The Challenge Initiative, Nigeria Hub, Johns Hopkins Center for Communication Programs, Abuja, Nigeria.
The Challenge Initiative, Johns Hopkins Center for Communication Programs, Baltimore, MD, USA.
Glob Health Sci Pract. 2024 May 21;12(Suppl 2). doi: 10.9745/GHSP-D-22-00225.
In Nigeria, health care services and commodities have increasingly been accessed through private sector entities, including retail pharmacies and drug shops (also called proprietary patent medicine vendors [PPMVs]). However, PPMVs cannot provide long-acting or permanent methods, and concerns have been raised about their quality of services and their need to better comply with government regulations. This article describes how The Challenge Initiative's (TCI) family planning program supported 4 state governments in Nigeria to develop a model to strengthen public-private partnerships between PPMVs and primary health centers (PHCs) to leverage PPMVs to provide adolescents and youth with high-quality contraceptive information, services, and referrals to PHCs.
The intervention implemented a hub-spoke model by strengthening the linkages between neighboring PPMVs and large PHCs for delivering contraceptive services to adolescents and youth. The steps in the implementation process included: (1) introducing the intervention to state governments, (2) selecting PPMVs as spokes and high-volume PHCs as hubs, (3) conducting whole-site orientations jointly with PPMV and PHC staff, (4) strengthening referral links between PPMVs and PHCs, (5) implementing supportive supervision and coaching, and (6) strengthening client data management. TCI worked with the state and local ministry of health to improve PPMV operators' knowledge, attitudes, and skills to deliver adolescent- and youth-friendly services.
Implementing the PPMV intervention with state governments and PHCs strengthened the public-private partnership. A functional referral system in Plateau State demonstrated significant success, enabling increased contraceptive choice and adherence to regulations for adolescents and youth. We recommend that the government strengthen the working relationship between PPMVs and PHCs, incorporate PPMVs into the routine supportive supervision of the state health system, and incorporate a referral linkage with PHCs into the design and implementation of PPMV programs.
在尼日利亚，医疗服务和商品越来越多地通过私营部门实体获得，包括零售药店和药店（也称为专利药供应商[PPMV]）。然而，PPMV 无法提供长效或永久性方法，并且对其服务质量以及需要更好地遵守政府法规表示关注。本文描述了挑战倡议（TCI）的计划生育项目如何支持尼日利亚的 4 个州政府制定一个模型，以加强 PPMV 与初级保健中心（PHC）之间的公私伙伴关系，利用 PPMV 为青少年和青年提供高质量的避孕信息、服务，并将其转介到 PHC。
该干预措施实施了一个中心辐射模型，通过加强相邻 PPMV 和大型 PHC 之间的联系，为青少年和青年提供避孕服务。实施过程中的步骤包括：（1）向州政府介绍干预措施，（2）选择 PPMV 作为辐条，选择高容量 PHC 作为中心，（3）与 PPMV 和 PHC 工作人员共同进行全面的方向指导，（4）加强 PPMV 和 PHC 之间的转诊联系，（5）实施支持性监督和指导，以及（6）加强客户数据管理。TCI 与州和地方卫生部合作，提高 PPMV 运营商提供青少年友好和青年友好服务的知识、态度和技能。
与州政府和 PHC 一起实施 PPMV 干预措施加强了公私伙伴关系。在高原州建立的一个功能齐全的转诊系统取得了显著成功，使青少年和青年能够增加避孕方法的选择并遵守法规。我们建议政府加强 PPMV 和 PHC 之间的工作关系，将 PPMV 纳入州卫生系统的常规支持性监督中，并将与 PHC 的转诊联系纳入 PPMV 计划的设计和实施中。
