Policy and regulatory gaps influencing antimicrobial dispensing in urban slums of Ebonyi state Nigeria

Abstract In Nigeria’s underserved areas, weak regulatory oversight of informal healthcare providers particularly patent medicine vendors (PMVs) allows the sale and inappropriate dispensing of antimicrobials to persist. This study examined how PMVs and policymakers perceive regulatory gaps, barriers to compliance, and factors influencing adherence in urban slum settings. The research team conducted a qualitative study guided by institutional theory in three urban slums in Ebonyi State, Nigeria. The team collected data through 10 key informant interviews with regulatory and health officials and community leaders and 12 in-depth interviews with PMVs. The research team analysed transcripts thematically using NVivo version 15. Participants identified the Pharmacy Council of Nigeria, NAFDAC, and NDLEA as key oversight bodies regulating antimicrobial dispensing among PMVs. Limited resources, open drug markets, and institutional constraints weakened enforcement, while poverty and entrenched cultural practices hindered PMV compliance.