African Journal of Public Health and Health Systems | 24 February 2026
A Methodological Framework for Investigating Patent Medicine Vendors' Management of Childhood Illnesses and Antibiotic Stewardship in Northern Nigeria
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Abstract
<strong>Background:</strong>
Patent medicine vendors (PMVs) are frequently the first point of care for childhood illnesses in northern Nigeria. Their case management and antibiotic dispensing practices are poorly documented, posing public health challenges for antimicrobial resistance and child mortality.
<strong>Purpose and objectives:</strong>
This methodology article outlines a framework for a study aiming to investigate PMVs’ knowledge, dispensing practices, and adherence to guidelines in managing common childhood illnesses, with a focus on antibiotic stewardship.
<strong>Methodology:</strong>
The sequential explanatory mixed-methods design spans 2024–2026. Phase one involves a cross-sectional survey of 450 PMVs in three northern states using structured questionnaires. Phase two employs in-depth interviews and focus group discussions with a purposively selected sub-sample of PMVs, caregivers, and community health workers. Phase three entails covert observational visits to a subset of PMV premises to document actual client interactions.
<strong>Findings/Key insights:</strong>
As a methodology article, empirical findings are not presented. However, the framework is designed to generate key insights. The covert observation component, for instance, will quantify the proportion of inappropriate antibiotic dispensing for non-bacterial childhood illnesses, a critical stewardship metric.
<strong>Conclusion:</strong>
This multi-phase framework is structured to produce comprehensive, contextual evidence on PMV practices, addressing a significant evidence gap within a crucial informal healthcare sector.
<strong>Recommendations:</strong>
Researchers should employ integrated methodologies that capture both reported and observed behaviours. Policymakers should use such evidence to design targeted interventions, including tailored training and regulatory support for PMVs, to improve child health outcomes.
<strong>Key words:</strong>
Antibiotic stewardship, childhood illnesses, methodology, mixed-methods, Nigeria, patent medicine vendors.
<strong>Contribution statement:</strong>
This article provides a practical methodological framework for studying informal healthcare providers in low-resource settings. It is designed for researchers and public health practitioners working on antimicrobial resistance and child survival.