Evaluation of the Participation of Community Pharmacists in Primary Healthcare Services in Nigeria: A Mixed-Method Survey

Abstract

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.

Path Analysis of Determinant Factors Influencing Purchasing Decisions among Community Pharmacists in Nigeria using Structural Equation Modeling

“…[17] This is crucial considering the expanded roles of the community pharmacist (CP) as a first-line healthcare workforce in primary healthcare delivery. [18] In this study, educational qualifications have been shown to have minimal impact on buying decisions. [12,16,19] The study utilized structural equation modeling techniques to examine the impact of gender, location of the business, and type of business model on decision-making on CP in selected cities in South West, Nigeria.…”

Community pharmacists on the frontline in the chronic disease management: The need for primary healthcare policy reforms in low and middle income countries

“…For example in Nigeria, CPs have been rendering primary healthcare with extended roles in chronic disease management, public health, and health promotion unofficially. 78 , 79 In Malaysia, despite the lack of a legal framework for primary care roles, CPs offer health screenings and chronic diseases services to the general public. 80 , 81 , 82 , 83 In Jordan, there is a lack of legal backing for pharmacist's primary care role 84 despite evidence that clinical pharmacy and medication therapy management services in hospitals and community pharmacies improved patient health outcomes.…”

Suicide Prevention in Nigeria: Can Community Pharmacists Have a Role?

“…Most community pharmacies in Nigeria are independently owned and operated by licensed pharmacists [ 4 ]. Community pharmacists are easily accessible and trusted frontline healthcare professionals who provide pharmaceutical care to the community [ 4 ].…”

“…Most community pharmacies in Nigeria are independently owned and operated by licensed pharmacists [ 4 ]. Community pharmacists are easily accessible and trusted frontline healthcare professionals who provide pharmaceutical care to the community [ 4 ]. Moreover, it costs less to receive health services in community pharmacies than in Nigerian hospitals due to free consultation and counselling [ 5 ].…”