Okeibunor Joseph, Smith Andrew, Jolley Emma, Elhassan Elizabeth, Adekeye Oluwatosin, Kontagora Lawal Hasfat, Isiyaku Sunday, Adamani William, Mpyet Caleb, Faal Hannah, Schmidt Elena, Gilbert Clare E
Social Scientist, Department of Anthropology and Sociology, University of Nigeria Nssuka, Enugu State, Nigeria.
Honorary Professor, International Centre for Evidence in Disability, Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2025 Jun 24;20(6):e0326132. doi: 10.1371/journal.pone.0326132. eCollection 2025.
In Nigeria, patent and proprietary medicine vendors (PPMVs) are permitted to sell a limited range of medication. They are important providers of health care despite their limitations and may be trained to manage specific conditions, such as malaria, but not ear and eye conditions. In this study, PPMV's knowledge and management of ear and eye problems and community members health seeking behaviour were explored, as well as whether community members would access PPMVs if they were trained in primary ear and eye care.
Quantitative and qualitative methods were used in a cross-sectional observation study: a survey of 1,591 adults in 40 clusters in two urban and two rural areas; 64 focus group discussions with community members and four with health professionals in two ear, nose, throat and eye clinics; in-depth interviews with ten community leaders, 11 primary health care workers, and 21 hospital staff. A check list was used to assess 36 PPMVs' facilities and structured questionnaires were administered to 36 PPMVs and 401 hospital patients in ear and eye outpatient departments.
Community members reported that eye and ear problems were frequent but less common than other conditions. Health seeking behaviour was influenced by accessibility, availability, cost of medication, and trust in the provider. Most PPMVs had no formal training, had little knowledge of ear and eye conditions and were enthusiastic about being trained to manage them. Living far (>5km) from a health facility, being male, uneducated and poor were significantly associated with willingness to access PPMV after training in primary ear or eye care.
PPMVs might be able to play a role in delivering primary ear and eye health care for common conditions, in collaboration with local clinicians. To do this, PPMVs would require training in eye and ear conditions and skills in their detection and counselling clients as well as reliable supply chains for medication, and skills in stock control, record keeping and facility management.
在尼日利亚，专利药和成药销售商（PPMVs）被允许销售有限种类的药物。尽管存在局限性，但他们是重要的医疗服务提供者，可能接受过管理特定病症（如疟疾）的培训，但未接受过耳部和眼部疾病的管理培训。在本研究中，探讨了PPMVs对耳部和眼部问题的知识与管理情况、社区成员的就医行为，以及如果PPMVs接受初级耳部和眼部护理培训，社区成员是否会选择他们。
在一项横断面观察研究中采用了定量和定性方法：对两个城市和两个农村地区40个群组中的1591名成年人进行调查；与社区成员进行64次焦点小组讨论，与两家耳鼻喉科和眼科诊所的卫生专业人员进行4次讨论；对10名社区领袖、11名初级卫生保健工作者和21名医院工作人员进行深入访谈。使用检查表评估36家PPMVs的设施，并向36家PPMVs以及耳部和眼科门诊的401名医院患者发放结构化问卷。
社区成员报告称，眼部和耳部问题很常见，但不如其他病症普遍。就医行为受到可及性、药品可获得性、药品成本以及对提供者信任度的影响。大多数PPMVs没有接受过正规培训，对耳部和眼部疾病了解甚少，并且热衷于接受管理这些疾病的培训。居住在距离医疗机构较远（>5公里）、男性、未受过教育和贫困与在接受初级耳部或眼部护理培训后选择PPMVs的意愿显著相关。
PPMVs可能能够与当地临床医生合作，在提供常见病症的初级耳部和眼部医疗保健方面发挥作用。要做到这一点，PPMVs需要接受耳部和眼部疾病的培训，掌握疾病检测和为患者提供咨询的技能，以及可靠的药品供应链，同时还需要具备库存管理、记录保存和设施管理技能。
