Comparative Analysis of Private Retail Community Pharmacies’ Participation in the National Health Insurance Scheme of Nigeria and Ghana Implications for Access to Essential Medicines

Abstract

BACKGROUND: Frequent stock-out of drugs in the publichospitals causes National Health Insurance Scheme (NHIS)enrollees to purchase most of their medicines out-of-pocket incommunity pharmacies, thereby imposing financial constraints onthem against the main objective of the scheme. The objectives ofthis study were to determine and compare the level of participationof private retail community pharmacies (PRCPs) in the NHIS ofNigeria and Ghana, to describe their spatial distribution, and tohighlight from literature major factors that would influence theparticipation of these pharmacies in the scheme.

METHODS: PRCPs data were collected from the Nigerian NHISactive secondary healthcare providers list of 1 st July 2017 and theGhanaian NHIS active providers online list of 2018. PRCPsdensities at the national levels were calculated from last publishednational coverage data for each country.
RESULTS: The total number of PRCP accredited by NHIS of bothNigeria and Ghana is 964(639[66.3% versus 325[33.7%]). NHISaccredited PRCPs densities for Nigeria and Ghana were 1 PRCPper 9, 390 enrollees and 1 PRCP per 33, 108 enrollees respectively.Across the Nigerian States, it was noted that Lagos State has thehighest proportion (21.4%, n = 137) of community pharmacyparticipation in the scheme whereas, in Ghan, Greater AccraRegion has the highest participation (34.2%, n = 111).
CONCLUSION: This study revealed low participation of PRCPsand skewed spatial distribution between urban and rural areas ofboth countries, although there was higher participation of thesepharmacies in Nigeria due to Nigerian lower NHIS coverage datacompared to Ghana.