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J Pharm Policy Pract. 2018 Sep 10;11:21. doi: 10.1186/s40545-018-0148-8. eCollection 2018.

Country ownership and sustainability of Nigeria's HIV/AIDS Supply Chain System: qualitative perceptions of progress, challenges and prospects.

Author information

1
West African Postgraduate College of Pharmacists, Lagos, Nigeria.

Abstract

Background:

The emergency response phase to HIV epidemic in Nigeria and other countries saw to the deployment of donors' resources with little consideration for country ownership (CO) and sustainability. The progress that has been made in the fight against the pandemic has however precipitated a paradigm shift towards CO and sustainability. With the decline in donors' funding, countries must continually evaluate their readiness to own and sustain their HIV response especially the supply chain system (SCS) and bridge any observed gaps. This study assessed the current understanding of CO and sustainability of Nigeria's HIV/AIDS SCS, established progress that has been made, identified challenges that may be hampering CO and possible recommendations to address these challenges. It also explored opportunities that the country can leverage on.

Methods:

We conducted a cross sectional descriptive study through semi-structured interview of twelve purposefully selected key informants involved in HIV/AIDS supply chain management. Transcribed qualitative data were analyzed using a thematic approach.

Results:

Among other submissions, respondents acknowledged that CO involves non-government stakeholders. Key CO and sustainability achievements were: development of national strategic plans and policy documents, establishment of coordinating structures, allocation of funds for some logistics activities at the state level and payment of salaries of government staff, institution of pre-service training, use of logistics data for decision making and the unification of the hitherto parallel HIV/AIDS supply chains. Challenges included: inadequate domestic funding, bureaucratic bottlenecks and inadequate manpower at the health facility level. Respondents recommended more political commitment and increased government funding, exploration of alternative sources of funding, improved accountability, effective healthcare workforce planning and local manufacture of HIV commodities. Existing structures and programmes that the country can leverage on included: Nigeria Supply Chain Integration Project, National Health Insurance Scheme and the private sector.

Conclusions:

Nigeria has made some progress towards achieving CO and sustainability. The country however needs to address financial and human resource gaps through innovative resource mobilization and effective workforce planning. As other countries plan for CO and sustainability, it is important to secure political buy-in and adopt a working definition for CO and sustainability while resource mobilization and workforce planning should be prioritized.

KEYWORDS:

Coordinating structures; Country ownership; Health financing; Human resource; Nigeria supply chain integration project; Supply chain system; Sustainability

Conflict of interest statement

Participation in this study was voluntary and participants were free to decline being interviewed. To ensure confidentiality, names of respondents were not mentioned in the final analysis and discussions. Approval for the conduct of this study was obtained from the Federal Capital Territory Health Research Ethics Committee with approval number FHREC/2016/01/55/29–07-16 (see Additional file 5).Not applicable as datasets are not individually identifiable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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