Enablers and barriers of the Hub and Spoke Supervision Model among private sector providers in Nigeria: A theory-informed qualitative study

Patent and Proprietary Medicine Vendors (PPMVs) are important sources of information and care for many Nigerians, meeting a notable gap in healthcare supply, especially in rural and hard-to-reach areas. The Hub and Spoke Supervisory Model (HSSM) implemented by the IntegratE Project aims to address the persistent challenge of suboptimal care provided by PPMVs by strengthening PPMVs’ capacity to consistently deliver quality services to their clients. The Project conducted in-depth interviews with all (8) pharmacists supervising PPMVs and focus group discussions (FGDs) with 19 purposively selected PPMVs participating in the pilot in Kaduna and Lagos, Nigeria between June and July 2023 to identify the enablers and barriers to the HSSM. The study used Semi structured IDI and FGD guides developed based on the seven constructs of the theoretical framework of acceptability (TFA): affective attitude, ethicality, burden, opportunity cost, intervention coherence, perceived effectiveness, and self-efficacy to obtain information from the pharmacists and PPMVs, respectively. All the interviews and discussions were audio-recorded, transcribed verbatim and analyzed thematically.