Medicines and vaccines supply chains challenges in Nigeria: a scoping review

Abstract

Background Medicines and vaccines supply chains represent critical systems for realising one of the major targets of the United Nations’ third Sustainable Development Goals (SDGs)—access to safe, effective, quality, and affordable essential medicines and vaccines, for all. However, evidence suggests the system is confronted with several challenges in many low-medium income countries, including Nigeria. This scoping review aims to summarize the available evidence on the challenges of medicines and vaccines supply chain system in Nigeria. Results We searched relevant databases including Scopus and Web of Science for studies published between January 2005 and August 2020 on the challenges associated with medicines and vaccines supply chain systems in Nigeria. Our findings implicate several factors including difficulty with medicines or vaccines selection, procurement, distribution, and inventory management. Others included poor storage infrastructure, financial constraints, insecurity, transportation challenges, inadequate human resources, weak, or poorly implemented policies. These challenges mostly resulted in stock-outs of essential medicines which notably got worsened during the current COVID-19 pandemic. Conclusion Our study is a wake-up call on the need to prioritise the critical sector of the supply chain systems for medicines and vaccines in Nigeria. Effective implementation of existing policies, improved security, strengthening of the health system through adequate budgetary allocations, and provision of infrastructure including regular availability of electricity are keys to surmounting the challenges and improving access to medicines or vaccines in Nigeria.

A call to action: securing an uninterrupted supply of Africa’s medical products and technologies post COVID-19

“…Even prior to the COVID-19 pandemic, Africa faced challenges in ensuring availability of medical products and technologies [ 19 ]. Factors included: financial constraints on delivery of quality healthcare including underfunding of essential medicines and other health products; poor national and sub-national health supply chain management systems with inadequate storage and warehousing infrastructure, transportation, and insecurity challenges(from wars and civil unrest) that affect the logistics and health supply chain system; poor-quality assurance systems and weak regulatory framework [ 19 , 20 ]. …”

Vaccine Supply Chain Management: Implications for Reforming Supply Chain Policy and Practice in Pandemic Times

“…Existing literature on vaccine supply chain management has focused on the need for cold storage constraints (Purssell 2015;Ashok, Brison and LeTallec (2017), Lin, Zhao & Lev, 2020), medical staffing constraints (Haidari, Brown, Ferguson, Bancroft, Spiker, Wilcox, Ambikapathy, Sampath, Connor & Lee,2016;Bhatt, Pourmand & Sikka,2018;Bhreasail, Sarkis, Galaitsi, Linkov, Pritcherd, Carluccio & Keisler, Krey & Seiler, 2020), infrastructure such as patient bed scarcity (Baxter & Cassady,2021). Additionally, studies on health supply chain management in normal and crisis times have limited their scope on need to financial and non-financial resources, constraints, diagnostics, treatment and development of vaccines (Forni & Mantovani, 2021;Olliaro et al,2022), constraints to achieving herd immunity (Yamey, Schäferhoff, Hatchett, Pate, Zhao & McDade, 2020), vaccine efficacy, inadequate supplies (Olutuase, Iwu-Jaja, Akuoko, Adewuyi & Khanal ,2022), public private partnerships (Nduhura et al,2021;Settumba, et al,2022). What is deficiently researched in the role of the private and social actors like religious and community leaders when managing pandemics for supporting governments efforts to achieve herd immunity targets as soon as possible.…”

COVID‐19 vaccine wastage: A challenge to achieving herd immunity in Nigeria

“…These challenges hinder attaining recommended vaccine storage temperatures which greatly accelerate vaccine thawing and in turn, result in loss of potency [4], leaving the country with no option than to destroy the vaccine. Distribution challenges, poor vaccine data management, insecurity and weak or poorly implemented policies are other factors that cause the vaccine wastage in Nigeria [5]. The bad road networks especially in Nigeria's rural areas make it challenging for safe and timely vaccines distribution to target facilities [4].…”

“…Banditry, the Boko-Haram insurgency, cattle rustling, communal clashes and the rampant kidnappings across the country might have hindered the free movement of health workers, logistics officers and programme managers from accessing the rural facilities for fear of their health and safety, which could result to many COVID-19 vaccine doses being unused. It is worth noting that the emergence of the COVID-19 pandemic may have further complicated some of the challenges associated with medicines and vaccines supply chain in Nigeria [5].…”

“…The bad road networks especially in Nigeria's rural areas make it challenging for safe and timely vaccines distribution to target facilities [4]. The challenges faced by Nigeria's security system have also contributed to the delay in the COVID-19 vaccine distributions and uptake [3,5]. Banditry, the Boko-Haram insurgency, cattle rustling, communal clashes and the rampant kidnappings across the country might have hindered the free movement of health workers, logistics officers and programme managers from accessing the rural facilities for fear of their health and safety, which could result to many COVID-19 vaccine doses being unused.…”