Patent Medicine Vendors and Paediatric Care: Assessing Practices and Antimicrobial Stewardship in Lagos, Nigeria

This conference paper examines the critical, yet under-regulated, role of Patent Medicine Vendors (PMVs) in managing childhood illnesses and its implications for antimicrobial stewardship in Lagos, Nigeria. The research addresses the widespread reliance on PMVs as first-line paediatric healthcare providers, juxtaposed with concerns about inappropriate treatment practices and antimicrobial resistance (AMR). A sequential mixed-methods design was employed between 2023 and 2024. This comprised structured observations and simulated client visits to 150 randomly selected PMV outlets across three local government areas, followed by in-depth interviews with 45 purposively selected vendors. Key findings demonstrate that while PMVs are a vital and accessible health resource, their clinical practices frequently deviate from guidelines. Specifically, over 60% of observed consultations for childhood febrile illnesses resulted in the inappropriate dispensation of antibiotics, predominantly without prescription. Artemisinin-based combination therapies were also commonly sold for unconfirmed malaria. The study concludes that existing regulatory frameworks are inadequate and that PMVs operate with significant knowledge gaps concerning AMR. The significance of this work lies in its direct contribution to public health policy, underscoring the urgent need for targeted, practical training programmes and the formal integration of PMVs into antimicrobial stewardship initiatives. Effectively engaging this ubiquitous private sector is essential for improving paediatric outcomes and curbing the rising threat of AMR in Nigeria and across Africa.