Response of patent medicine vendors in rural areas of Lagos state Nigeria to antimalarial policy change

Background: Patent medicine vendors (PMVs) play an important role in the treatment of malaria, especially in the rural areas. Nigeria recently changed her antimalarial treatment policy from chloroquine to artemisinin-based combination therapy (ACT).
Objectives: To determine the response of PMVs to the new policy.
Methods: A baseline study was conducted in two local government areas (LGAs) of Lagos state Nigeria as the first phase in an intervention study aimed at improving the malarial treatment practices of PMVs in rural Lagos. A mixed method design involving a questionnaire survey of 180 PMVs and four key informant interviews were used. An antimalarial drug (AMD) audit was also performed.
Results: More than 80% of respondents were aware of the policy change in malaria treatment, but only 23.9% sold an ACT for the last case of malaria treated in an under five child. The main determining factor of the particular AMD sold was PMV’s personal choice (70.6%). About half (58.9%) of the shops stocked ACTs, the newly recommended antimalarials.
Conclusions: The high awareness of the policy change did not translate to a commensurate increase in the sale of the new drugs. Factors beyond the PMVs need to be addressed for a successful adoption of the new policy.

Keywords
Patent Medicine Vendors; ACTs; policy change; malaria; artemisinin monotherapies; non-artemisinin therapies