Community pharmacies in Nigeria are registered as private pharmaceutical premises. In 2014, there were 530 registered pharmacies in the capital city of Abuja. In this model, ART refill services are decentralized by referring clients who were established on ART from public ART hospitals to community pharmacies, to collect their ART refills. These clients take a referral document and prescription to their preferred pharmacy, where their ART refills are dispensed bimonthly for a small fee paid by the client. Clients attend 6-monthly clinical consultations at the public hospital. Clients observed to be unwell are immediately referred back for medical assessment. The community pharmacies are also provided with leadership and management services aimed at maintaining good relationships with patients.
Impact: In total, 375 clients were successfully decentralized from 14 public hospitals to 26 community pharmacies between February 2016 and May 2017. Prescription refill was 100% and almost all participants (99.7%) were retained in care. This model has now been scaled from Abuja to three more Nigerian states – Kano, Nasarawa and Katsina – with 64 registered pharmacies providing ART refills to 5,017 clients by mid-March 2019. There are plans for further expansion to the southern part of the country, starting with River State
Eligibility
More than six months on ART, virally suppressed and on first-line ART regimens
Building Blocks
ART refills
What
ART and cotrimoxazole refills
Brief symptom /adverse events screen
Adherence check
Ensure attendance for clinical consultation on due date
When
2 monthly
(3 monthly in cases of frequent travel)
Where
Community pharmacy
Who
Community pharmacist
Clinical consultation
What
Clinical assessment
Laboratory investigations (viral load)
Rescripting
When
6 monthly
Where
Health facility
Who
Doctor
Further reading
Interested in Prioritizing differentiated ART delivery for clinically stable clients in West and Central Africa? Read more here (English) or here (French).
Access our policy brief for differentiated ART delivery for clinically stable clients in West and Central Africa here (English) or here (French).
Learn more about another West and Central African DSD intervention: “Community-based points of ART distribution (PODI) in the DRC” here.
Learn more about another West and Central African DSD intervention: “ART refills through clubs in Côte d’Ivoire” here.
Learn more about another West and Central African DSD intervention: “Differentiated ART delivery for key populations: Providing ART to clinically stable men who have sex with men in Ghana” here.
