Collaborative design of a care pathway for pharmacy-based PrEP delivery in Nigeria: insights from stakeholder consultation
Abstract Background HIV remains a significant public health problem, particularly in Africa, where two-thirds of global cases occur. Nigeria is among the three countries with the highest burden. Despite free access to pre- and post-exposure prophylaxis (PrEP and PEP) in Nigerian hospitals, stigma, d...
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BMC
2024-12-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-024-12107-4 |
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| author | Obinna I. Ekwunife Theodora C. Omenoba Ugochi Eyong Valentine Okelu Michael Alagbile Ifeanyi Ume Ambrose Eze Aderinola Fisayo Gloria Aidoo-Frimpong Farah Shroff Chimezie Anyakora |
| author_facet | Obinna I. Ekwunife Theodora C. Omenoba Ugochi Eyong Valentine Okelu Michael Alagbile Ifeanyi Ume Ambrose Eze Aderinola Fisayo Gloria Aidoo-Frimpong Farah Shroff Chimezie Anyakora |
| author_sort | Obinna I. Ekwunife |
| collection | DOAJ |
| description | Abstract Background HIV remains a significant public health problem, particularly in Africa, where two-thirds of global cases occur. Nigeria is among the three countries with the highest burden. Despite free access to pre- and post-exposure prophylaxis (PrEP and PEP) in Nigerian hospitals, stigma, distance, and restrictive clinic hours hinder uptake, especially among vulnerable populations. Building on the successful pilot implementation of pharmacy-based PrEP delivery in Kenya, we engaged Nigerian stakeholders in adapting the model, addressing user and provider concerns to ensure effective implementation in Nigeria. Methods The stakeholder meeting took place in Abuja, Nigeria, which is selected for its central location and accessibility to various stakeholders, particularly those involved in HIV prevention efforts. The participants were purposefully selected to ensure diverse representations, including youth who are potential PrEP users, pharmacy providers, regulators, and representatives from civil society organizations. The meeting utilized the Nominal Group Technique (NGT)—a structured method for facilitating group decision-making and prioritizing ideas—to adapt the Kenyan pharmacy-delivered PrEP model for implementation in the Nigerian context. Mock role play was conducted to help participants understand the care pathway. The discussions culminated in identifying challenges and viable strategies for implementing the model in Nigeria. Results The one-day stakeholder meeting on 9 October 2024 was attended by 20 participants from various sectors involved in HIV prevention services. Stakeholders expressed enthusiasm for pharmacy-based PrEP delivery while acknowledging challenges associated with clinic-based services, such as stigma, limited hours, and long wait times. The key recommendations included training pharmacy providers, increasing awareness, ensuring confidentiality, establishing referral linkages, and integrating program data into the Health Management Information System (HMIS) as well as ensuring commodity availability and access. To enhance the success of the pilot study, stakeholders proposed engaging a research assistant, forming a monitoring team, and submitting the results to the Pharmacy Council of Nigeria (PCN) for review. Conclusions The identified challenges and strategies for implementing the model in Nigeria will inform the development of a refined pharmacy-delivered PrEP framework that is ready for pilot testing and potential scaling across the country. |
| format | Article |
| id | doaj-art-2294d97348b449ee80478e474e986315 |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | BMC Health Services Research |
| spelling | doaj-art-2294d97348b449ee80478e474e9863152025-01-19T12:15:28ZengBMCBMC Health Services Research1472-69632024-12-0124111010.1186/s12913-024-12107-4Collaborative design of a care pathway for pharmacy-based PrEP delivery in Nigeria: insights from stakeholder consultationObinna I. Ekwunife0Theodora C. Omenoba1Ugochi Eyong2Valentine Okelu3Michael Alagbile4Ifeanyi Ume5Ambrose Eze6Aderinola Fisayo7Gloria Aidoo-Frimpong8Farah Shroff9Chimezie Anyakora10Division of Population Health, Department of Medicine, University at BuffaloDepartment of Clinical Pharmacy and Pharmacy Management, Veritas UniversityBloom Public HealthDepartment of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe UniversitySociety for Family HealthBloom Public HealthAssociation of Community Pharmacists of NigeriaPharmacy Council of NigeriaDepartment of Epidemiology and Environmental Health, University at BuffaloFaculty of Medicine, The University of British ColumbiaBloom Public HealthAbstract Background HIV remains a significant public health problem, particularly in Africa, where two-thirds of global cases occur. Nigeria is among the three countries with the highest burden. Despite free access to pre- and post-exposure prophylaxis (PrEP and PEP) in Nigerian hospitals, stigma, distance, and restrictive clinic hours hinder uptake, especially among vulnerable populations. Building on the successful pilot implementation of pharmacy-based PrEP delivery in Kenya, we engaged Nigerian stakeholders in adapting the model, addressing user and provider concerns to ensure effective implementation in Nigeria. Methods The stakeholder meeting took place in Abuja, Nigeria, which is selected for its central location and accessibility to various stakeholders, particularly those involved in HIV prevention efforts. The participants were purposefully selected to ensure diverse representations, including youth who are potential PrEP users, pharmacy providers, regulators, and representatives from civil society organizations. The meeting utilized the Nominal Group Technique (NGT)—a structured method for facilitating group decision-making and prioritizing ideas—to adapt the Kenyan pharmacy-delivered PrEP model for implementation in the Nigerian context. Mock role play was conducted to help participants understand the care pathway. The discussions culminated in identifying challenges and viable strategies for implementing the model in Nigeria. Results The one-day stakeholder meeting on 9 October 2024 was attended by 20 participants from various sectors involved in HIV prevention services. Stakeholders expressed enthusiasm for pharmacy-based PrEP delivery while acknowledging challenges associated with clinic-based services, such as stigma, limited hours, and long wait times. The key recommendations included training pharmacy providers, increasing awareness, ensuring confidentiality, establishing referral linkages, and integrating program data into the Health Management Information System (HMIS) as well as ensuring commodity availability and access. To enhance the success of the pilot study, stakeholders proposed engaging a research assistant, forming a monitoring team, and submitting the results to the Pharmacy Council of Nigeria (PCN) for review. Conclusions The identified challenges and strategies for implementing the model in Nigeria will inform the development of a refined pharmacy-delivered PrEP framework that is ready for pilot testing and potential scaling across the country.https://doi.org/10.1186/s12913-024-12107-4Stakeholder analysisDifferentiated service deliveryHIV preventionPreexposure prophylaxisNigeriaCommunity pharmacies |
| spellingShingle | Obinna I. Ekwunife Theodora C. Omenoba Ugochi Eyong Valentine Okelu Michael Alagbile Ifeanyi Ume Ambrose Eze Aderinola Fisayo Gloria Aidoo-Frimpong Farah Shroff Chimezie Anyakora Collaborative design of a care pathway for pharmacy-based PrEP delivery in Nigeria: insights from stakeholder consultation BMC Health Services Research Stakeholder analysis Differentiated service delivery HIV prevention Preexposure prophylaxis Nigeria Community pharmacies |
| title | Collaborative design of a care pathway for pharmacy-based PrEP delivery in Nigeria: insights from stakeholder consultation |
| title_full | Collaborative design of a care pathway for pharmacy-based PrEP delivery in Nigeria: insights from stakeholder consultation |
| title_fullStr | Collaborative design of a care pathway for pharmacy-based PrEP delivery in Nigeria: insights from stakeholder consultation |
| title_full_unstemmed | Collaborative design of a care pathway for pharmacy-based PrEP delivery in Nigeria: insights from stakeholder consultation |
| title_short | Collaborative design of a care pathway for pharmacy-based PrEP delivery in Nigeria: insights from stakeholder consultation |
| title_sort | collaborative design of a care pathway for pharmacy based prep delivery in nigeria insights from stakeholder consultation |
| topic | Stakeholder analysis Differentiated service delivery HIV prevention Preexposure prophylaxis Nigeria Community pharmacies |
| url | https://doi.org/10.1186/s12913-024-12107-4 |
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