Perceptions of patent and proprietary medicine vendors and communities of the tiered accreditation programme for family planning services in Lagos and Kaduna states, Nigeria

Figures & data

Figure 1. The conceptual framework.

Figure 2. The study model using χ2 association analysis.

Figure 3. The study model using structural equation modelling (SEM)-designed path analysis (A_M_S; Average monthly sales in 2021, SFP; Sales from FP services, CSFP; Revenue increase, PMI; Percentage increase in sales in 2021, HQ; Health qualification, and OP_line; Years of operation).

Figure 4. Ground theory approach to theme development.

Table 1. PPMV’s demographic characteristic.

Characteristics	Pilot PPMVs n = 224
Gender
Female	130 (58.0)
Male	94 (42.0)
Years of Operation		Male (%)	Female (%)
1–5 years	60 (26.7)	14 (14.9)	46 (35.4)
5y-10 years	75 (33.5)	32 (34.0)	43 (33.1)
>10 years	89 (39.7)	48 (51.1)	41 (31.5)
Educational level and Tier level
Health Qualification	97 (43.3%)	50 (38.5)	58 (61.7)
Non-Health Qualification	127 (56.7%)	80 (61.5)	36 (38.3)
Tier 1	97 (43.3%)	53 (54.6)	44 (45.4)
Tier 2	120 (53.6%)	41 (34.2)	79(65.8)
Tier 3	7 (3.1%)	0 (0.0)	7 (100.0)
**Family Planning Service Provision
Injectables	130 (58.0%)
Implants	108 (48.2%)
Condoms	215 (96.0%)
Cyclebeads	47 (21.0%)
Contraceptive pills	217 (96.9%)
Counselling	196 (87.5%)

**Multiple answer observation; PPMV, patent and proprietary medicine vendors.

Table 2. Programme-related outcomes (return on investment).

Outcomes	No. of PPMVs N = 224 (%)
Drivers for change in business revenue
Which of these do you think is responsible for your increase in revenue?
Malaria management	143 (64%)
Family planning	47 (21%)
Business training	22 (10%)
Pain relief management	9 (4%)
First aid	2 (1%)
Perceived monetary benefits
What was your average monthly sales in 2021?
10000–50000 naira	105 (46.9%)
50000–100000 naira	60 (26.8%)
100000–250000 naira	38 (16.9%)
>250000 naira	21 (9.4%)
How much did your business revenue increase?
<50%	90 (40%)
50–100%	130 (58%)
>100%	4 (2%)
What proportion of sales was family planning?
0–10000 naira	118 (52.7%)
10000–50000 naira	80 (35.7%)
50000–100000 naira	22 (9.8%)
>100000 naira	4 (1.7%)
How has your revenue margin increased since joining the accreditation programme?
Great extent	43 (19.2%)
To Some extent	64 (28.6%)
Very little	71 (31.7%)
Not at all	46 (20.5%)
What is the effect of planning service provision on your client flow?
Strong negative	2 (0.9%)
Moderately negative	7 (3.1%)
No change	88 (39.3%)
Moderately positive	59 (26.3%)
Strong positive	68(30.4%)
How would you describe the contribution of sales from family planning to your revenue?
Great extent	38 (17%)
To Some extent	102 (45.5%)
Very little	79 (35.3%)
Not at all	5 (2.2%)
Perceived non-monetary benefits
What non-monetary benefit or value did the accreditation add to your business?
Access to quality products	123 (54.9%)
Increased patronage/customer base	157 (70.1%)
Recognition by NAPPMED/PCN	113 (50.4%)
Increased stock	154 (68.8%)
Perceived usefulness
**What aspect(s) of the accreditation did you find the most useful?
Business improvement	206 (92.0)
Training of FP service provision	198 (88.4%)
Recognition by PCN/NAPPMED	126 (56.3%)
Branding	105 (46.9%)
Business training	94 (41.9%)
Willingness to pay for the accreditation programme
Will you be willing to continue with the accreditation programme?
No	6 (2.7%)
Yes	218 (97.3%)
Will you be willing to pay to continue the accreditation programme?
No	56 (25.0%)
Yes	168 (75.0%)
How much are you willing to pay for the accreditation programme?
0–5000 naira	11 (6.5%)
5000–14900 naira	94 (56.0%)
15000–24,900 naira	8 (4.7%)
25000–35000 naira	25 (14.9%)
>35,000 naira	30 (17.9%)

**Multiple answer observation.

FP, family planning; NAPPMED, National Association of Patent and Proprietary Medicines; PCN, Pharmacy Council of Nigeria; PPMV, patent and proprietary medicine vendors

Table 3. The association between indicators of usefulness and non-monetary benefits and the willingness to be accredited.

			Accreditation willingness
Variables	Indicators	Yes/No	Yes (%)	No (%)	Chi-square	P-value
Usefulness
	Business improvement	Yes	203 (93.1)	3 (50)	9.436	0.002
		No	15 (6.9)	3 (50)
	Branding of premises	Yes	102 (46.8)	3 (50)	0.000	1.000
		No	116 (53.2)	3 (50)
	Training on FP service provision	Yes	194 (89.0)	4 (66.7)	1.078	0.299
		No	24 (11.0)	2 (33.3)
	Registration with PCN	Yes	95 (43.6)	3 (50.0)	0.000	1.000
		No	123 (56.4)	3 (50.0)
Non-monetary benefit
	Business training	Yes	92 (42.2)	2 (33.3)	0.000	0.988
		No	126 (57.8)	4 (66.7)
	Access to quality products	Yes	120 (55.0)	3 (50.0)	0.000	1.000
		No	98 (45.0)	3 (50.0)
	Increased patronage/customer base	Yes	154 (70.6)	3 (50.0)	0.406	0.524
		No	64 (29.4)	3 (50.0)
	Recognition by NAPPMED or PCN	Yes	110 (50.5)	5 (83.3)	1.487	0.223
		No	5 (83.3)	1 (16.7)
	Increased stock	Yes	150 (68.8)	4 (66.7)	0.000	1.000
		No	68 (31.2)	2 (33.3)

FP, family planning; NAPPMED, National Association of Patent and Proprietary Medicines; PCN, Pharmacy Council of Nigeria.

Table 4. The association between indicators of usefulness and non-monetary benefits and willingness to pay for the accreditation.

Variables			Willingness to pay
	Indicators	Yes/No (%)	Yes	No	Chi-square	P-value
Usefulness
	Business improvement	Yes	157 (93.5)	49 (87.5)	1.289	0.256
		No	11 (6.5)	7 (12.5)
	Branding of premises	Yes	81 (48.2)	24 (42.9)	0.293	0.588
		No	87 (51.8)	32 (57.1)
	Training on FP service provision	Yes	152 (90.5)	46 (82.1)	2.089	0.148
		No	16 (9.5)	10 (17.9)
	Registration with PCN	Yes	100 (59.5)	26 (46.4)	2.419	0.120
		No	68 (40.5)	30 (53.6)
Non-monetary benefit
	Business training	Yes	74 (44.0)	20 (35.7)	0.880	0.348
		No	94 (56.0)	36 (64.3)
	Access to quality products	Yes	103 (61.3)	20 (35.7)	10.103	0.001
		No	65 (38.7)	36 (64.3)
	Increased patronage/customer base	Yes	121 (72.0)	36 (64.3)	0.859	0.354
		No	47 (28.0)	20 (35.7)
	Recognition by NAPPMED or PCN	Yes	94 (56.0)	19 (33.9)	7.292	0.007
		No	74 (44.0)	37 (66.1)
	Increased stock	Yes	125 (74.4)	29 (51.8)	8.977	0.003
		No	43 (25.6)	27 (48.2)

FP, family planning; NAPPMED, National Association of Patent and Proprietary Medicines; PCN, Pharmacy Council of Nigeria.

Figure 5. Path model (standardised regression coefficients) and analysis of association.

Figure 6. The value of PPMVs as family planning (FP) service provider to the community.

Figure 7. Barriers to uptake family planning (FP) services.