The Society for Family Health has urged governments at all levels to adopt and sustain community-based healthcare initiatives that leverage the services of community pharmacists and Patent and Proprietary Medicine Vendors to expand access to primary healthcare.
The Group Managing Director of SFH, Dr Omokhudu Idogho, represented by the Finance Director of the IntegratE Project, Julius Abayomi, made the call in Gombe during the IntegratE 2.0 project closeout and dissemination meeting.
The project was implemented by SFH in partnership with the Pharmaceutical Council of Nigeria, Population Council, PSN Foundation, An-Impact and Ask Nivi, with funding support from the Gates Foundation, in collaboration with the Gombe State Ministry of Health.
Idogho said the IntegratE 2.0 project was designed as a follow-up to IntegratE 1.0, which began in 2017 as a proof of concept in Kaduna and Lagos states.
He said, “IntegratE 2.0 is a follow-on to IntegratE 1.0. The project started in 2017 as a proof of concept in two states; Kaduna and Lagos.
“By the time the empirical evidence from IntegratE 1.0 became available, we had discussions with the donor, which eventually resulted in the approval of IntegratE 2.0 and its expansion to nine additional states, including Gombe State.”
According to him, the additional states were implemented in phases, with Gombe joining the programme in 2022.
He explained that while the first phase focused mainly on family planning, IntegratE 2.0 expanded its scope to include primary healthcare services.
“In IntegratE 1.0, our focus was primarily on family planning. However, with the second phase, we expanded the scope to include primary healthcare. This covers a range of services, particularly for children under five, including the treatment of pneumonia and malaria, as well as other common health conditions,” he said.
Idogho said the project had demonstrated the capacity of community-based healthcare providers to complement government efforts when properly trained, supervised and regulated.
“The project has demonstrated that if community-based healthcare providers, including pharmacists and Patent and Proprietary Medicine Vendors, are properly trained, monitored, supervised and regulated, they can play a significant role in delivering quality healthcare services within communities,” he said.
He called on the government to utilise the evidence generated by the project in designing and implementing health policies, particularly through task shifting and task sharing.
“For now, what we are using this forum to do is to present the empirical data we have generated so that the government is aware that this set of manpower exists within society and can be utilised.
“Through what we call task shifting and task sharing, government can delegate some health services to this level of care. This will enable us to strengthen and move forward our health programmes within communities,” he said.
Idogho stressed that government ownership would be critical to sustaining the gains recorded under the donor-funded initiative
“This is a donor-funded initiative, with support from the Gates Foundation. However, donor resources cannot continue forever.
“It is only when government takes ownership of initiatives like this and bases its policies and programmes on empirical evidence generated from projects that we can sustainably improve the health system, particularly at the community level,” he said.
Data presented at the meeting showed that about 247,000 people were reached in Gombe State through the programme, while more than 56,000 women accessed family planning services under IntegratE 2.0.
Idogho urged stakeholders to ensure that the skills acquired by participating healthcare providers were sustained beyond the life of the project.
“The essence of what we have done today is to recognise these people and encourage them to continue building on the gains achieved through the project.
“Whatever skills we have developed will be lost if they are not continuously practised. If we do not sustain the activities, providers can lose their skills and eventually become demotivated,” he said.
He added that creating the right environment for community-based providers would strengthen healthcare delivery at the grassroots.
“If the right environment is created, I am very sure this set of community-based providers can go a long way in strengthening our healthcare delivery system,” he said.
Also speaking, the Registrar of the Pharmacy Council of Nigeria, Pharm. Ibrahim Ahmed, represented by Pharm. Fisayo Aderinola, said the council’s collaboration with the IntegratE Project had produced significant milestones in the regulation and delivery of community-based pharmaceutical services.
Ahmed said the partnership, which began with the signing of a Memorandum of Collaboration in 2018 and was renewed in 2023, provided an opportunity to pilot and strengthen the Three-Tier Accreditation System, known as 3TAS.
He said, “Through this partnership, the Council has had the opportunity to test, refine, and strengthen the 3-Tier Accreditation System, alongside efforts to integrate, expand, and improve the quality of family planning and basic primary healthcare services provided through Community Pharmacists and PPMVs across ten project states, including Gombe State.”
According to him, more than 4,000 PPMVs and over 800 community pharmacists were trained across the participating states in standard family planning and integrated community case management practices.
“The results of this collaboration are significant as across these states, more than 4,000 PPMVs and over 800 Community Pharmacists have been trained in standard family planning and integrated community case management practices,” he said.
He added that the project had strengthened institutional systems and generated evidence to support policy and regulatory decisions, while innovative supervision approaches such as the Hub and Spoke model were also explored.
Ahmed noted that interest in the initiative had extended beyond Nigeria, with learning engagements involving Uganda and Kenya.
He, however, stressed that sustaining and expanding the Three-Tier Accreditation System would require continued collaboration among the PCN, state ministries of health, implementing partners and other stakeholders.
“As we reflect on these achievements, it is important to recognise that the sustainability and wider adoption of the 3-Tier Accreditation System will require continued collaboration,” he said.
Ahmed described the conclusion of the IntegratE Project as a transition rather than an endpoint, urging stakeholders to preserve the systems, evidence and lessons generated through the programme.
“The conclusion of the IntegratE Project therefore marks not an endpoint, but a transition. It presents an opportunity for us to consolidate what has been achieved, preserve the lessons and systems that have been built, and ensure that the gains in regulatory strengthening, access to quality products and services, and stakeholder confidence are carried forward,” he said.
He commended the project team, the Gombe State Ministry of Health, community pharmacists, PPMVs and other partners for their contributions to the initiative.
Ahmed said the relationships and systems developed through the collaboration would provide a foundation for further strengthening community-based pharmacy services and regulatory systems in Nigeria.