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Itinerant Vending of Medicines Inside Buses in Nigeria: Vending Strategies, Dominant Themes and Medicine-Related Information Provided

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Itinerant Vending of Medicines Inside Buses in Nigeria: Vending Strategies, Dominant Themes and Medicine-Related Information Provided Yusuff KB, Wassi Sanni A. Itinerant vending of medicines inside buses in Nigeria: vending strategies, dominant themes and medicine-related information provided. Pharmacy Practice (Internet) 2011 Jul-Sep;9(3):128-135. Original Research Itinerant vending of medicines inside buses in Nigeria: vending strategies, dominant themes and medicine-related information provided Kazeem B. YUSUFF, Abd’ WASSI SANNI. Received (first version): 3-Mar-2011 Accepted: 3-Jul-2011 ABSTRACT* related enquiries, or provide detailed factual Objective: To determine vending strategies and medicines information to guide appropriate use. marketing themes employed by itinerant bus These misleading promotional activities could vendors, and assess the accuracy and potentially encourage inappropriate purchase and completeness of information provided on medicines probable self-medication by consumers. being sold in an urban setting in Nigeria Methods: Cross-sectional study and content Keywords: Self Medication. Nonprescription Drugs. analysis of itinerant vending of medicines inside Propaganda. Advertising as Topic .Nigeria. buses recorded with a mobile telephone on purposively selected routes in a mega city with an VENTA ITINERANTE DE MEDICAMENTOS estimated 18 million residents in southwestern EN AUTOBUSES EN NIGERIA: Nigeria over a 2-month period. Two coders ESTRATEGIAS DE VENTA, TEMAS independently assessed 192 vending episodes by DOMINANTES Y E INFORMACIÓN SOBRE 56 vendors for 147 OTC and prescription medicines. Inter-rater reliability (Gwet AC1 =0.924; MEDICAMENTOS PROPORCIONADA p<0.0001). Results: Fourteen thousands and four hundred RESUMEN potential consumers encountered 192 recorded Objetivo: Determinar las estrategias de venta y los episodes of vending of medicines inside 192 buses temas de marketing empleados por los vendedores within the study periods. Forty-four (78•5%) of the en autobuses itinerantes y evaluar la precisión y 56 vendors were females in the 30-45 years age compleción de la información sobre medicamentos bracket, were mostly (75%) attired in the local ‘Iro proporcionada durante la venta en un área urbana and Buba’ Ankara fabric and showed laminated de Nigeria. identity cards (97.5%) issued by the local Métodos: Estudio transversal y análisis de association for ‘marketers’ of medicines inside contenido de la venta itinerante de medicamentos buses, markets, and motor parks. Of the 14400 en autobuses grabadas con un teléfono móvil en consumers encountered inside buses during the rutas seleccionadas a propósito en una mega-ciudad study period, between 6.7% and 48.3% purchased de 18 millones de habitantes en el suroeste de the medicines promoted. Prayers against death Nigeria durante un periodo de dos meses. Dos from road traffic accidents and diseases of physical codificadores evaluaron independientemente 192 and / or meta-physical origins were the most episodios de venta de 56 vendedores para 147 frequently used (76•8%) ice-breaking opening medicamentos OTC y de prescripción. Fiabilidad statement / strategy to gain consumers’ attention. inter-evaluador (K de Cohen)=0.89 [IC95% 0.76- Hematinics, multi-vitamins, simple analgesic, 0.92]. NSAIDs and corticosteroids were the most Resultados: 14.400 potenciales consumidores frequently vended medicines. Consumers’ enquiries visitaron los 192 episodios grabados de venta de were related to dosing for children (51.8%), elderly medicamentos en el interior de 192 autobuses en el (28.6%), and pregnancy (52.7%); and contra- periodo de estudio. 44 (78.5%) de los 56 indications during pregnancy (8.9%). Factual vendedores eran mujeres entre los 30-45 años, medicines information such as dose, frequency, estaban mayoritariamente (75%) con tejidos potential side effects and contra-indications were tradicionales ‘Iro and Buba’ Ankara y mostraban not provided in majority of vending episodes. tarjetas identificativas plastificadas (97.5%) Conclusion: Itinerant vending of medicines and the emitidas por las autoridades locales para use of misleading and melodramatic themes to ‘vendedores’ de medicamentos en autobuses, secure high consumer patronage appear mercados y aparcamientos. De los 14.400 considerable in Nigeria. Majority of the vendors did consumidores que visitaron el interior de los buses not correctly respond to consumers medicine- durante el periodo de estudio, el 6.7% y el 48.3% compró los medicamentos promocionados. Oraciones contra la muerte en accidentes de tráfico * Kazeem B. YUSUFF. BPharm, MPharm, PhD . y enfermedades de orígenes físicos o metafísicos Department of Pharmacy Administration & Practice. eran los mensajes para romper el hielo / estrategias Faculty of Pharmacy, Rhodes University. Grahamstown para ganar la atención de los clientes más (South Africa). frecuentemente utilizados (76.8%). Los Abd’ WASSI SANNI. BPharm. Hospital Pharmacist, medicamentos más frecuentemente vendidos eran Pharmacy Department, University College Hospital, los hematínicos, multivitamínicos, analgésicos Ibadan (Nigeria). 128 www.pharmacypractice.org (ISSN: 1886-3655) Yusuff KB, Wassi Sanni A. Itinerant vending of medicines inside buses in Nigeria: vending strategies, dominant themes and medicine-related information provided. Pharmacy Practice (Internet) 2011 Jul-Sep;9(3):128-135. simples, AINE y corticoides. Las preguntas de los Administration and Control Cap 73 of 1990 also consumidores estaban relacionadas con las dosis prohibit distribution and sale of any medicines in para niños (51.8%), ancianos (28.6%) y embarazo market, buses and on the streets.9-11 (52.7%); y contraindicaciones durante el embarazo Notwithstanding this plethora of laws, itinerant (8.9%). En la mayoría de los episodios de venta no vending of medicines remain pervasive in Nigeria.12- se proporcionaba informaciones objetivas sobre los 14 This phenomenon is probably fueled by medicamentos, como dosis, frecuencia, efectos inadequate drug regulatory capacity, ineffectual adversos potenciales y contraindicaciones. enforcement of the pharmaceutical laws regulating Conclusión: La venta itinerante de medicamentos y the distribution and sales of medicines.13 poorly el uso de temas engañosos y melodramáticos para organized and chaotic drug distribution systems asegurar el elevado consumo aparecen Furthermore, itinerant vending of medicines could frecuentemente en Nigeria. La mayoría de los have dire public health consequences in a vendedores no respondió correctamente a las developing setting like Nigeria where irrational self preguntas sobre medicamentos de los medication with prescription-only medicines, over- consumidores, ni proporcionó información objetiva the-counter medicines (OTC) and herbal remedies detallada para guiar en el uso adecuado. Estas of both known and unknown contents.15,16 Poorly actividades promocionales engañosas guided self medication practices have been shown probablemente podrían animar a la compra y a la to provoke adverse drug reactions, delay or mask automedicación de los consumidores. diagnosis of a serious underlying medical problem and increase the risk of potentially harmful drug– Palabras clave: Auto-medicación. Medicamentos drug or drug–disease interactions.17,18 This sin receta. Propaganda. Publicidad como unbridled drug use habit among Nigerians has been tema.Nigeria. linked to factors such as the peculiar health-seeking behavior which favours self-medication as the first response to perceived health problems, and uncontrolled access patients have to both orthodox and herbal medicines in Nigeria.8,15,19 Furthermore, INTRODUCTION the extensive direct-to-consumer advertising of Geographic and economic access to safe, over-the-counter medicines (OTC) which is focused efficacious and affordable essential medicines of on positive emotional appeals but contained good quality is predicated on a well structured and insufficient educational information and thus may be properly regulated medicines distribution system. misleading have been reported by previous studies 20,21 This is particularly important in the public sector in Nigeria. which caters for majority of the populace in Studies of the sale of medicines in developing developing and resource-limited setting. Such countries have been focused on mainly static access will ultimately provide an opportunity to outlets such as pharmacies and patent medicines reduce the increasing morbidity and mortality from 22-27 1,2 stores. Pharmacies are usually owned and / or high disease burden. superintended by registered graduate pharmacists Health services have been severely hampered in who have undergone the requisite training Nigeria by acute shortage of essential medicines for prescribed by the Pharmacists Council of Nigeria. In many years. Hence, health care coverage is addition, the patent medicine stores are manned by perennially low with less than 30% having regular authorized persons who have been licensed under access to essential medicines, particularly in the the relevant sections of the PPA to sell the listed 9,25,27 public sector.3,4 The majority of Nigerians have patents and proprietary medicines. There is been willy-nilly driven to the private sector to meet very little attention on the activities of ambulant their medicines needs due to poor availability of vendors and this is probably due to its illegal nature. essential medicines at public health facilities. Furthermore, very little is known about the activities However, this shift has worsened economic access, of itinerant vendors of medicines with regards to as payment for medicines’ purchase is generally
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