Submission ID 129605
| Issue/Objective | Nigeria's health system is characterized by significant inequities: over 47% of the population lives in rural areas, only about 20% of primary health care (PHC) facilities are fully functional. Underserved populations, particularly those in lower wealth quintiles, depend heavily on community pharmacists (CPs) and patent and proprietary medicine vendors (PPMVs) for essential health services. Despite their reach, these providers have historically been excluded from formal health systems, limiting quality assurance, data visibility, and coordinated care. This project aimed to create enabling policy environment, strengthen service quality, expand equitable access to family planning (FP) and PHC services through CPs and PPMVs, aligning with the global call to restore equity-driven health systems. |
|---|---|
| Methodology/Approach | The IntegratE Project (2017-2026) adopted phase implementation strategy across 11 Nigerian states, beginning with Lagos and Kaduna. The approach combined policy reform, capacity building, and implementation science. Key strategies included: supporting the Pharmacists Council of Nigeria (PCN) to design and operationalize the three-tier accreditation system (TSTS); training CPs and PPMVs on FP and PHC service delivery; strengthening supervision through Quality and Integrated Supportive Supervision models; integrating providers into the Community Health Management Information System (CHMIS). Data from routine service delivery and monitoring systems (2018-2025) informed adaptive program improvements. |
| Results | The project trained 863 CPs and 4,677 PPMVs, thereby improving service quality and access. Over 1,023,140 women accessed FP services, with 33% being new users, indicating expanded reach to previously underserved populations. Additionally, 312,558 couple-years of protection were generated, averting 90,025 unintended pregnancies. Beyond FP, 850,000 children under five received PHC services, including malaria treatment, diarrhea management, and pneumonia care. Policy achievements included revision of 2022 TSTS policy to allow expanded FP services, inclusion of CPs/PPMVs in national health data systems, and formal recognition within community health frameworks. |
| Discussion/Conclusion | The IntegratE Project demonstrates that strategically engaging private sector providers can address systemic inequities and expand access to essential health services in fragmented systems. Institutionalizing policy reforms, strengthening provider capacity, and integrating data systems, the model advances a more inclusive, resilient PHC system. Scaling approach nationally offers pathway to reclaim global health equity by ensuring that underserved populations receive quality, accessible, and accountable care. |
| Presenters and Affiliations | Sani Ochepo Society for Family Health (SFH) - Nigeria Emmanuel Odiniya Society for Family Health (SFH) - Sani Ochepo Society for Family Health (SFH) - Nigeria Delafrida ukaga Society for Family Health (SFH) - Nigeria |
