefore inadequate. This is why this study has been designed to bridge the knowledge gap, attitudes, as well as the perception and practice of community pharmacists about generic medicines in Nigeria. Method A questionnaire-guided cross-sectional survey was used to collect data from 380 community pharmacists who were randomly selected from community pharmacies between April and June 2019 in Southwestern Nigeria. Data generated in the course of this study was analysed with the Statistical Package for Social Sciences version 18. Descriptive statistics were used to summarize data. Chi-square was used to test proportions and to determine associations between categorical variables. Pearson’s Correlation Coefficient was used to determine correlation between dependent variables. Result Mean knowledge score of community pharmacists about generic medicines(GM) was 5.6 ± 2.9 out of a total maximum score of 10. Results showed that 47.9% of respondents had poor knowledge, 27.6% average knowledge and 24.5% good knowledge about GM. Knowledge was significantly associated (p = .000) with all demographic characteristics except professional qualifications. A majority (89%) of the respondents were of the view that patients need more explanations when GMs are dispensed to them. In addition, 90.3% of the respondents were of the opinion that GM will improve access to medicine because they are cheaper and easily affordable. About 93% practice generic substitution without consulting prescribing physicians. Furthermore, 85% of the respondents claim they stock mainly GMs. Conclusion Community pharmacists in Nigeria had a positive attitude, perception and practice about GM, but exhibited sub-optimal knowledge in understanding issues concerning generic medicines. It is concluded that there is the need for continuous training and education to enhance professional knowledge of pharmacists in the area of GM substitution.
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