*As consortium pushes IntegrateE project to expand access to family planning

By Joseph Erunke

ABUJA–THE Pharmacists Council of Nigeria, PCN,has said the current status of the nation’s primary healthcare system had placed overbearing burden on the shoulder of private health sector.

The Registrar of the Council, Elijah Mohammed, who said this,also added that the development has made informal healthcare more prominent.

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His statement came as a consortium in the nation’s health industry galvanise support through an initiative, IntegrateE, to expand citizens’ access to family planning and primary healthcare services through community pharmacists and patent and proprietary medicines vendors.

The media roundtable which was organised by Nigeria Health Watch, in collaboration with Society for Family Health, lead implementers of the IntegratE project,according to the organisers, was aimed at bringing together, top media stakeholders in health media as well as general media 

practitioners to discuss outcomes from the 4-year IntegratE project with project implementers and stakeholders towards  creating dialogue between project implementers and media practitioners.

On the other hand,the IntegratE project,being co-funded by Bill and Melinda Gates Foundation and MSD for mothers, is aimed at  improving the quality of Family Planning,FP services delivered by Community Pharmacists (CPs) and Patent and Proprietary Medicines Vendors (PPMVs) in underserved areas beginning with a pilot scheme in Lagos and Kaduna states. 

Speaking in Abuja,Thursday, at the one-day event which was also aimed at providing in-depth information on the IntegratE project,,the PCN boss said the  private sector accounts for 58% of health services provision, including child-related health services 

Mohammed,in his remarks at the event,said:”The status of primary health system as at today has created an overburden on the private health sector and made more prominent the informal healthcare.”

He continued: ” The Community Pharmacies (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) shops are usually the first point of accessing primary health care (PHC) for most Nigerian populace.  This situation is more pronounced in the rural and underserved areas. The private sector accounts for 58% of health services provision, including child-related health services,   with drug shops and pharmacists comprising 40% of the private healthcare sector and 83% of all child health care services in Nigeria. Majority of young women (<25 years) also obtain their Family Planning (FP) methods from CPs and PPMVs.. 

According to him,”While PPMVs are especially popular for FP due to their widespread availability, location in the community, consistent drug stocks, extended hours, personable interactions, and free consultation services they are often responsible for prevalent sub-optimal care in the health sector.”

” Consequently, because of their poor-quality services occasioned by poor skills and knowledge, PPMVs have not been streamlined into the formal health system by the public sector and Government, which impacts on timely referrals and follow-on treatments. Pharmacists, who should be the healthcare professionals in charge of safe and effective medication use are insufficient to serve the entire country’s population. The national bureau of statistics discloses that there is indeed 1 pharmacist for every 10,000 Nigerians even though in actual fact there are fewer licensed and practicing pharmacists in-country.”

He explained that:” As part of efforts to increase access to quality pharmaceutical products and services, Bill & Melinda Gates Foundation (BMGF) awarded MSH the LaunchDSI grant to facilitate the development, implementation and scale-up of accredited drug sellers’ initiatives (ADSIs) in 2016. “

“The grant supported PCN in building capacity to develop an accredited patent proprietary medicine vendor model for Nigeria to improve regulation of the private sector medicines outlets and ultimately improve access to quality services and medicines. LaunchDSI served as precursor to the IntegratE project, which commenced implementation in November 2017. 

“The IntegratE project, implemented by a consortium led by the Society of Family Health (SFH) and co-funded by Bill & Melinda Gates Foundation and MSD for Mothers and has since 2017 been working with the Federal Ministry of Health (FMoH) to broaden its task-sharing and task-shifting (TSTS) policy by piloting a 3- Tier accreditation system, led by the Pharmacists Council of Nigeria (PCN) to test a task-shifting model in underserved areas Lagos and Kaduna States with the view to future scale-up.  

“Over the past four years, PCN in collaboration with the IntegratE project and other stakeholders has worked to improve the contribution of private health sector providers – especially- Community Pharmacists (CP) and Patent Proprietary Medicine Vendors (PPMVs) in the healthcare delivery system,” he further explained.

Explaining that the ratio of one pharmacist for every 10,000 Nigerians was not enough to cater for the health needs of the nation’s populace,he said following the negligible number of licensed and practicing pharmacists,it had become imperative to employ the service of Community Pharmacists, CPs and Patent and Proprietary Medicines Vendors (PPMVs) at this time has become critical. 

“The pharmacist population ratio is very low. But we are tackling that apart from the fact that there is also a serious brain drain of pharmacists.  Most of them are migrating to Canada. Pharmacists, who should be the healthcare professionals in charge of safe and effective medication use are insufficient to serve the entire country’s population”, he said. 

He said though the country was producing about 1500 pharmacists per annum, the accreditation of more faculties of pharmacy and pharmaceutical sciences in universities would jerk up the figure to about 2000 or 2500 per year. 

“As at today we have 22 accredited faculties of pharmacy and pharmaceutical sciences in various universities in Nigeria. There are about eight pending to be accredited. It is interesting that more private universities are coming up with faculties of pharmaceutical sciences and with that we will be able to churn out more pharmacists  to address the shortfall”, he stated. 

Also speaking,the Director and Head, Reproductive Health Division, Ministry of Health, Dr. Kayode Afolabi, said the low uptake of family planning has been recorded as a major factor of high fertility pattern as well as high population growth rate of the country. 

He said private sector account for almost 60 per cent of health services provision, including child-related health services, with drug shops and pharmacists comprising 40 per cent of the private healthcare sector and 83 per cent of all child health care services in Nigeria.

“Improving uptake of family planning cannot be done alone by the government but with collaboration with stakeholders, especially the private sector”, he added 

Managing director, Society for Family Health (SFH), Omokhudu Idogho said the government was  committed to achieving the goal of a contraceptive prevalence rate of 27 per cent by 2024, including working with state and local governments to secure complementary budgets for family planning and reproductive health services. 

Idogho who was represented by the deputy chief of party for the integrate project, SHF, Micheal Alagbile, added ; 

“The commitment includes training frontline health workers to deliver a range of contraceptives and actions to improve equity and access to family planning for the poorest and to partner with the private sector, civil society, traditional and religious institutions and development partners.”.