Amara Frances Chizoba1,2*, Chima Chizoba1,3, Williams Maya1, Chukwuemeka Okekeze1, Chinedu J Asiegbu1, Collins Anyigor1, Kingsley Nshiowo1, Ifeyinwa Izuaka1, Nkiru Mbawike1, Emmanuel Nkpozi1, Chidoeme Ezedinachi1, Christian Ajah1, Chioma Chizoba1, Chinazom Ajulufo-Udezue1, Chizoba Chiamaka Aloh1,4, Lucy Ukachukwu1, Nnenna Ezeokafor5, Chukwuka Nwadike2,5, Abuchi Emmanuel Nwafia6, George Adikibe-nana7, Obieze Nwanna-Nzewunwa8 and Chukwuebuka Ugwu9
1Mission to Elderlies Project, Nigeria
2Center for Clinical care and clinical Research Nigeria
3Federal University Ndufu-Alike Ikwo Ebonyi State, Nigeria
4Ebonyi State University Nigeria, Nigeria
5Maryland Global Initiative Cooperation Nigeria, Nigeria
6Chukwuemeka Odumegwu Ojukwu University Anambra Nigeria, Nigeria
7Geriatric Care and Vulnerable Support Initiative, Nigeria
8Joint Medical Lifesavers foundation, California, US
9World Health Organisation, Anambra Nigeria
*Corresponding Author: Amara Frances Chizoba, Mission to Elderlies Project, Center for Clinical care and clinical Research, Nigeria. E-mail : firstname.lastname@example.org
Received: November 18, 2019; Published: January 03, 2020
Background: United Nations in 2017 reported that over the coming decades, the number of older persons is expected to grow fastest in Africa, including Nigeria. As population aging increases, it comes with health system burden of age-related chronic illness which has become prominent cause of morbidities and mortalities among the elderly, especially in absence of reliable access to medications. Nigeria is challenged with poor accessibility and affordability of quality health care and medications, impeding the achievement of Universal Health Coverage (UHC) goal. To address this challenge in face of increasing age-related chronic illnesses, attention must be given to status of UHC among the elderly in order to inform intervention strategies. We aimed to assess UHC among the elderly through assessing the accessibility of medication by chronically ill older patients in Nigeria.
Methods: Using a cross-sectional study design, study was conducted in three communities in Nigeria from Dec 2016 to Aug 2017. From total 6,632,730 population of older persons in Nigeria, minimum sample size of 385 was calculated. Using a systematic random sampling technique, participants who met inclusion criteria were selected from list of older persons who attended community projects held in study areas. A guided structured questionnaire was used to conduct an in-depth interview among participants. Participants’ demographics were recorded along with self-reported chronic medical conditions and UHC assessment questions. Key questions on accessibility of medication and UHC were “Can you always afford the medicine that you need for your chronic medical condition?” and “Are you under the National Health Insurance scheme that aids health access?” Data was analyzed using SPSS version 20, comparing demographic characteristics of respondents and responses from assessments of UHC.
Findings: Respondents were 521 (above minimum sample size of 385), with age range of 55–95 years. 365 (70%) were female, 302 (58%) had a minimum of primary education, and 240 (46%) reported farming as their occupation. 235 (45%) reported hypertension, 229 (44%) arthritis, and 57 (11%) had diabetes. Only 22% (114/521) responded yes to the question “Can you always afford the medicine that you need for your chronic medical condition?”; 19% (44/234) of hypertensive patients, 24% (55/229) of arthritic patients, and 7% (4/57) of diabetic patients. The remaining 78% had missed medications owing to unaffordability/cost. Those who stated “business” as occupation were most likely to afford medications compared to others (X2 =129.71, p < 0.00001 at 95% CI). On the other hand, only 18% are enrolled into health insurance program to aid health and medication access.
Conclusion: Chronically ill older patients in Nigeria cannot always afford medications and majority are not enrolled into health insurance program to aid health and medication access. Thus aim of UHC is short of being achieved among the elderly in Nigeria. Innovative strategies - such as enrollment of elderly persons into health insurance program to aid access to health care and medication and providing socioeconomic support for the elderly - are recommended to improve UHC among the elderly in Nigeria.
Keywords: Accessibility of Medications; Chronically Ill; Older Persons; Universal Health Coverage; Nigeria
Citation: Amara Frances Chizoba., et al. “Accessibility of Medications by Chronically Ill Older Patients: A Cross-Sectional Assessment of Universal Health Coverage Among the Elderly in Nigeria". Acta Scientific Medical Sciences 4.2 (2020): 01-09.
Copyright: © 2020 Amara Frances Chizoba., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.