Assessment of integrated Community Case Management of Childhood illness (iCCM) practices by trained Patent and Proprietary Medicine Vendors (PPMVs) in Ebonyi and Kaduna States, Nigeria

Introduction: Malaria, Pneumonia and diarrhea has remained the leading cause of high mortality among children under the age of five years in Nigeria despite government responses in form of policies and programs. The most identifiable cause of these deaths has been attributed to service delivery gaps that limits access to quality child health services in the rural and hard to reach communities were most of these deaths occur at the household level. Patent and proprietary medicine vendors have remained a good resource to addressing the service delivery gaps that lead to the unacceptable high mortality, however little has been done by the government, agencies and organizations to strengthen their capacity and improve their skill to provide quality health services in their various communities. Methods In Ebonyi and Kaduna States, 387 registered PPMVs were selected and trained on integrated community case management of childhood illness, out of which 165 with consistent and accurate data reporting practice were selected for study. The 165 PPMVs selected for this study were assessed on the first and last quarter of the intervention to measure the quality-of-service delivery of child health services in their various communities. Results The study revealed a significant improvement in the quality of treatment provided by the PPMVs across the three disease areas. 21.8% trained PPMVs could not appropriately treat malaria in the first quarter of the intervention, however, there was a significant decrease to 1.8% in second quarter in the number of those that cannot appropriate diagnose and treat malaria. There was also a decrease in the number of those who could not treat cough and fast breathing from 47(28.5%) to 14(8.5%) in the second quarter and for diarrhea from 33.3% in the first quarter to 2.4% in the second quarter. Conclusion Due to the ubiquitous nature of the PPMVs and their outnumbering presence in the hard-to-reach communities, they serve as valuable resource in addressing the health care delivery gap that has led to the continuous rise in the unacceptable high mortality rate of children under the age of five years in Nigeria. Trial registration Project No: IRB/20/099 dated 12th Jan 2021