PT  - JOURNAL ARTICLE
AU  - Rotimi, Kunle
AU  - Itiola, Ademola Joshua
AU  - Fagbemi, Babatunde Ariyo
AU  - Aiden, Jimmy
AU  - Ibinaiye, Taiwo
AU  - Dabes, Chrysantus
AU  - Okwulu, Andrew
AU  - Oguche, Daniel
AU  - Aidenagbon, Adaeze
AU  - Abubakar, Umar Babuga
AU  - Tukura, Rose
AU  - Mohammad, Danladi Chonoko
AU  - Bewa, Christopher
AU  - Danzaki, Ahmad Muhammad
AU  - Oresanya, Olusola
TI  - Examining Public Sector Availability and Supply Chain Management Practices for Malaria Commodities: Findings From Northern Nigeria
AID  - 10.9745/GHSP-D-22-00547
DP  - 2024 Jun 27
TA  - Global Health: Science and Practice
PG  - e2200547
VI  - 12
IP  - 3
4099  - http://www.ghspjournal.org/content/12/3/e2200547.short
4100  - http://www.ghspjournal.org/content/12/3/e2200547.full
SO  - GLOB HEALTH SCI PRACT2024 Jun 27; 12
AB  - Key FindingsThe persistence of malaria as a leading cause of mortality and morbidity in Nigeria, especially in children aged younger than 5 years, may be related to factors that result in a weak public sector supply chain management (SCM) system.An assessment of malaria commodities availability in 7 states in northern Nigeria found that more than 50% of health facilities in 5 states had stock-outs of malaria rapid diagnostic tests and, in all states, stock-out rates of most artemisinin-based combination therapies were over 50%.The poor availability of these commodities highlights the need to strengthen coordination and supply chain workforce capacity and organization to ensure that SCM best practices and standard procedures are followed consistently.Key ImplicationsLocal and international stakeholders need to invest more in strengthening the public health supply chain, especially at the subnational level, to reduce malaria-related morbidity and mortality among children aged younger than 5 years in Nigeria.The logistics management coordination units should be adequately funded to enhance their effectiveness and improve commodity management.Using 3PL service providers for distribution could improve commodity availability and should be encouraged where it is deemed sustainable, given the funding and oversight capacity requirements.Background:Nigeria accounts for substantial proportions of global malaria infections and deaths, with children aged younger than 5 years being the most affected group. This suggests that access to lifesaving malaria interventions could be suboptimal, especially at public health facilities where most rural dwellers seek health care. We conducted this study to ascertain if public health facilities have the commodities and the robust supply chain management (SCM) system required to deliver malaria interventions to children younger than 5 years.Method:We conducted a cross-sectional survey in 1,858 health facilities across 7 states in Nigeria. Using structured questionnaires, we assessed the availability of selected malaria commodities required by children aged younger than 5 years. We also interviewed health workers to evaluate other core SCM activities.Result:More than 50% of health facilities in 5 states were stocked out of malaria rapid diagnostic tests (mRDTs), and stock-out rates for artemisinin-based combination therapies (ACTs) were over 50% for almost all assessed ACTs across all states. The percentage of health facilities that received malaria commodities within the recommended lead time was below average across most states (71%). States with a higher percentage of health workers who were aware of and placed orders following the national reporting timeline and those that delivered commodities to the last mile predominantly through third-party logistics service providers tended to have higher availability of mRDTs and artemether/lumefantrine combinations. The top 2 logistics challenges were insecurity and inadequate funding.Conclusion:The availability of lifesaving malaria commodities across the health facilities visited was suboptimal, possibly due to several SCM challenges. The results from this study underscore the urgent need to implement effective interventions to address the observed gaps. This will contribute to reducing malaria morbidity and mortality among children aged younger than 5 years in Nigeria.