ArticleBMJ open2022
Stakeholder perspectives on the demand and supply factors driving substandard and falsified blood pressure lowering medications in Nigeria: a qualitative study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Trial
- Stakeholder Perceptions on Innovative Private Pharmacy Distribution Channels and Implications for Medicine Quality in Zambia: A Qualitative Study.Global health, science and practice · 2026Article
- Design and implementation of a drug revolving fund for hypertension treatment in primary care setting of the Federal Capital Territory, Nigeria.BMJ global health · 2025Article
- Factors influencing primary health care service provision to older adults in lagos, nigeria: understanding the experiences of the demand population.BMC public health · 2025Article
- Inequities in Household Out-Of-Pocket Spending Among Urban Slum Dwellers in Southeast Nigeria.International journal of public health · 2025Article
- Perceptions and practices on substandard and falsified medicines in humans and animals in Wakiso district, Uganda: A qualitative study.PloS one · 2025Article
- Evaluating diabetes care in primary healthcare centers in Abuja, Nigeria: a cross-sectional formative assessment.BMC primary care · 2024Article
- Evaluation of Primary Healthcare Centers' Service Availability and Readiness for Implementing Diabetes Care in Abuja, Nigeria: A Cross-Sectional, Formative Assessment.Research square · 2024Article
- The role of pharmacists in eliminating counterfeit medicines in Nigeria.Frontiers in public health · 2023Article
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Authors and funding
11 authors.
Funding
Abstract
objectivesAlthough substandard and falsified (SF) blood pressure (BP) lowering medications are a global problem, qualitative research exploring factors driving this in Nigeria has not been reported. This study provides information on factors driving demand for and supply of low-quality BP lowering medications in Nigeria and potential strategies to address these factors.
methodsThis was a cross-sectional qualitative study. Between August 2020 and September 2020, we conducted 11 in-depth interviews and 7 focus group discussions with administrators of health facilities, major manufacturers and distributors of BP lowering medications, pharmacists, drug regulators, patients and primary care physicians purposively sampled from the Federal Capital Territory, Nigeria. Data were analysed using directed content analysis, with the aid of Dedoose.
resultsWe found that demand for SF BP lowering medications in Nigeria was driven by high out-of-pocket expenditure and stockouts of quality-assured BP lowering medications. Supply of low-quality BP lowering medications was driven by limited in-country manufacturing capacity, non-adherence to good manufacturing and distribution practices, under-resourced drug regulatory systems, ineffective healthcare facility operations, poor distribution practices, limited number of trained pharmacists and the COVID-19 pandemic which led to stockouts. Central medicine store procurement procedures, active pharmaceutical ingredient quality check and availability of trained pharmacists were existing strategies perceived to lower the risk of supply and demand of SF BP lowering medications.
conclusionOur findings suggest that demand for and supply of SF BP lowering medications in Nigeria are driven by multi-level, interrelated factors. Multi-pronged strategies need to target stakeholders and systems involved in drug production, distribution, prescription, consumption, regulation and pricing.
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