A cross-sectional assessment of expanding basic healthcare services to rural and underserved communities through proprietary patent medicine vendors in Northern Nigeria

The poor health indices in Nigeria are widely reported to be fueled by an acute shortage of skilled medical personnel. Opinions are converging that Proprietary and Patent Medicine Vendors (PPMVs) can bridge this human resource for health gaps. This study therefore aimed to assess the acceptability, appropriateness, and feasibility of providing expanded basic health services among the skilled health workers operating PPMVs in underserved communities in Northern Nigeria states. This is a cross-sectional study of all the 220 PPMVs operated by skilled health workers in underserved communities of six randomly selected Local Government Areas in Jigawa state) and Kaduna State from July to October 2022). Statistical significance was determined at P<0.05. Of the 220 respondents surveyed, 77% are males; the median age was 33 years (IQR = 9). More than half (52.3%) were community health extension workers, and 16.4% are nurses/midwives. The median scores (with IQR) for Acceptability, Appropriateness, and Feasibility were 18 (16), 17 (15), and 17 (15), respectively. We reported that PPMVs of tribes other than Hausa, Fulani or Kanuri; operating their shops in the evening or morning or possessed positive behavioral control expressed lower acceptability (P< 0.05). Operating in Kaduna State and perceived negative behavioral control were significantly associated with lower appropriateness measure(P<0.01). PPMVs operating below 24 hours had higher appropriateness (P<0.01). PPMVs operating below 24 hours and perceived negative behavioral control had lower feasibility scores. Our Study findings suggests that there is significant potential for medically trained PPMVs operating in underserved communities in Northern Nigeria to contribute to bridging the gap in access to basic health services in hard-to-reach areas.