The Role of Patent Medicine Sellers in Home Management of Childhood Malaria: A Situational Analysis of Experience in Rural Nigeria

Abstract

Patent medicine sellers (PMS) play an important role in supplying the medication needs of the community particularly antimalaria. A situational analysis of the role of PMS in home management of malaria was carried out in four rural local government areas in Southwestern Nigeria using both cross sectional and observational study methods. The results showed that patent medicine stores constituted 76.2% of the medicine shops in the areas. The PMS provided not only drugs but also consultation services. Malaria constituted the commonest fever for which drugs were purchased. The most commonly mentioned drug best for malaria was the 4 aminoquinolone. Many (55.4%) of the PMS have received some form of training on malaria treatment. However, this was carried out in many instances (41.9%) by the shop owners to the apprentice PMS or shopkeepers. Health personnel were mentioned as trainers by only 27% of the PMS. The use of guidelines provided by PMS was infrequent and only 13.8% could produce the guideline at the time of survey. PMS would like to have more training on causes and recognition of malaria and antimalaria dosages. These topics were least taught. The rural PMS is important to the management of malaria. If quality training and supervision is provided to them, home management of malaria should improve.

A Systematic Review of the Role of Proprietary and Patent Medicine Vendors in Healthcare Provision in Nigeria

“…A single study of dispensing practices for non-malaria illnesses found that 69% of PPMVs reported ORS as their first-line treatment for diarrhea in under-fives [ 48 ]. The reliance of these studies on self-reported data may overstate rates of proper treatment; a study comparing self-reported to observed dispensing practices for child malaria found that PPMVs under-reported dispensing of improper treatments [ 75 ].…”

“…Nineteen articles assessed the interactions between PPMVs and their clients ( Table 1 ), focusing on drug choice, consultation about the illness, and instructions regarding drug administration. Interactions about drug choice, and the majority of drug sales, were largely driven by customer demand for specific drugs [ 37 , 38 , 44 , 49 , 70 , 75 , 76 ]. Although some PPMVs report that customers ask for recommendations on drug choice, particularly for sick children [ 75 ] and anti-malarial drugs [ 37 , 38 ], observational data showed that PPMVs only suggested drug choices in 31% of encounters [ 21 ], and that between 58% and 69% of PPMVs sold drugs as requested without asking the customer for any clarification [ 21 , 60 ].…”

“…Interactions about drug choice, and the majority of drug sales, were largely driven by customer demand for specific drugs [ 37 , 38 , 44 , 49 , 70 , 75 , 76 ]. Although some PPMVs report that customers ask for recommendations on drug choice, particularly for sick children [ 75 ] and anti-malarial drugs [ 37 , 38 ], observational data showed that PPMVs only suggested drug choices in 31% of encounters [ 21 ], and that between 58% and 69% of PPMVs sold drugs as requested without asking the customer for any clarification [ 21 , 60 ]. Very few customers requested drugs based on prescriptions [ 49 , 58 , 70 , 75 ]; observational data found that between zero and 9% of clients brought a prescription to the PPMV shop [ 21 , 60 ], with higher percentages in rural areas [ 60 ].…”

Prevalence of Malaria Parasites among Nnamdi Azikwe University Students and Anti-Malaria Drug Use

“…In Nigeria, malaria is holoendemic (Bruce-Chwatt, 1983). It is worst hit in the poorest countries and those under difficult and impoverished conditions (WHO, 1987;Uko et al, 1994) and accounts for about 1 million episodes annually with a mortality rate of 1% (Ajayi et al, 1995). About four species of Plasmodium have been found to commonly infect man.…”

Promoting The Integrated Community Case Management of Under-Five Pneumonia In Nigeria: A Cost-Benefit Analysis

“…The iCCM strategy has led to the removal of amoxicillin DT from the prescription-only medicine list to enable the PPMVs to have access to the drug for the treatment of non-severe childhood pneumonia at the community level [5]. In Nigeria, this decision was also supported by the fact that majority of the populace in rural areas visit PPMVs for medical advice, diagnosis, medications and general health management due to their low service cost and accessibility [6,7]. A study in Uganda has also shown that PPMVs are indispensable at the rural communities [8].…”