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Cited by 99Pharmaceutical Economics and PolicyPharmaceutical Quality and CounterfeitingSupply Chain and Inventory Management

Medicines and vaccines supply chains challenges in Nigeria: a scoping review

Open access
Olutuase, Victory O., Iwu-Jaja, Chinwe J., Akuoko, Cynthia P., Adewuyi, Emmanuel O., Khanal, Vishnu·2022·BMC Public Health
DOI 10.1186/s12889-021-12361-9PMC PMC8727467
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Abstract

Background: Medicines and vaccines supply chains represent critical systems for realising one of the major targets of the United Nations’ third Sustainable Development Goals (SDGs)—access to safe, effective, quality, and affordable essential medicines and vaccines, for all. However, evidence suggests the system is confronted with several challenges in many low-medium income countries, including Nigeria. This scoping review aims to summarize the available evidence on the challenges of medicines and vaccines supply chain system in Nigeria. Results: We searched relevant databases including Scopus and Web of Science for studies published between January 2005 and August 2020 on the challenges associated with medicines and vaccines supply chain systems in Nigeria. Our findings implicate several factors including difficulty with medicines or vaccines selection, procurement, distribution, and inventory management. Others included poor storage infrastructure, financial constraints, insecurity, transportation challenges, inadequate human resources, weak, or poorly implemented policies. These challenges mostly resulted in stock-outs of essential medicines which notably got worsened during the current COVID-19 pandemic. Conclusion: Our study is a wake-up call on the need to prioritise the critical sector of the supply chain systems for medicines and vaccines in Nigeria. Effective implementation of existing policies, improved security, strengthening of the health system through adequate budgetary allocations, and provision of infrastructure including regular availability of electricity are keys to surmounting the challenges and improving access to medicines or vaccines in Nigeria.

AI snapshot

Written from the paper’s full text.

TL;DR

This scoping review summarizes evidence on challenges in Nigeria’s medicines and vaccines supply chains, identifying stock-outs, human resource gaps, storage and infrastructure problems, financial constraints, transportation delays, weak policy implementation, technical issues, and poor data management. It concludes that these challenges undermine access to essential medicines and vaccines and calls for stronger implementation, funding, security, infrastructure, and electricity.

Key findings

  • Medicines or vaccine stock-outs were the most frequently reported challenge, appearing in 18% of included articles (n=8).
  • Human resource, storage, and technical challenges were each reported in 14% of articles (n=6 each); financial, transportation/distribution, and policies/SOPs challenges were each reported in 11% (n=5 each); poor data management was least reported at 7% (n=3).
  • The review included 28 articles; 68% (n=19) were published between 2016 and 2020, 50% focused on medicines (n=14), and 50% focused on vaccines (n=14).
  • Reported consequences included regular stock-outs of essential medicines, incomplete immunization, vaccine stock-outs, substandard medicines, and disrupted supply, with the paper noting these were worsened by the COVID-19 pandemic.

Methods

  • Scoping review following Joanna Briggs Institute methodology, asking: “What are the challenges of medicines and vaccines supply chain systems in Nigeria?”
  • Searched Scopus and Web of Science for English-language studies published January 2005–August 2020, plus an additional search in March 2021 and one Google Scholar article; screening used Rayyan and a two-stage process.
  • Data were extracted into Excel and analyzed quantitatively for frequencies/percentages and qualitatively in Atlas.ti version 7; 28 articles were finally included.

Limitations

  • The paper states that additional evidence may have been missed because articles in unaccredited, un-indexed, or predatory journals may not have been captured by the search strategy.
  • The paper states that analyses did not extend to the quality of included articles because it is a scoping review.
  • The text makes evident that study settings were rarely clearly described, rural–urban or regional comparisons were limited, and most data were more likely from urban areas, so some challenges may have been underestimated.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12889-021-12361-9

Cites

40 of 40 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 59 cited sources checked · 0 supported · 0 flagged

  • Findingreasoning

    The identified supply chain challenges mostly resulted in stock-outs of essential medicines in Nigeria.

    “These challenges mostly resulted in stock-outs of essential medicines which notably got worsened during the current COVID-19 pandemic.”
    Quote in the paperSubstantial claim
  • Findingown data

    The review found difficulty with medicines or vaccines inventory management as a challenge in Nigeria.

    “Our findings implicate several factors including difficulty with medicines or vaccines selection, procurement, distribution, and inventory management.”
    Quote in the paperSubstantial claim
  • Findingown data

    Transportation and distribution challenges were reported by 5 articles (11%).

    “Eleven per cent of the articles (n=5) further reported on financial challenges, transportation and distributions challenges, policies, and SOPs challenges respectively.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Human resource challenges were reported by 6 articles (14%).

    “14 per cent of the articles (n=6) reported on human resource challenges, storage challenges and technical issues respectively.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The review found difficulty with medicines or vaccines distribution as a challenge in Nigeria.

    “Our findings implicate several factors including difficulty with medicines or vaccines selection, procurement, distribution, and inventory management.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 11
  • May combine two claims. 20

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The database searches produced a total of 2,835 citations.

    “Database searches produced a total of 2,835 citations”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The review found that half (50%) of included studies reported challenges confronting medicine supply chains, and the other half (50%) reported vaccine supply challenges in Nigeria.

    “In this review half of the studies (50%) reported on the challenges confronting medicine supply chains, while the other half (50%) reported the vaccine supply challenges in the country.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The review identified human resource challenges in Nigeria's medicine supply chain, including lack of support for personnel involved in medicine logistics, inadequate personnel, lack of human resources, corruption, and killing of personnel due to insurgency.

    “Challenges experienced by pharmacists with the various aspects of the supply chainLack of support for personnel involved in medicine logistics, inadequate personnel, lack of human resources as well as corruption, killing of personnel due to insurgency”
    • Also stated in: § Human resource challenges · plain
      “Lack of support for personnel involved in medicine logistics and killing of personnel due to insurgency, inadequate personnel, lack of human resources, as well as corruption, were some of the medicine supply chain challenges identified in some states in Nigeria [2, 3, 8, 18].”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [2] Chukwu OA, Chukwu U, Lemoha C. Poor performance of medicines logistics and supply chain systems in a developing country context: lessons from Nigeria. J Pharm Heal Serv Res. 2018;9:289–91. source

      Not checked in the free run.

    • cites [3] Aigbavboa S, Mbohwa C. The headache of medicines’ supply in Nigeria: An exploratory study on the most critical challenges of pharmaceutical outbound value chains. In: Procedia Manufacturing. Elsevier B.V. 2020:336–43. https://doi.org/10.1016/j.promfg.2020.02.170. source

      Not checked in the free run.

    • cites [8] Chukwu OA, Ezeanochikwa VN, Eya BE. Supply chain management of health commodities for reducing global disease burden. Res Soc Adm Pharm. 2017;13:871–4. https://doi.org/10.1016/j.sapharm.2016.08.008. source

      Not checked in the free run.

    • cites [18] Mohammed S, Magaji MG, Lawal GS, Masoud MG. Medicine supply management in Nigeria : A case study of ministry of health. Kaduna State. Niger J Pharm Sci. 2007;6:116–20.

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The review identified poor data management challenges in Nigeria's medicine and vaccine supply chains, including poor procurement, incomplete forecasting, poor data collection, use and management, poor reliability and availability of data for forecasting and decision making, and sub-optimal data on vaccine stock.

    “Poor procurement, incomplete forecasting, poor data collection, use and management, Poor reliability and availability of data for forecasting and decision making, Sub-optimal data on vaccine stock, Poor reliability and availability of data for forecasting and decision making”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22] Sarley D, Mahmud M, Idris J, Osunkiyesi M, Dibosa-osadolor O, Okebukola P, et al. Transforming vaccines supply chains in Nigeria. Vaccine. 2017;35:2167–74. https://doi.org/10.1016/j.vaccine.2016.11.068. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The review identified policy and standard operating procedure challenges in Nigeria's medicine supply chain, including inadequate implementation of medicine distribution policies, sub-optimal implementation of policies, and non-adherence to policies.

    “Inadequate implementation of medicine distribution policies, sub-optimal implementation of policies, non-adherence to policies”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4] Amadi C, Tsui EK. How the quality of essential medicines is perceived and maintained through the pharmaceutical supply chain: A perspective from stakeholders in Nigeria. Res Soc Adm Pharm. 2019;15:1344–57. https://doi.org/10.1016/j.sapharm.2018.11.011. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The review identified financial challenges in Nigeria's medicine and vaccine supply chains, including corruption concerning funds meant for medicine supply, poor or inadequate funding, and lack of funds.

    “Lack of financial resources, Poor funding for vaccine supply”
    • Also stated in: § Financial challenges · plain
      “Furthermore, corruption concerning funds meant for medicine supply, poor or inadequate funding, and lack of funds are some of the medicine and vaccine supply chain financial challenges, that have been reported by authors [2, 18, 20, 22, 23].”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [2] Chukwu OA, Chukwu U, Lemoha C. Poor performance of medicines logistics and supply chain systems in a developing country context: lessons from Nigeria. J Pharm Heal Serv Res. 2018;9:289–91. source

      Not checked in the free run.

    • cites [18] Mohammed S, Magaji MG, Lawal GS, Masoud MG. Medicine supply management in Nigeria : A case study of ministry of health. Kaduna State. Niger J Pharm Sci. 2007;6:116–20.

      Not checked in the free run.

    • cites [20] Obioha EE, Ajala AS, Matobo TA. Analysis of the Performance of Expanded Programme on Immunization ( EPI ) for Four Child Killer Diseases under the Military and Civilian Regimes in Nigeria, 1995-1999 ; 2000- 2005. Ethno Med. 2010;4:43–52. source

      Not checked in the free run.

    • cites [22] Sarley D, Mahmud M, Idris J, Osunkiyesi M, Dibosa-osadolor O, Okebukola P, et al. Transforming vaccines supply chains in Nigeria. Vaccine. 2017;35:2167–74. https://doi.org/10.1016/j.vaccine.2016.11.068. source

      Not checked in the free run.

    • cites [23] Omole TM, Sanni FO, Olaiya PA, Aturaka O, Abdulsalam M, Gwa ZT, et al. The Challenges of Nigeria Vaccine Supply Chain, a Community of Practice Perspective. Int J Res Sci Innov. 2019;6:151–7.

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The review identified infrastructure and storage challenges in Nigeria's medicine and vaccine supply chains, including destruction of storage facilities, inadequate storage facilities for ivermectin, inadequate cold storage facilities, and inadequate ice-packs.

    “Disruption of the supply chain through the destruction of storage facilities, inadequate storage facilities for ivermectin, inadequate cold storage facilities, inadequate ice-packs”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [29] Surakat OA, Sam S, Ademolu K, Adekunle MF, Adekunle ON, Monsuru AA, et al. Assessment of community knowledge and participation in onchocerciasis programme, challenges in ivermectin drug delivery, distribution and non - compliance in Ogun State. Southwest Nigeria. Infect Dis Heal. 2018;23:137–45.

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Lack of stringent policy and weak implementation of existing policies were identified as major challenges in many of the reviewed studies.

    “This recommendation assumes greater importance given that a lack of stringent policy and weak implementation of existing policies were identified as major challenges in many of the reviewed studies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    The review identified stockouts and related issues in Nigeria's medicine and vaccine supply chains, including stock-outs, substandard medicines, inadequate supply of vaccines, and regular stock-outs of essential medicines due to inefficient inventory management systems, equipment and corruption.

    “Stock-outs, substandard medicines, shortage of vaccine stock and vaccine stock-outs, Regular stock-outs of essential medicines due to inefficient inventory management systems, equipment and corruption, Inadequate supply of vaccines”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [2] Chukwu OA, Chukwu U, Lemoha C. Poor performance of medicines logistics and supply chain systems in a developing country context: lessons from Nigeria. J Pharm Heal Serv Res. 2018;9:289–91. source

      Not checked in the free run.

    • cites [3] Aigbavboa S, Mbohwa C. The headache of medicines’ supply in Nigeria: An exploratory study on the most critical challenges of pharmaceutical outbound value chains. In: Procedia Manufacturing. Elsevier B.V. 2020:336–43. https://doi.org/10.1016/j.promfg.2020.02.170. source

      Not checked in the free run.

    • cites [21] Babalola S. Maternal reasons for non-immunisation and partial immunisation in Maternal reasons for non-immunisation and partial immunisation in northern Nigeria. J Paediatr Child Health. 2011;47 September. source

      Not checked in the free run.

    • cites [33] Sato R. Differential determinants and reasons for the non- and partial vaccination of children among Nigerian caregivers. Vaccine. 2019. https://doi.org/10.1016/j.vaccine.2019.09.097. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The review identified technical issues in Nigeria's medicine and vaccine supply chains, including interruption of drug supplies, unreliable vaccine supply, inefficient procurement systems, damaged products and packages, loss of potency of cold chain medical supplies, irregular power supply, use of archaic technology in vaccine handling, and inadequate ice blocks to maintain a cold chain.

    “Interruption of drug supplies, Unreliable vaccine supply, Inefficient procurement systems, Damaged products and packages, loss of potency of cold chain medical supplies, Irregular power supply and use of archaic technology in vaccine handling, inadequate ice blocks to maintain a cold chain”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [3] Aigbavboa S, Mbohwa C. The headache of medicines’ supply in Nigeria: An exploratory study on the most critical challenges of pharmaceutical outbound value chains. In: Procedia Manufacturing. Elsevier B.V. 2020:336–43. https://doi.org/10.1016/j.promfg.2020.02.170. source

      Not checked in the free run.

    • cites [31] Ashok A, Brison M, Letallec Y. Improving cold chain systems: Challenges and solutions. Vaccine. 2017;35:2217–23. https://doi.org/10.1016/j.vaccine.2016.08.045. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    The review identified delay, transportation, and distribution challenges in Nigeria's medicine and vaccine supply chains, including delays in importation, difficulty maintaining delivery vehicles, delays due to inventory report submission, inaccurate inventory reports, vehicle breakdowns, insecurity during vaccine transportation, logistics distance between manufacturer and Nigeria, and inabilityto

    “Delays in importation and difficulty in maintaining delivery vehicles. Distribution challenge due to delay in submission of inventory reports and submission of inaccurate inventory reports, insecurity during transportation of vaccines and logistics distance between manufacturer and Nigeria. Inability to monitor and maintain optimum temperatures for vaccines during transportation”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [23] Omole TM, Sanni FO, Olaiya PA, Aturaka O, Abdulsalam M, Gwa ZT, et al. The Challenges of Nigeria Vaccine Supply Chain, a Community of Practice Perspective. Int J Res Sci Innov. 2019;6:151–7.

      Not checked in the free run.

    • cites [24] Jatau B, Avong Y, Ogundahunsi O, Shah S, Smith KT, Van Den BR, et al. Procurement and Supply Management System for MDR-TB in Nigeria : Are the Early Warning Targets for Drug Stock Outs and Over Stock of Drugs Being Achieved ? PLoS One. 2015;1–10. source

      Not checked in the free run.

    • cites [25] Palafox B, Patouillard E, Tougher S, Goodman C, Hanson K, Kleinschmidt I, et al. Understanding Private Sector Antimalarial Distribution Chains : A Cross-Sectional Mixed Methods Study in Six Malaria-Endemic Countries. PLoS One. 2014;9. source

      Not checked in the free run.

    • cites [26] Oli AN, Agu RU, Ihekwereme CP, Esimone CO, Davis R, Cochi S, et al. An evaluation of the cold chain technology in South-East, Nigeria using Immunogenicity study on the measles vaccines. Pan Afr Med J. 2017;27(Supp 3):1–5.

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Financial constraints, poor information management and inadequate human resources were identified as parts of the challenges confronting the supply chains for medicines in Nigeria.

    “Furthermore, financial constraints, poor information management and inadequate human resources were identified as parts of the challenges confronting the supply chains for medicines in the country.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Challenges relating to medicines or vaccines stockouts were reported by the highest number of articles (n=8), while challenges relating to poor data management were reported by only three articles.

    “Challenges relating to medicines or vaccines stockouts were reported by the highest number of articles (n=8), while challenges relating to poor data management of medicines and vaccines supply were only reported by three articles.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The scoping review was conducted following the Joanna Briggs Institute methodology for scoping reviews.

    “This scoping review was conducted following the Joanna Briggs Institute methodology for scoping reviews [14].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Peters MDJ, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13:141–6. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Analyses did not extend to the quality of included articles as this is only a scoping review.

    “It should, however, be noted that analyses did not extend to the quality of included articles as this is only a scoping review [13].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Peters M, Godfrey CM, Mcinerney P, Baldini Soares C, Khalil H, Parker D. 2017 Guidance for the Conduct of JBI Scoping Reviews. Joana Briggs Inst Rev Man. 2017;141–6. https://www.researchgate.net/publication/319713049_2017_Guidance_for_the_Conduct_of_JBI_Scoping_Reviews?enrichId=rgreq-2c63bf47a03bf1c379fed09bf9a175b4-XXX&enrichSource=Y292ZXJQYWdlOzMxOTcxMzA0OTtBUzo1NDA5MDcxMjY4ODY0MDBAMTUwNTk3MzcxNjg4MA%3D%3D&el=1_x_2&.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Challenges associated with medicine supply chain in Nigeria have been identified in the literature, ranging from poor infrastructure, weak policy or regulatory implementation, and quality compromised by substandard or counterfeit medicines.

    “Challenges associated with medicine supply chain, in Nigeria, have been identified in the literature ranging from poor infrastructure, weak policy or regulatory implementation and quality compromised by substandard or counterfeit medicines [4].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4] Amadi C, Tsui EK. How the quality of essential medicines is perceived and maintained through the pharmaceutical supply chain: A perspective from stakeholders in Nigeria. Res Soc Adm Pharm. 2019;15:1344–57. https://doi.org/10.1016/j.sapharm.2018.11.011. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Reviewers resolved conflicts following the simple majority rule of two out of three reviewers.

    “Reviewers met to resolve these conflicts following the simple majority rule of two out of three reviewers.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Other challenges such as stock-outs, poor supply chain practices, and inadequate human resources have been reported.

    “Other challenges such as stock-outs, poor supply chain practices (e.g., poor inventory, poor forecasting, etc.), and inadequate human resources, amongst other factors, have been reported [3, 7–11].”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [3] Aigbavboa S, Mbohwa C. The headache of medicines’ supply in Nigeria: An exploratory study on the most critical challenges of pharmaceutical outbound value chains. In: Procedia Manufacturing. Elsevier B.V. 2020:336–43. https://doi.org/10.1016/j.promfg.2020.02.170. source

      Not checked in the free run.

    • cites [7] Akinyandenu O. Counterfeit drugs in Nigeria: A threat to public health. African J Pharm Pharmacol. 2013;7:2571–6. source

      Not checked in the free run.

    • cites [8] Chukwu OA, Ezeanochikwa VN, Eya BE. Supply chain management of health commodities for reducing global disease burden. Res Soc Adm Pharm. 2017;13:871–4. https://doi.org/10.1016/j.sapharm.2016.08.008. source

      Not checked in the free run.

    • cites [9] Fatokun O. Curbing the circulation of counterfeit medicines in Nigeria. Lancet. 2016;388:2603. https://doi.org/10.1016/S0140-6736(16)32121-3. source

      Not checked in the free run.

    • cites [10] Maternal N and CHP (MNCH2). Improving reliability of drugs and medical supplies throough integrated supply chain management. 2016.

      Not checked in the free run.

    • cites [11] Hasan S, Wanyanga W. Pharmaceutical Sector Profile : Kenya Global UNIDO Project. Strengthening the local production of essential generic drugs in the least developed and developing countries. 2011.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    Nine articles were allocated to three reviewers for data extraction, and data were extracted following a data extraction matrix suggested in literature.

    “Nine articles were allocated to three reviewers (VOO, CJI, and CKA.) each for data extraction. The reviewers extracted the data following the data extraction matrix as suggested in literature [13].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Peters M, Godfrey CM, Mcinerney P, Baldini Soares C, Khalil H, Parker D. 2017 Guidance for the Conduct of JBI Scoping Reviews. Joana Briggs Inst Rev Man. 2017;141–6. https://www.researchgate.net/publication/319713049_2017_Guidance_for_the_Conduct_of_JBI_Scoping_Reviews?enrichId=rgreq-2c63bf47a03bf1c379fed09bf9a175b4-XXX&enrichSource=Y292ZXJQYWdlOzMxOTcxMzA0OTtBUzo1NDA5MDcxMjY4ODY0MDBAMTUwNTk3MzcxNjg4MA%3D%3D&el=1_x_2&.

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    To avoid bias, the BLIND-review feature in Rayyan was activated for all authors to conduct an independent review of titles and abstracts based on the inclusion criteria.

    “To avoid bias, the BLIND-review feature in Rayyan was activated for all authors to conduct an independent review of titles and abstracts based on the inclusion criteria.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    A two-stage screening process was carried out as required by the Joanna Briggs Institute Manual for Evidence Synthesis.

    “A two-stage screening process was carried out as required by the scoping review methodology set in Joanna Briggs Institute Manual for Evidence Synthesis [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. The Joanna Briggs Institute; 2020. doi:10.46658/JBIMES-20-01. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The possibility of missing additional evidence is likely as articles published in unaccredited or un-indexed journals, considered predatory, may have been missed from the search strategy.

    “The possibility of missing additional evidence related to this subject is likely as articles published in unaccredited or un-indexed journals, considered predatory, may have been missed from the search strategy.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The challenges in Nigeria and other countries like Taiwan have been further complicated by the COVID-19 pandemic.

    “It is important to note that the challenges in Nigeria and other countries like Taiwan have been further complicated by the COVID-19 pandemic [46, 47].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [46] Akande-Sholabi W, Adebisi YA. The impact of COVID-19 pandemic on medicine security in Africa: Nigeria as a case study. Pan Afr Med J. 2020;35(Supp 2):1–2. source

      Not checked in the free run.

    • cites [47] Kuo S, Ou HT, Wang CJ. Managing medication supply chains: Lessons learned from Taiwan during the COVID-19 pandemic and preparedness planning for the future. J Am Pharm Assoc. 2021;61:e12–5. https://doi.org/10.1016/j.japh.2020.08.029. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The emergence of the COVID-19 global pandemic may have further complicated some of the challenges associated with medicines and vaccines supply chain in Nigeria.

    “It is worth noting that the emergence of the COVID-19 global pandemic may have further complicated some of the challenges associated with medicines and vaccines supply chain in Nigeria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Stockouts would impact access to quality essential medicines, thereby undermining efforts aimed at meeting the SDG target in Nigeria for access to safe, effective, quality, and affordable essential medicines and vaccines for all.

    “Stockouts would impact access to quality essential medicines thereby undermining efforts aimed at meeting one of the major targets of SDGs in Nigeria—access to safe, effective, quality, and affordable essential medicines and vaccines, for all.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Most of the data, including those from multiple centres such as the seven multi-drug resistant tuberculosis centres, were more likely to be from urban areas, and thus less likely to be nationally representative.

    “Nonetheless, most of the data, including those from multiple centres, for example, the seven multi-drug resistant tuberculosis (MDR-TB) centres [24] were more likely to be from urban areas, and, thus, less likely to be nationally representative.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] Jatau B, Avong Y, Ogundahunsi O, Shah S, Smith KT, Van Den BR, et al. Procurement and Supply Management System for MDR-TB in Nigeria : Are the Early Warning Targets for Drug Stock Outs and Over Stock of Drugs Being Achieved ? PLoS One. 2015;1–10. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Infrastructural development and regular availability of electricity supply are keys to the success of the supply chain system for medicines and vaccines in Nigeria.

    “Infrastructural development and regular availability of electricity supply are keys to the success of the supply chain system for medicines and vaccines in the country.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Challenges related to inefficient inventory control systems were consistently identified in several reviewed studies and contributed largely to regular stock-outs of medicines.

    “Challenges related to inefficient inventory control systems were consistently identified in several of the reviewed studies contributing largely to regular stock-outs of medicines.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Many reviewed studies used data from multiple centres across the country or population-based surveys, and thus may be nationally representative.

    “Many of the reviewed studies used data from multiple centres across the country (or population-based surveys) [3, 8, 15, 20, 22–24, 28, 31, 33, 34, 37, 38], and thus, maybe nationally representative.”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [3] Aigbavboa S, Mbohwa C. The headache of medicines’ supply in Nigeria: An exploratory study on the most critical challenges of pharmaceutical outbound value chains. In: Procedia Manufacturing. Elsevier B.V. 2020:336–43. https://doi.org/10.1016/j.promfg.2020.02.170. source

      Not checked in the free run.

    • cites [8] Chukwu OA, Ezeanochikwa VN, Eya BE. Supply chain management of health commodities for reducing global disease burden. Res Soc Adm Pharm. 2017;13:871–4. https://doi.org/10.1016/j.sapharm.2016.08.008. source

      Not checked in the free run.

    • cites [15] Gooding E, Spiliotopoulou E, Yadav P. Impact of vaccine stockouts on immunization coverage in Nigeria. Vaccine. 2019;37:5104–10. https://doi.org/10.1016/j.vaccine.2019.06.006. source

      Not checked in the free run.

    • cites [20] Obioha EE, Ajala AS, Matobo TA. Analysis of the Performance of Expanded Programme on Immunization ( EPI ) for Four Child Killer Diseases under the Military and Civilian Regimes in Nigeria, 1995-1999 ; 2000- 2005. Ethno Med. 2010;4:43–52. source

      Not checked in the free run.

    • cites [22] Sarley D, Mahmud M, Idris J, Osunkiyesi M, Dibosa-osadolor O, Okebukola P, et al. Transforming vaccines supply chains in Nigeria. Vaccine. 2017;35:2167–74. https://doi.org/10.1016/j.vaccine.2016.11.068. source

      Not checked in the free run.

    • cites [23] Omole TM, Sanni FO, Olaiya PA, Aturaka O, Abdulsalam M, Gwa ZT, et al. The Challenges of Nigeria Vaccine Supply Chain, a Community of Practice Perspective. Int J Res Sci Innov. 2019;6:151–7.

      Not checked in the free run.

    • cites [24] Jatau B, Avong Y, Ogundahunsi O, Shah S, Smith KT, Van Den BR, et al. Procurement and Supply Management System for MDR-TB in Nigeria : Are the Early Warning Targets for Drug Stock Outs and Over Stock of Drugs Being Achieved ? PLoS One. 2015;1–10. source

      Not checked in the free run.

    • cites [28] Scotney S, Snidal S, Saidu Y, Ojumu A, Ngatia A, Bagana M, et al. Succeeding in New Vaccine Introduction : Lessons Learned From the Introduction of Inactivated Poliovirus Vaccine in Cameroon, Kenya, and Nigeria. J Infect Dis. 2017;216(Suppl):1.

      Not checked in the free run.

    • cites [31] Ashok A, Brison M, Letallec Y. Improving cold chain systems: Challenges and solutions. Vaccine. 2017;35:2217–23. https://doi.org/10.1016/j.vaccine.2016.08.045. source

      Not checked in the free run.

    • cites [33] Sato R. Differential determinants and reasons for the non- and partial vaccination of children among Nigerian caregivers. Vaccine. 2019. https://doi.org/10.1016/j.vaccine.2019.09.097. source

      Not checked in the free run.

    • Rests on an assumption: Studies using data from multiple centres across the country or population-based surveys are nationally representative.
29 of 29

  • The authors state this as an assumption.

    No prior study has systematically reviewed the challenges of medicines and vaccines supply chains in Nigeria.

    “However, to the best of our knowledge, no study has systematically reviewed the challenges either in the form of a scoping or a systematic review.”

  • The paper relies on this without support.

    Vaccine supply chains require cold storage while medicines do not, except for some medications such as insulin.

    “the supply chain of vaccines requires cold storage while medicines do not, except for some medications such as insulin.”

  • The paper relies on this without support.

    Scopus and Web of Science databases have large abstracts and citations covering numerous academic publications and a rich collection of research output in medicine and health sciences.

    “These databases have large abstracts and citations covering numerous academic publications such as scientific journals, books, and conference proceedings. Moreover, the databases have a rich collection of research output in the field of medicine and health sciences coupled with a dynamic and flexible search engine for retrieving articles.”

  • The paper relies on this without support.

    Rural areas in Nigeria would normally be expected to experience greater challenges associated with medicine and vaccine supply chain systems than urban centres.

    “as rural areas would normally be expected to experience even greater challenges associated with medicine and vaccine supply chain systems than urban centres in Nigeria”

  • The paper relies on this without support.

    Local government areas in Nigeria may have a mix of rural and urban centres.

    “since LGAs in Nigeria may have a mix of rural and urban centres”

  • The paper relies on this without support.

    Studies using data from multiple centres across the country or population-based surveys are nationally representative.

    “Many of the reviewed studies used data from multiple centres across the country (or population-based surveys) [3, 8, 15, 20, 22–24, 28, 31, 33, 34, 37, 38], and thus, maybe nationally representative.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The chronic stock-outs of psychotropic medications in rural facilities remain a major sustainability challenge, reflecting systemic failures common across sub-Saharan Africa.

    “The chronic stock-outs of psychotropic medications in rural facilities (affecting 62.4% of PHCs) remain a major sustainability challenge, reflecting systemic failures common across sub-Saharan Africa [42].”

    From Co-creating systems change for mental health: a theory of change approach from the MeHPriC initiative in Lagos, Nigeria (2025) · cites this paper as [42]

    The Discussion and Results report frequent stock-outs of essential medicines in Nigeria linked to supply-chain problems, and the Discussion notes similar problems in other African countries. But the paper does not identify psychotropic medications or establish stock-out rates in rural facilities, including the cited 62.4% of PHCs; its Results say rural–urban evidence is limited. It therefore supports the general supply-chain concern, not the claim's specific setting, medication class, or figure. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Stockout percentage uses a different denominator from the stated one

    Major

    Eight of the 28 included articles is 28.57%, not 18%. The reported 18% corresponds approximately to eight of the 44 challenge reports in Table 6, rather than eight of the articles.

    Reported 18 · recomputed 28.571429

  • Sato study has conflicting publication years

    Minor

    Table 4 lists the Sato study as published in 2020, while its reference lists 2019.

  • Vaccine storage study has conflicting publication years

    Minor

    Table 4 gives 2019 as the publication year for this study, but its reference gives 2013.

  • Medicine supply management study has conflicting publication years

    Minor

    Table 4 lists this study's publication year as 2008, whereas its reference lists 2007.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 6

  1. Ogbonna BO. National Drug Distribution in Nigeria ; Implications for the Goals of National National Drug Distribution in Nigeria ; Implications for the Goals. Eur J Pharm Med Res. 2016;3:1–4.
  2. Ogbonna BO, Ilika AL, Nwabueze S. National Drug Policy in Nigeria, 1985-2015. World J Pharm Res. 2015;4:248–64.
  3. Peters M, Godfrey CM, Mcinerney P, Baldini Soares C, Khalil H, Parker D. 2017 Guidance for the Conduct of JBI Scoping Reviews. Joana Briggs Inst Rev Man. 2017;141–6. https://www.researchgate.net/publication/319713049_2017_Guidance_for_the_Conduct_of_JBI_Scoping_Reviews?enrichId=rgreq-2c63bf47a03bf1c379fed09bf9a175b4-XXX&enrichSource=Y292ZXJQYWdlOzMxOTcxMzA0OTtBUzo1NDA5MDcxMjY4ODY0MDBAMTUwNTk3MzcxNjg4MA%3D%3D&el=1_x_2&.
  4. Mohammed S, Magaji MG, Lawal GS, Masoud MG. Medicine supply management in Nigeria : A case study of ministry of health. Kaduna State. Niger J Pharm Sci. 2007;6:116–20.
  5. Omole TM, Sanni FO, Olaiya PA, Aturaka O, Abdulsalam M, Gwa ZT, et al. The Challenges of Nigeria Vaccine Supply Chain, a Community of Practice Perspective. Int J Res Sci Innov. 2019;6:151–7.
  6. Ameen HA, A.G S, O.A B, M.M.B U, O.I M, S.A A. Vaccine Storage and Handling Practices among routine immunization service providers in a metropolitan city of North-Central Nigeria. J Community Med Prim Heal Care. 2013;26:18–28.

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Related

Authors
Olutuase, V. O., Iwu-Jaja, C. J., Akuoko, C. P., Adewuyi, E. O., & Khanal, V.
Affiliations
  • University of Jos (NG)
  • Christian Service University College (GH)
  • Edith Cowan University (AU)
Corresponding author
Olutuase, Victory O.
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2022-01-05
Volume
22
Issue
1
Pages
11-11
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-021-12361-9
PMC
PMC8727467
OpenAlex
W4205808241
Cited by
99
References
40
Citations by year
2026: 28 · 2025: 33 · 2024: 18 · 2023: 16 · 2022: 4
FWCI
3.28
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • SUNScholar (Stellenbosch University) (publishedVersion)
  • Australasian Journal of Paramedicine (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • eSpace (Curtin University) (submittedVersion, cc-by)
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pharmaceutical Quality and Counterfeiting
  • Social Sciences › Business, Management and Accounting › Management Information Systems › Supply Chain and Inventory Management
Keywords
Nigeria, essential medicines, vaccine access, stockouts, procurement, distribution, inventory management, storage infrastructure, COVID-19 pandemic, health care financing, health policy implementation, human resources for health
MeSH terms
COVID-19, SARS-CoV-2, Humans, Nigeria, Vaccines, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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