University of Ibadan, Ibadan, Nigeria.
Population Council, Washington D.C., USA.
BMC Health Serv Res. 2022 Sep 3;22(1):1119. doi: 10.1186/s12913-022-08503-3.
Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) are often the first point of care for many Nigerians, and when sufficiently trained, they contribute to the expansion of family planning services. Nigeria's task shifting policy and existing regulatory and licensing bodies provide the enabling environment for PPMVs to be stratified and trained. This study explored the perceptions of stakeholders toward the pilot three-tier accreditation system instituted by the Pharmacists Council of Nigeria with support from the IntegratE project.
Two rounds of qualitative phone interviews were conducted among stakeholders in Kaduna and Lagos states in 2020 and 2021. In addition, there were two rounds of phone interviews with CPs and PPMVs (program recipients) from Lagos and Kaduna states. All participants were purposively selected, based on their involvement in the IntegratE project activities. Interviews were recorded, transcribed, and coded using Atlas.ti software. Thematic analysis was conducted.
Fifteen stakeholders and 28 program recipients and 12 stakeholders and 30 program recipients were interviewed during the first and second rounds of data collection respectively. The data are presented around three main themes: 1) the pilot three-tier accreditation system; 2) enabling environment; and 3) implementation challenges. The accreditation system that allows for the stratification and training of PPMVs to provide family planning services was perceived in a positive light by majority of participants. The integrated supportive supervision team that included representation from the licensing and regulatory body was seen as a strength. However, it was noted that the licensing process needs to be more effective. Implementation challenges that need to be addressed prior to scale up include bottlenecks in licensing procedures and the deep-rooted mistrust between CPs and PPMVs.
Scale up of the three-tier accreditation system has the potential to expand access to family planning services in Nigeria. In other resource-poor settings where human resources for health are in short supply and where drug shops are ubiquitous, identifying drug shop owners, training them to offer a range of family planning services, and providing the enabling environment for them to function may help to improve access to family planning services.
社区药剂师（CPs）和专利药品销售商（PPMVs）通常是许多尼日利亚人的第一护理点，并且经过充分培训后，他们为扩大计划生育服务做出了贡献。尼日利亚的任务转移政策以及现有的监管和许可机构为 PPMV 分层和培训提供了有利的环境。本研究探讨了利益相关者对尼日利亚药剂师理事会在 IntegratE 项目支持下建立的试点三层认证系统的看法。
在 2020 年和 2021 年，在卡杜纳州和拉各斯州的利益相关者中进行了两轮定性电话访谈。此外，还对来自拉各斯州和卡杜纳州的 CPs 和 PPMV（项目接受者）进行了两轮电话访谈。所有参与者均根据他们参与 IntegratE 项目活动的情况，通过有针对性的选择。使用 Atlas.ti 软件对访谈进行录音、转录和编码。进行了主题分析。
在第一轮和第二轮数据收集期间，分别采访了 15 名利益相关者和 28 名项目接受者，以及 12 名利益相关者和 30 名项目接受者。数据围绕三个主要主题呈现：1）试点三层认证系统；2）有利环境；3）实施挑战。该认证系统允许对 PPMV 进行分层和培训，以提供计划生育服务，大多数参与者对此持积极态度。包括来自许可和监管机构代表在内的综合支持性监督小组被认为是一个优势。然而，有人指出，许可过程需要更加有效。在扩大规模之前需要解决的实施挑战包括许可程序中的瓶颈以及 CPs 和 PPMV 之间根深蒂固的不信任。
扩大三层认证系统的规模有可能扩大尼日利亚计划生育服务的获取渠道。在人力资源短缺且药店无处不在的其他资源匮乏的环境中，确定药店老板，对他们进行培训以提供一系列计划生育服务，并为他们提供运作的有利环境，可能有助于改善计划生育服务的获取。
