E.F.O. Enato

Access to essential medicines is central to Universal Health Coverage, yet patients continue to face high out-of-pocket costs, frequent drug stock-outs and limited formularies. The National Health Insurance Authority (NHIA, formerly NHIS) aims to improve affordability and access, but its real-world impact on medicine accessibility at tertiary hospitals requires evaluation. Objectives General: To evaluate the impact of NHIA on accessibility to medicines at the University of Benin Teaching Hospital (UBTH).
Method: A cross-sectional, descriptive survey of NHIA-enrolled patients attending the General Patients Clinic (GPC) and Consultant Out-patients (COPD) NHIA pharmacy units at UBTH. A structured, self-administered questionnaire was completed by 311 patients (100% response rate). Data were coded and analysed in SPSS v21, using descriptive statistics and Chi-square tests;
significance set at p < 0.05. Results: 311 respondents (majority 41–60 years, 58.2% male) participated in the study. Overall,
accessibility and service efficiency under NHIA were rated moderate: respondents acknowledged improved affordability, but reported persistent problems with drug availability and the collection process. Major barriers were drug stock-outs, long waiting times and poor staff communication. Statistically significant associations were observed between medicine accessibility and age
(χ²=22.0, p=0.005), education (χ²=13.8, p=0.03), duration of NHIA enrolment (χ²=16.9, p=0.02) and awareness (χ²=6.00, p=0.05). Perceived NHIA efficiency was significantly associated with age (χ²=15.5, p=0.04). A cross-tabulation of barriers/recommendations versus efficiency showed no significant association (χ²=11.46, p=0.32). Conclusions: NHIA enrolment at UBTH provides measurable financial relief and improves affordability of medicines, but is constrained by operational challenges—chiefly inconsistent medicine supply, limited formulary coverage and administrative delays. Strengthening supplychain
management, expanding the NHIA drug list, digitalizing claims and pharmacy workflows, improving staffing and instituting routine beneficiary feedback are recommended to enhance medicine accessibility and service efficiency

: The effective integration of Pharmaceutical Care (PC) is essential for optimizing therapeutic outcomes and improving patient safety, particularly in resource- constrained Primary Healthcare (PHC) Centres. However, the successful implementation of PC
is critically dependent on the level of knowledge, attitude, and interprofessional dynamics among the entire healthcare team. Understanding these perceptions in the PHC setting is crucial for identifying enablers and systemic barriers to collaborative patient care. Objectives: This study aimed to determine the level of awareness and knowledge of PC among PHC pharmacists and other healthcare providers; assess their attitudes toward the pharmacist's role in PC provision; identify perceived barriers to PC implementation in PHC centres; and evaluate the level of interprofessional collaboration in PC delivery. Methods: A cross-sectional descriptive study was conducted in Primary Healthcare facilities within Benin City, Nigeria. A total of 150 healthcare professionals (including Pharmacists, Physicians, Nurses, and Community Health Workers) were recruited using a convenient
sampling technique. Data were collected via a structured, self-administered questionnaire. Descriptive statistics, one-way Analysis of Variance (ANOVA), and Pearson correlation were used to analyze the data, with the significance level set at p < 0.05. Results: The study found a generally good overall knowledge of PC (Mean = 3.71) and a highly positive attitude (Mean = 3.85) toward its implementation. Pharmacists recorded the highest mean scores for both knowledge (4.50) and attitude (4.52), with these differences being statistically significant across professions (p = 0.000). A strong positive correlation was observed
between knowledge and attitude (r = 0.736, p < 0.05), confirming that higher understanding promotes positive disposition. The most critical barriers identified were role conflict (Mean = 3.94), lack of clinical training (Mean = 3.71), and limited staffing/high workload (Mean = 3.65). However, inter-professional collaboration was rated as generally strong (Mean score range: 3.87
– 4.03).