Nigeria

Key research question:

Are there new types of regulatory partnership in Nigeria that could enable poor people to obtain safe and effective treatment for Malaria?

Members of the Nigeria research team

Nigeria is the 13th poorest country in the world with 70% living in poverty and 37.5% living in extreme poverty. This level of poverty affects everything from social cohesion and security to health. Malaria is a major cause of mortality and ill-health in Nigeria and has huge consequences for the productivity of the country. Many health systems in Nigeria have become increasingly pluralistic and poor people are faced with a confusing myriad of health providers and drug sellers. Old barriers between private and public, modern and traditional and formal and informal health providers are breaking down.

The recent systematic reviews of government health policies have shown the government’s determination to use research evidence to address the challenges of poverty. The government is targeting Malaria as a way of reducing poverty. This is a key approach in addressing the first millennium development goal (MDG) ‘Eradicate extreme poverty and hunger’ and is highly relevant to a number of other MDG indicators such as the infant and maternal mortality rates.

Medicine shop owner in Nigeria displays poster for prepackaged antimalarial drugs in child doses

As part of ‘Future Health Systems’ the University of Ibadan in Nigeria is conducting an exploratory and cross-sectional study. This will be carried out in four (two urban and two rural) randomly selected Local Government Areas (LGAs) in Oyo State.

This study will ask the following questions:

• What is the nature of poverty and vulnerability within the targeted population and how is it affected by malaria?
• What are the concerns of poor people about malaria treatment? Is it low quality drugs or a lack of access to reliable information about treatment?
• What is the evidence to show the effectiveness of interventions aimed at improving the knowledge of poor people and assisting them in understanding and exercising their entitlements and rights in health and other sectors?
• Who are the major suppliers of anti-malaria drugs to poor people in these areas and how do these suppliers operate? Do they provide access to relevant information? Are they regulated? Are they a part of local networks and associations?
• What do national and local stakeholders understand about patent medicine vendors (PMVs), how can we work on an intervention aimed at reducing the risks of PMVs supplying ineffective drugs and how can we increase the knowledge of PMVs and local people about appropriate drug treatment for malaria?
• What sort of innovations can work for the poor to address the problems of access to and use of low quality anti-malarial drugs? The aim would be to reduce wasted expenditure on ineffective drugs and instead channel income into improving health.

The findings of this scoping study will be used to inform the designing of an appropriate intervention that would address the problems of malaria which disproportionately affects the poor.