Various types of AEs were seen and documented during the CEM programme. The findings suggested that the AA/AL monitored during this programme was generally safe and remarkably well tolerated among the Nigerian populations.

BackgroundThe introduction of the Standard Treatment Guideline (STG) for use by clinicians in hospital is intended to promote rational, safe and cost effective use of medicines in the health care system. The Nigerian National Standard Treatment Guideline (NNSTG) was introduced in 2008 and the second edition has just been recently launched (July 2017). The process of development of the STG entailed the participation of expert clinicians in all the subspecialties building consensus and upholding the state of the art/ standard of care with endorsement from the Federal Ministry of Health (FMOH). This study evaluates the level of awareness, acceptance and use of this tool within the Nigerian Health Care System. MethodsThe study was carried out at the University of Benin Teaching Hospital , Benin City , Nigeria-a tertiary healthcare facility with over 800 beds. A semi-structured questionnaire was administered to doctors in the hospital over a seven months period -January -July 2017. Information sought included the bio-data,awareness of the STG, publication and use of the STG, the perceived advantages and disadvantages, and suggestions on how to improve its use.The findings are represented as the frequency (percentages) and Mean (SD). Result The response rate was 77.5%(155/200) with 104 males, aged 34.1 (SD 6.4) years. The level of awareness was 46.5% (72/155) with 21.9%(34/155) having received lessons on the subject; 53.0% (18/34) as students. Awareness of the date of the initial introduction of the STG at the National level was 4.5% (7/155) with 1.3% (2/155) aware of the current edition of the NSTG. The description of the STG was satisfactory in 27.7% (43/155) participants. Again only 20.6% (32/155) currently use the NSTG with 12.3% (19/155) rating the entire STG utilization as successful. ConclusionThese findings suggest a low awareness and poor utilization of the STG among doctors in the facility which may be a reflection of the national situation. There is need to encourage the use of this clinical tool so as to ensure rational use of medicines and delivery of health care in Resource Limited Settings.

Background: An important factor hindering the growth of pharmacovigilance (PV) in resource-limited settings is the lack of adequate funds to establish a functional National Pharmacovigilance System. Consequently, the crucial function of monitoring and ensuring the availability of safe medicines in these settings cannot be guaranteed considering the peculiarities of diseases and medicines used. Objectives: The objective of this paper is to provide an overview as to the availability of potential sources of funds, which could be explored to ensure Medicine Safety and to proffer a potential framework likely to ensure sustainable funding of PV in Africa. Methods/processes: The process of developing this framework entailed a review of PV financing in some developed economies, a landscape study of funding of PV in some African countries, an in-depth understanding of the PV system and the organisational structure and nexus between the regulatory agencies and National Pharmacovigilance Centre. Critical points for consideration included the sources of funds, revenue pool, the disbursement of funds, budgeting and expenditure profile and the legal framework. Consultative meetings, webinars and interviews with experts were carried out. Results: The findings showed that most of the PV systems were mainly integrated into the regulatory agencies regarding operational and fiscal governance with few facilities being independent of the regulatory agencies. The main source of funding was from the government with significant donor funding which is ad hoc and non-sustainable. Several potential sources were identified but yet to be exploited. There were no legal provisions for PV financing. A framework likely to ensure sustainable PV financing is suggested to capture all available sources of funding, mine the potential sources providing a sizeable pool of revenue to address its activities and enabling legal framework which will engender autonomy. Furthermore, it will address the nexus between the regulatory agencies and the PV outfits, thus enabling appropriate share of resources and blockage of diversions. Conclusion: In all, addressing the various elements identified in this study and providing the legal provisions which guarantees some degree of autonomy will provide a sustainable mechanism for PV funding in the resource-limited setting of Africa.

BackgroundThe Essential Medicines (EM) Concept crystallized into a drug supply programme four decades ago and can be regarded as one of the major contributions of the WHO to healthcare in the seven decades of its existence. The Action Programme on EM, the establishment of a funding mechanism ensured supply of medicines in resource limiited settings (RLS) as well as its rational, safe and cost effective use. This study is intended to assess the current status, understanding and level of penetration of the concept amongst health professionals in a tertiary healthcare facility after four decades of its introduction. MethodsThe study was carried out at the University of Benin Teaching Hospital Benin Nigeria -a tertiary healthcare facility with over 800 beds. A semi-structured questionnaire was administered to health professionals (doctors, nurses and phaemacists) in the hospital wards and pharmacy over a seven month period -January -July 2017. Information sought included the biodata, awareness of the EM Concept, publication and use of the EM List, the perceived advantages and disadvantages and suggestions on how to improve the programme. The findings are represented as the frequency (percentages) and Mean/SD. ResultsThe response rate of 92.7% (278/300) was obtained for questionnaires distributed. The participants (131 Male), aged 31.9 (SD 7.3) years included Doctors 155, Nurses 58, Pharmacists 22, Not Stated 43. EML awareness was 65.8% (183/278) with 139/278 (50.0%) having received lessons on the subject; 108/278 (38.8%) while as students. Awareness of the timing of the initial introduction of the EML at the National level was 3/278 (1.1%) with 0% aware of the current edition of the National EML. A satisfactory description of the EML was obtained from 76/278 (27.3%) participants. Again only 54/278 (19.4%) admitted to using the National EML, with 52/278 (18.7%) rating the entire EM program as successful Conclusions These findings may highlight the poor appreciation, penetration and utilization of the laudable EM Concept and Programme among health professionals four decades after its introduction. There is urgent need to rejuvenate this concept on which hinges the rational supply and safe use of medicines especially in RLS