Background The trio of commonest illnesses and causes mortality among children under five (Malaria, Pneumonia and Diarrhea) are easily treatable through timely exposure to cost effective interventions at the community level. Patent and proprietary medicine vendors (PPMVs) are a leading source of care for illnesses among under-five children in Nigeria. This study was designed to explore child health services offering, particularly commodity stocking patterns and case management knowledge for common childhood illnesses among PPMVs in Ebonyi and Kaduna States. Methods A descriptive cross-sectional study was conducted among PPMVs in four local government areas across Ebonyi and Kaduna States. Data was collected using semi-structured interviewer-administered questionnaires. Information was obtained on medicine and supplies, knowledge of common childhood illnesses management and referral practices. Results A total of 374 PPMVs were interviewed; the mean age was 33.7 ± 9.8 years. Among the 132 health trained respondents, 59.0% offer treatment services for sick children while 83.5% of the non-health trained respondents offer the same service. At least, 88.0% of the respondents keep stock ACTs, Amoxycilin DT, ORS and Zinc. About 38.5% reported stock-out of ACTs in the month preceding the study, 55.1% reported stock out lasting only 0 to 6 days. Only 83 (22.2%) of respondents knew the correct diagnosis of fast breathing among children aged 2 to less than 12 months old. Education and health training background were associated with a good knowledge of common childhood illnesses management (X2 = 44.88, p < 0.001; X2 = 27.14, p < 0.001). Conclusion The relative constant availability of medicines and commodities for managing childhood illnesses positions PPMVs as a preferred source of care for these illnesses. There is a need to complement steady stock availability with provision of quality services by exposing PPMVs to trainings on integrated community case management of childhood illnesses and implementation of robust supervision mechanism to monitor them.

Background The continuous supply of affordable and quality HIV self-test (HIVST) is a key pillar toward achieving the global HIV 95–95-95 target in Nigeria. This was a descriptive qualitative study that explored private sector stakeholders’ perceptions of the enablers and barriers of the HIVST market in Nigeria. Methods A total of 29 In-depth interviews (IDIs) were conducted with HIVST supply chain stakeholders and private sector providers (PPMVs and Community Pharmacies). Responses were analyzed using Nvivo software and we systematically developed a total market approach analysis for supply chain stakeholders and archetypes for community Pharmacies and PPMVs based on insights gathered from their journey map. Results Challenges to the supply side dynamics include forecasting, point of care service delivery, the availability of free and subsidized HIVST kits in the market, neglect of private sector providers (Community Pharmacists and PPMVs) in the healthcare delivery system, limited demand for HIVST, and regulatory bottlenecks influences the overall market dynamics. High cost of the HIVST kit, which triggers low availability, accessibility and affordability from the demand side, depicts the need to understand the market dynamics. Addressing the barriers and optimizing the enablers of the three-model pharmacist and PPMV’s will change the market dynamic and service delivery to generate demand. Conclusion To address challenges which already exist, the government need to revise the process guidelines for introducing new HIVST products in the Nigerian market, developing contingency plans to ensure the supply of HIVST remains sufficient when experiencing economic shocks, and create a sustainable roadmap toward optimizing the market for HIVST kits.

Background Behaviour change communication is a proven health communication strategy among used in promoting changes in knowledge, attitudes, beliefs, and behaviours’, especially for communicable diseases. Few studies have been conducted on its effectiveness for non-communicable diseases prevention and control. This study was conducted as an evaluation assessment for a non-communicable disease focused intervention implemented in Imo and Kaduna States, Nigeria. Methods A twelve-month long strategic behaviour change communication intervention on hypertension and diabetes was implemented in selected communities across Imo and Kaduna States, Nigeria. This study adopted a quasi-experimental design approach among adult residents aged at least 35 years to assess the effectiveness of the intervention. Data was collected at baseline (prior to implementation of the interventions) and at the endline; among study and control groups. A uniform study tool was used to collect information on awareness & lifestyle related factors for Hypertension & Diabetes. Results The awareness of hypertension was 98.9% among the respondents in the study group compared to 94.4% among the baseline respondents (χ2 = 20.276, p < 0.001). The history of blood pressure check was recorded among 86.8% of the study group compared to 79.0% of the baseline group (χ2 = 20.27, p < 0.001). In the last 6 months prior to the study, 71.9% of the study group compared to 30.6% of the baseline group (χ2 = 243.34, p = 0.002) had blood glucose check at least once. Daily alcohol consumers make up 36.8% of the baseline respondents, compared to 22.6% in the study group (χ2 = 33.84, p < 0.001) and 30.6% of those in the control group compared to the 22.6% of the study group (χ2 = 9.23, p = 0.002). The mean (± SD) knowledge score on hypertension and diabetes was 18.12 (± 8.36) among the study group compared to 11.84 (± 6.90) among the baseline group (t = 15.29, p < 0.001), and compared to 10.97 (± 8.79) among the control group (t = 13.08, p < 0.001). Conclusion Significant changes in lifestyle practices, knowledge of hypertension and diabetes and risk perception was observed following the implementation of community-based behaviour change communication interventions. There is a need to increased access to health education and promotion interventions for non-communicable diseases.

Introduction Effective management of hypertension and diabetes through accurate diagnosis and treatment can reduce the risk of complications and early deaths. This study was a descriptive cross-sectional study aimed at determining practices regarding hypertension and type 2 diabetes management among healthcare providers in Kaduna and Imo States, Nigeria. Data were collected using a semi-structured interviewer administered questionnaire consisting of questions across four major domains: 1) screening; 2) diagnosis; 3) pharmacological; and 4) non-pharmacological treatment of hypertension and diabetes. Results A total of 77 healthcare providers were interviewed and they included; 20 (26.5%) medical doctors, 25 (32.5%) nurses/midwives, 18 (23.4%) community health extension workers and 3 (3.9%) pharmacists. Almost half (46.8%) of the respondents indicated that they prioritize routine blood pressure (BP) checks among all adult patients while only 30 (39.0%) and 8 (10.4%) correctly identified the diagnostic criteria for hypertension and diabetes, respectively. Calcium chain blockers only were the most prescribed medication for treatment of hypertension across all stages of hypertension while metformin (glucophage) was stated as the preferred medication prescribed for controlling blood glucose levels among the respondents. Only 32.5% of the respondents stated that they have a means in place in their facilities to ensure that hypertension and diabetes patients adhere to follow-on visit recommendations. Conclusion A significant knowledge gap was identified in the diagnosis and treatment of hypertension and diabetes among the respondents due to unavailability of properly outlined management guidelines for these conditions for the different cadres of healthcare workers in Nigeria. There is a need for the development and wide distribution of guidelines highlighting cadre-specific roles for healthcare providers in hypertension and diabetes management and standard operating procedures based on such guidelines should be available at various points of care to ensure better treatment outcomes.

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