Comparative analysis of private retail community pharmacies' participation in the national health insurance scheme of Nigeria and Ghana: implications for access to essential medicines

BACKGROUND: Frequent stock-out of drugs in the public hospitals causes National Health Insurance Scheme (NHIS) enrollees to purchase most of their medicines out-of-pocket in community pharmacies, thereby imposing financial constraints on them against the main objective of the scheme. The objectives of this study were to determine and compare the level of participation of private retail community pharmacies (PRCPs) in the NHIS of Nigeria and Ghana, to describe their spatial distribution, and to highlight from literature major factors that would influence the participation of these pharmacies in the scheme. METHODS: PRCPs data were collected from the Nigerian NHIS active secondary healthcare providers list of 1st July 2017 and the Ghanaian NHIS active providers online list of 2018. PRCPs densities at the national levels were calculated from last published national coverage data for each country. RESULTS: The total number of PRCP accredited by NHIS of both Nigeria and Ghana is 964(639[66.3% versus 325[33.7%]). NHIS accredited PRCPs densities for Nigeria and Ghana were 1 PRCP per 9, 390 enrollees and 1 PRCP per 33, 108 enrollees respectively. Across the Nigerian States, it was noted that Lagos State has the highest proportion (21.4%, n = 137) of community pharmacy participation in the scheme whereas, in Ghan, Greater Accra Region has the highest participation (34.2%, n = 111). CONCLUSION: This study revealed low participation of PRCPs and skewed spatial distribution between urban and rural areas of both countries, although there was higher participation of these pharmacies in Nigeria due to Nigerian lower NHIS coverage data compared to Ghana

Public Perception of Community Pharmacists in South Africa : Primary Study

This survey forms part of a study undertaken to identify and quantify the community pharmacist's involvement in the use of non-prescription/over-the-counter (OTC) medicine /self-medication in community pharmacies throughout South Africa. The objectives of this study were to establish the public's perception of the role of and the value added by community pharmacists in the treatment of minor ailments. A survey was conducted amongst 300 consumers prior to the recent changes and introduction of new legislation affecting pharmaceutical care and the dispensing of medicine. The major finding of this study was that the majority of consumers who consulted community pharmacists were satisfied with the comprehensiveness of the counselling and the effectiveness of the treatment provided. A large majority of the participants agreed that community pharmacists play a positive role and add value. It was found that the main reason for visiting a specific pharmacy was the proximity of that pharmacy

Community participation

One of the criteria of the Bamako Initiative for selecting participating districts is ability of district level management to assist communities mobilize and utilize resources for health i.e. the community should be in a position to receive a consignment of basic essential drugs and store them securely. From the sale of the drugs; they should recover fully the cost of the drug and realize a small profit that would be used to finance other primary health care activities. However it often happens that communities take it upon themselves to organize funding activities to buy essential drugs and finance other health activities as demonstrated by the inhabitants of Cape Verde

Factors contributing to shortage of essential drugs in health centres of the southern region; Malawi; 1989

Results of the study have shown that there is actually an overconsumption of tablets of chloroquine; mebendazole; sulphadimidine and ferrous sulphate but under supply of penicillin to health centres which clearly reject assumptions and claims that essential drugs are supplied in small quantities to health centres. If there are shortages in health centres in the southern region; the shortages could be due to irrational use of drugs