PMID- 30509851
OWN - NLM
STAT- MEDLINE
DCOM- 20200618
LR  - 20200618
IS  - 1934-8150 (Electronic)
IS  - 1551-7411 (Linking)
VI  - 15
IP  - 11
DP  - 2019 Nov
TI  - How the quality of essential medicines is perceived and maintained through the 
      pharmaceutical supply chain: A perspective from stakeholders in Nigeria.
PG  - 1344-1357
LID - S1551-7411(18)30647-8 [pii]
LID - 10.1016/j.sapharm.2018.11.011 [doi]
AB  - BACKGROUND: Limited access to essential medicines for maternal and child health 
      is a preventable cause of pregnancy-related deaths. This remains a predominant 
      challenge in Nigeria, where sub-standard and falsified medications have 
      historically been associated with maternal mortality. An in-depth understanding 
      of perceptions surrounding quality assurance of essential medicines is pertinent 
      for developing effective and sustainable interventions. OBJECTIVE: To examine 
      stakeholder perspectives on quality control of essential medicines for maternal 
      and child health, while characterizing pharmaceutical distribution of medicines 
      in Nigeria. METHODS: Key informant interviews were conducted with a purposive 
      sample of 26 participants between January and June 2018. Eligible participants 
      included: pharmacists, pharmaceutical sales representatives (pharm reps), supply 
      chain employees of pharmaceutical industries and regulatory agency personnel, 
      working in the public or private health sector in either of the four states: 
      Lagos, Enugu, Imo or Port-Harcourt. A 6-item survey was administered to collect 
      demographic information on the participants. This was followed by 15 
      semi-structured questions to gather qualitative data on the subject matter. 
      RESULTS: Verifying vendor credibility and use of identifiable regulatory markers 
      were the most common methods adopted by pharmacists and pharm reps with the 
      intent to control quality of medicines. Key challenges in assuring quality 
      included: inefficiency of regulatory agencies, illicit sales of prescription 
      medicines by patent medicine vendors, existence of open markets and failed policy 
      implementation. While pharmacists and pharm reps solicited improved regulations 
      and policy implementation; NAFDAC personnel primarily recommended an increased 
      government funding to improve their efficiency. CONCLUSION: Beyond stakeholder 
      recommendations, a fervent and consistent commitment on the part of the 
      government is needed to improve quality assurance in Nigeria's pharmaceutical 
      system. Public-private partnerships should be explored to address funding 
      limitations to quality assurance. Future studies need to examine challenges and 
      opportunities surrounding policy implementation, and regulatory enforcement in 
      pharmaceutical distribution.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Amadi, Chioma
AU  - Amadi C
AD  - City University of New York Graduate School of Public Health and Health Policy 
      (CUNY GSPHHP), Department of Epidemiology, 55W 125th street, NY, 10027, United 
      States. Electronic address: Chioma.amadi@sph.cuny.edu.
FAU - Tsui, Emma K
AU  - Tsui EK
AD  - City University of New York Graduate School of Public Health and Health Policy 
      (CUNY GSPHHP), Department of Community Health and Social Sciences, 55W 125th 
      street, NY, 10027, United States. Electronic address: Emma.tsui@sph.cuny.edu.
LA  - eng
PT  - Journal Article
DEP - 20181126
PL  - United States
TA  - Res Social Adm Pharm
JT  - Research in social & administrative pharmacy : RSAP
JID - 101231974
RN  - 0 (Drugs, Essential)
SB  - IM
MH  - Child Health
MH  - Drug Industry
MH  - *Drugs, Essential/supply & distribution/therapeutic use
MH  - Humans
MH  - Maternal Health
MH  - Nigeria
MH  - Perception
MH  - Pharmacies
MH  - Pharmacists
MH  - *Quality Control
MH  - Stakeholder Participation
OTO - NOTNLM
OT  - Essential medicines
OT  - Pharmaceutical supply chain
OT  - Policy
OT  - Quality control
EDAT- 2018/12/05 06:00
MHDA- 2020/06/19 06:00
CRDT- 2018/12/05 06:00
PHST- 2018/07/10 00:00 [received]
PHST- 2018/11/19 00:00 [revised]
PHST- 2018/11/23 00:00 [accepted]
PHST- 2018/12/05 06:00 [pubmed]
PHST- 2020/06/19 06:00 [medline]
PHST- 2018/12/05 06:00 [entrez]
AID - S1551-7411(18)30647-8 [pii]
AID - 10.1016/j.sapharm.2018.11.011 [doi]
PST - ppublish
SO  - Res Social Adm Pharm. 2019 Nov;15(11):1344-1357. doi: 
      10.1016/j.sapharm.2018.11.011. Epub 2018 Nov 26.