The Role of Research, Quality Improvement, and Training in Achieving Medicines Security in Nigeria: A Cross-Sectional Exploration of Stakeholders' Perspectives.
Adigwe Obi Peter OP, Onavbavba Godspower G, Alabi Toluwalope Folashade TF, Uzuh Nwakaego Rosemary NR
Equitable access to medicines remains a challenge in Nigeria with issues such as sub-optimal national pharmaceutical production capacities and the need to improve relevant quality standards. Thus, in order to identify context-specific solutions to this challenge, this study aimed to assess the perspectives of stakeholders in the healthcare value chain on the role of quality improvement and capacity-building strategies relevant to expediting medicines security in Nigeria. A national cross-sectional survey was conducted in Nigeria using a multistage sampling technique. A pretested questionnaire was administered to relevant stakeholders in the health sector. Descriptive and inferential statistical analyses were undertaken using Statistical Package for Social Sciences (SPSS) software version 25. A total of 416 questionnaires were retrieved. Just over a third of the study participants (37.9%) surveyed were actively employed in the pharmaceutical manufacturing sector. Nearly all the participants (94.8%) believed regulatory authorities should ensure the stringent implementation of Good Manufacturing Practices to sustain consistency in the quality of medicines. Similarly, over three-quarters of the study cohort (86.1%) indicated that the pharmaceutical sector, as well as relevant agencies in the industry, should be prioritised by the government, as this was critical in achieving medicines security. Also, a strong majority of the participants indicated that attaining the World Health Organization pre-qualification status was necessary to ensure access to high-quality medicines. There was a significant association between the participants' sociodemographic characteristics and key study variables. A higher proportion of the respondents with more than 5 years of experience agreed that investment in research and development was important to improve the quality of medicines, and this was statistically significant (p = 0.009). This cross-sectional study highlights strategic areas based on stakeholders' perceptions where interventions and reforms can be channelled to support efforts towards expediting the achievement of medicines security in Nigeria.