Are Patent Medicine Vendors Effective Agents in Malaria Control? Using Lot Quality Assurance Sampling to Assess Quality of Practice in Jigawa, Nigeria

Berendes, Sima; Adeyemi, Olusegun A.; Oladele, Edward Adekola; Oresanya, Olusola; Okoh, Festus; Valadez, Joseph J.

doi:10.1371/journal.pone.0044775

Cited by 29 publications

(37 citation statements)

References 31 publications

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“…In the future, RSS will randomly sample PHCCs and hospitals as a stratum and then randomly choose a PHCU in the catchment area for each selected PHCC, as was performed in Nigeria (Berendes et al . ). Another limitation was due to the low utilisation of many PHCUs, which rendered the clinical observation and exit interview modules difficult to carry out, as we had to exclude HFs if the misclassification error was ≤20% for both alpha and beta.…”

Section: Discussionmentioning

confidence: 97%

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Assessing the quality of care in a new nation: South Sudan's first national health facility assessment

Berendes

Lako

Whitson

et al. 2014

Tropical Med Int Health

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Abstractobjectives We adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments.methods Using a two-stage lot quality assurance sampling (LQAS) design, we conducted a national cross-sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations.results Quality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick-child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick-child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in-service training and supervision, for seven and ten states, respectively.conclusions Despite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state-by-state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states.

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Section: Discussionmentioning

confidence: 97%

“…Recently, we used LQAS for the rapid assessment of public and private HFs in Nigeria (Berendes et al . ; Oladele et al . ).…”

Section: Introductionmentioning

confidence: 99%

Assessing the quality of care in a new nation: South Sudan's first national health facility assessment

Berendes

Lako

Whitson

et al. 2014

Tropical Med Int Health

Self Cite

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“…The Ministry of Health (MOH) is responsible for providing operational supervision to the private sector to ensure compliance standards. However, enforcing these standards is difficult due to inadequate numbers of qualified personnel to carry out this task [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria: a cross-sectional study

Millar

McCutcheon

Coakley

et al. 2014

Malar J

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BackgroundDespite recent improvements in malaria prevention strategies, malaria case management remains a weakness in Northern Nigeria, which is underserved and suffers the country’s highest rates of under-five child mortality. Understanding malaria care-seeking patterns and comparing case management outcomes to World Health Organization (WHO) and Nigeria’s National Malaria Control Programme (NMCP) guidelines are necessary to identify where policy and programmatic strategies should focus to prevent malaria mortality and morbidity.MethodsA cross-sectional survey based on lot quality assurance sampling was used to collect data on malaria care-seeking for children under five with fever in the last two weeks throughout Sokoto and Bauchi States. The survey assessed if the child received NMCP/WHO recommended case management: prompt treatment, a diagnostic blood test, and artemisinin-based combination therapy (ACT). Deviations from this pathway and location of treatment were also assessed. Lastly, logistic regression was used to assess predictors of seeking treatment.ResultsOverall, 76.7% of children were brought to treatment—45.5% to a patent medicine vendor and 43.8% to a health facility. Of children brought to treatment, 61.5% sought treatment promptly, but only 9.8% received a diagnostic blood test and 7.2% received a prompt ACT. When assessing adherence to the complete case management pathway, only 1.0% of children received NMCP/WHO recommended treatment. When compared to other treatment locations, health facilities provided the greatest proportion of children with NMCP/WHO recommended treatment. Lastly, children 7–59 months old were at 1.74 (p = 0.003) greater odds of receiving treatment than children ≤6 months.ConclusionsNorthern Nigeria’s coverage rates of NMCP/WHO standard malaria case management for children under five with fever fall short of the NMCP goal of 80% coverage by 2010 and universal coverage thereafter. Given the ability to treat a child with malaria differs greatly between treatment locations, policy and logistics planning should address the shortages of essential malaria supplies in recommended and frequently accessed treatment locations. Particular emphasis should be placed on integrating the private sector into standardized care and educating caregivers on the necessity for testing before treatment and the availability of free ACT in public health facilities for uncomplicated malaria.

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“…They are authorized to sell over-the-counter drugs including common drugs such as pain killers, cough syrups, and antimalarials 10. Several studies have reported PPMVs as the most common source of malaria treatment in Nigeria 2,11–14. They are also reported to offer treatment of childhood diarrhea9 as well as hypertension 15.…”

Section: Introductionmentioning

confidence: 99%

An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria

Ujuju¹,

Adebayo²,

Anyanti³

et al. 2014

JMDH

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IntroductionIn Nigeria about 50% of oral contraceptive pill users obtain their products from proprietary patent medicine vendors (PPMVs). This group of service providers are poorly trained and have very limited knowledge about contraception. This paper investigated the nature of the advice offered to simulated current and potential users of oral contraceptive pills. The main objective was to assess the nature and quality of advice provided by PPMVs to pill users.MethodThis study is based on findings from a ‘mystery client’ approach in which three scenarios related to contraceptive pill use were simulated. Each of the 12 mystery clients simulated one of the following three scenarios: new pill users (new to family planning or switching from condom to pills); user seeking a resupply of pills; and dissatisfied pill users intending to discontinue use. Simple random sampling was used to select 410 PPMVs from a total of 1,826 in four states in Nigeria. Qualitative study using in-depth interviews was also conducted.ResultsA majority of the PPMVs had pills in stock on the day of the survey and resupplied pills to the clients. PPMVs also understood the reason and importance of referring clients who were new adopters of oral contraceptive methods to a health facility; 30% of the PPMVs referred new adopters to a health facility. However, demand from clients who do not want to go to health care facilities (for various reasons) necessitated the provision of oral contraceptive pills to 41% of the first time users. Some PPMVs prescribed treatment to mystery clients who presented with perceived complications arising from the use of pills, while 49% were referred to a health facility.ConclusionThe advice given by PPMVs often falls short of safety guidelines related to the use of oral contraceptive pills. There is a need to continuously update knowledge among the PPMVs to ensure that they provide quality oral contraceptive services as PPMVs bridge the gap between medical experts and users in rural communities.

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Are Patent Medicine Vendors Effective Agents in Malaria Control? Using Lot Quality Assurance Sampling to Assess Quality of Practice in Jigawa, Nigeria

Cited by 29 publications

References 31 publications

Assessing the quality of care in a new nation: South Sudan's first national health facility assessment

Assessing the quality of care in a new nation: South Sudan's first national health facility assessment

Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria: a cross-sectional study

An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria

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