objective(s) To determine the availability and affordability of asthma and COPD medicines across Nigeria. methods This was a cross-sectional survey conducted in 128 pharmacies (51 in public sector hospitals, 51 private sector community pharmacies and 26 charity or big private hospitals) across the six geopolitical zones of Nigeria using the WHO/Health Action Initiative method. The proportion of pharmacies where medicines were available, the median retail prices of originator and generics and affordability were analysed. A medicine was available if found in ≥ 80% of surveyed pharmacies. Unaffordability was defined as paying> 1 day's wage (> US$1.68) for a standard 30-day supply of the medicine. results The available medicines were oral corticosteroids and oral salbutamol which are not on the WHO Essential Medicine List. Medicines were found more frequently in private than public pharmacies and in the southern than northern zones. Inhalable corticosteroid was not available at any public pharmacy nationwide. None of the EML medicines were affordable. The least number of days' wages for a 30-day supply of any inhalable corticosteroid-containing medication was 3.5 days. conclusions There are very limited availability and affordability of recommended asthma and COPD medicines across Nigeria with disparity across regions. Medicines that were available and affordable are not recommended and are harmful for long-term use. This underpins the need for engagement of all stakeholders for the review of existing policies regarding access to asthma and COPD medicines to improve availability and affordability. keywords medicine, availability, affordability, asthma, chronic obstructive pulmonary disease, Nigeria Sustainable Development Goals (SDGs): SDG 3 (good health and well-being), SDG 17 (partnerships for the goals)

Background. Post-tuberculosis (TB) lung disease is a recognised cause of chronic respiratory disease, and its impact on health-related quality of life (HRQoL) has not been extensively described. Objective. To describe the clinical profile, spirometry impairment and impact of post-TB lung disease on HRQoL among patients attending two tertiary hospitals in Lagos, Nigeria. Methods. We conducted a cross-sectional study and obtained data through interviews, chart reviews and physical examination. We measured dyspnoea severity using the Medical Research Council (MRC) scale, HRQoL with the St George's respiratory questionnaire (SGRQ) and performed spirometry. Univariate regression was used to explore the associations between selected variables and HRQoL. Results. A total of 59 participants were recruited and their median (interquartile range (IQR)) age was 45 (36 -60) years. The most frequent symptom was cough (93.2%; n=55) and sputum production (91.5%; n=54). Less than two-thirds of the participants (62.4%; n=38) had received treatment for TB on more than one occasion, 50.8% (n=30) had moderate to very severe dyspnoea on the MRC scale and 88.7% (n=47/53) had abnormal spirometry with the mixed pattern predominating in 56.6% (n=30) of the participants. The mean (standard deviation (SD)) SGRQ component score for symptoms was 43.89 (18.66), followed by activity (42.50 (22.68)), impact (29.41 (17.82)) and total components (35.78 (17.25)). Dyspnoea, cough, sputum production and weight loss were associated with worsened HRQoL. Conclusion.Post-TB lung disease was characterised by a high symptom burden, severe spirometry impairment and poor HRQoL. There is a need for increased recognition and development of guidelines for diagnosis and treatment of post-TB lung disease and for further studies to explore preventive strategies. Keywords. tuberculosis; post-TB; TB sequelae; health-related quality of life; chronic respiratory diseases.

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Background: Clients’ satisfaction surveys are required to identify gaps and challenges in providing healthcare services; to ensure the quality of care and patient satisfaction. Objectives: To compare and assess factors responsible for healthcare satisfaction among rural and urban communities in Ilorin East Local Government Area (LGA) of Kwara State to improve service provision among the communities. Methods: This was a comparative, cross-sectional study involving rural (250) and urban (250) respondents selected through a multi-stage sampling technique and surveyed using an interviewer-administered questionnaire. Focus Group Discussion was also used to collect qualitative data. Participants were selected through the purposive sampling technique. Results: The proportion of clients who expressed satisfaction was 172 (68.8%) among urban and 175 (70.0%) among rural respondents, (z = 0.57; p = 0.45). The attitude of healthcare personnel influenced satisfaction among both the rural (56.0%) and urban (63.3%) respondents, respectively; short waiting time (12.8%) and privacy of the consulting rooms (13.7%) were reasons influencing satisfaction with service. Conclusion: Short waiting time and privacy of consulting room were reasons for service satisfaction among clients. Waiting time was a strong predictor of satisfaction. There is a need to improve health personnel’s attitude to work to ensure clients’ satisfaction with healthcare services.