Relationship Between Fake Drugs And People’s Perception Of Healthcare Delivery System In Onitsha Urban

Relationship Between Fake Drugs And People’s Perception Of Healthcare Delivery System In Onitsha Urban
Abstract
This study was conducted to assess the relationship between fake drug (FD) use and people’s attitude towards healthcare delivery system (HCDS). Participants (n = 103) were both healthcare providers (56) and consumers (47). 36 were males and 67 were females above eighteen years. They were selected through a random sampling technique. The mean ages were 37.2, 34.2 and 42.8 for all the participants, female participants and male participants respectively. All testing took place in Onitsha General Hospital, Community Pharmacies, medical Laboratories and classroom environments in Onitsha urban. Results revealed significant relationships (r = 0.6, p < 0.05). People’s attitude (selection, organization, and interpretation of health related information to form a meaningful picture of their health care needs) were considerably affected by the use of FD in HCDS.
Chapter One
Introduction
Drug Faking is a global public health problem, because the effects can be felt from both the country of manufacture to the recipient countries. Hence, national measures for combating of fake drugs in country might be insufficient because of the advanced sophistications of those who manufactures and sells them (bates, 2008).
Nigeria is not an exception in the problems of fake drugs till date. Some people still prefer to self medicate when they are ill, and often time the drugs are bought from unlicensed drug vendors, whose drug quality is not sure. Through the past two decades in Nigeria, the problem of fake drugs has been a very big issue. In addition, fake drugs proved a major factor in contributing to high death rates. Over 150 children died in 1989 as a result of a formulation error in a drug. Such problems led to the establishment of NAFDAC, which would help create a fake-drug-free environment (NAFDAC consumer safety, 2003). The intent was to ensure effective registration of good quality drugs that are inexpensive in Nigeria. Since the inception of the new NAFDAC in April 2001, Professor Dora Akunyili the Director General has worked hard in combating the problems of sale of fake drugs, but yet the existence of such still continues and this makes me to wonder why. My questions are, ‘why does Nigeria still have in existence open drug markets? Why do Nigerians in Drug Business breech the stipulated drug laws and still get away with it and continue with their business, committing mass murder and smiling to their banks? How long do we fight the battle of fake drug even with the threats on our lives who want to preserve the health of the Nation?
The consistent raids by my organization on fake drug dealers who contravene the applicable laws and regulations, have helped in clamping down on the illegal drug traders But when things seems as if its getting better, these illegal drug sellers begin to emerge from their hideouts. I continue to wonder, why? Could it be that the Agency is not doing enough to stop the evil activities, or could the problem be from the drug sellers themselves. The tragic irony is that the problems of fake drug have refused to go away from the shores of Nigeria.
My research work is by no means going to provide a solution to the drug problems in Nigeria. However, it prepares me on the challenges to be faced at home in finding the next alternative solution to the problem, and insight to my colleagues in combating the menace of fake drugs sold in the streets and open markets resulting in adverse effects to the consuming public.
Background of Study
The usefulness of a good health care delivery system to any population is an obvious fact that cannot be over emphasized. A healthy individual is a valuable asset not only to himself, to his family, but also to his society.
The World Health Organization (WHO) (1948) defined health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
In 1986, the WHO in the Ottawa Charter for Health Promotion said health is “a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.” Overall health is achieved through a combination of physical, mental, emotional, and social well-being.
To achieve an overall health, we need health care delivery systems (HCDS) that can provide high quality medical care, that are responsive to the health needs and expectations of the populations they are intended to serve, and at affordable costs.
On the other hand, the efforts geared toward achieving overall health, that is, health care delivery is the prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical, nursing, pharmaceutical, dental, clinical laboratory sciences and allied health professions (Wikipedia, 2009).
According to WHO, health care delivery embraces all the goods and services designed to promote health, including “preventive, curative and palliative interventions, whether directed to individuals or to populations”. The organized provision of such services constitutes a health care delivery system. When fake drugs are used in health care delivery the main purpose of health care delivery system, which is an overall health will not be achieved.
The relationship between fake drug use in healthcare delivery system and how people perceive health care delivery system will better be appreciated by looking at the levels of health care delivery systems.
All health care systems contain four essential levels of care (Lunde, 1990):
- Lay self-care
- Primary professional care.
- General specialist care, that is, secondary care.
- Super specialist care, that is, tertiary care.
And there is a fifth level of care – quaternary care.
The WHO defines self – care as “activities individuals, families, and communities undertake with the intention of enhancing health, preventing disease, limiting illness, and restoring health. These activities are derived from knowledge and skills from the pool of both professional and lay experience. They are undertaken by lay people on their own behalf, either separately or in participative collaboration with professionals.” The skills and knowledge of self – care will be manifested in an individual’s ability to take appropriate action(s) to achieve overall health. Such actions include the ability to know when to seek for professional care, gather information on what type of care to seek for and where to get desired medical service.
Reports of the media (print and electronic), and lay information on incidences and effects of fake drugs can influence an individual’s decision on how to access health care. Therefore, it becomes necessary to determine the relationship between fake drug use in HCDS and how such use affects people’s perception of HCDS.
Primary health care (PHC) as defined in Alma – Ata Declaration (1978), is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-determination.
Primary health care is promotive, preventive, and rehabilitative. Health services based on PHC include at least immunization against the major infectious diseases: measles, whooping cough, diphtheria, polio, tetanus, and tuberculosis and other components of National Health Policy.
When fake vaccines were used and no immunity conferred on the immunized, such individuals would be highly disposed to developing the specific disease.
The term secondary health care is a service provided by medical specialists who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists. A physician might voluntarily limit his or her practice to secondary care by refusing patients who have not seen a primary care provider first, or a physician may be required, usually by various payment agreements, to limit the practice this way (Wikipedia, 2009).
Tertiary health care is a specialized consultative care, usually on referral from primary or secondary health care personnel, by specialists working in a centre that has personnel and facilities for special investigation or diagnosis and treatment ( Wikipedia, 2008).
Quaternary health Care –Quaternary health care is the advanced level of medicines which are highly specialized and not widely used (Intota, 2009). It is the provision of health care to patients in cardiac care, orthopedic, neurosciences, oncology, renal care, and so forth.
Given the present situation in Nigeria, the environment is intensely stressful and virtually everyone’s health is dangerously threatened in one way or another. In periods like this, our health care delivery system should provide relief to Nigerians, so many of whom are daily on edge (Adelusi-Adeluyi, 1995). Unfortunately, this painful situation has been compounded by the use of fake drugs in our health care delivery. It is worthwhile to note that decisions as to the genuineness of drugs one consumes, appropriateness and competence of both the health care facilities and personnel deserve a great attention.
In Nigeria, because of chaotic drug distribution, possibility of one becoming a victim of counterfeit drugs is very high. After all, it is more difficult to secure a house with over a thousand doors than the one with one or two doors. There are so many handlers (intermediaries) in drug distribution in Nigeria. Each intermediary is a potential entry point for fake drugs.
According to WHO (2006), “a counterfeit drug is one which is deliberately and fraudulently mislabeled with respect to identity and / or source. Counterfeiting can apply to both branded and generic products and counterfeit products may include products with the correct ingredients or with the wrong ingredients, without active ingredients, with insufficient active ingredients or with fake packing.”
In the Nigerian counterfeit and Fake Drugs and Unwholesome Processed Foods (Miscellaneous Provisions) Decree 1993 as amended, a fake drug is defined as
- Any drug or drug product which is not what it purports to be; or
- Any drug or drug product which is so colored, coated, powdered or polished that the damage is concealed or which is made to appear to be better or of greater therapeutic value than it really is, which is not labeled in the prescribed manner or which label or container or anything accompanying the drug bears any statement, design or device which makes false claim for the drug or which is false or misleading; or
- Any drug or drug product whose container is so made, formed or filled as to be misleading; or
- Any drug product whose label does not bear adequate directions for use and such adequate warning against use in those pathological conditions or by children where its use may be dangerous to health or against unsafe dosage or methods or duration of use; or
- Any drug product which is not registered by the National Agency for Food and Drug Administration and Control (NAFDAC) in accordance with the provisions of the Food, Drugs and related products (Registration, etc).
The consumption of counterfeit drugs is worst error that can occur in HCDS. It is an error because both the health care provider and consumer do not know they are using the wrong drug. Fake drugs are eroding both the essence of health care delivery system (HCDS) and confidence people have in the system. Counterfeiters are into everything the pharmaceutical industry produces – from life saving drugs, for example, HIV/AIDS, antituberculosis, anticancer, antidiabetic, antihypertensive to recreational drugs. The existence and functionality of our HCDS is being threatened, as many pharmaceutical manufacturers who spend large amounts of money on research, production and supply of genuine drugs are being edged out of business by fake drug manufacturers.
The relationship between fake drugs and people’s perception of health care delivery system can be looked at from two perspectives:
- Health care consumers’ perspective
- Health care providers’ perspective
Statement of the Problem
Counterfeit drugs are believed to be poisonous, toxic, threats to life, health risks, without therapeutic usefulness, with insufficient therapeutic benefits; and can cause treatment failures, death, disease complications, worsening of disease conditions, development of drug resistance, delayed recovery and human organ damage. Because of these effects, the confidence of both the health care professionals and consumers in our health care delivery system is in doubt.
In the past, Nigerian government through her regulatory agencies such as NAFDAC had made serious efforts toward solving this problem. The regulatory agencies have increased public awareness on fake drugs, ensured that drugs in use in Nigeria are approved and registered, known fake drug manufacturers are banned from marketing their products in Nigeria, re-inspection of production facilities to ensure that such facilities still conform to appropriate standards, and persons caught with fake drugs were made to pay heavy penalties. Also, the agencies have interacted with some foreign governments to ensure that such countries’ pharmaceutical industries export to Nigeria only genuine products.
This study will investigate the relationship between fake drug use in health care delivery system and people’s perception of health care delivery system.
Purpose of the Study
We might have heard, we might have observed, and we might have read reports on problems of fake drugs. Unfortunately, what is known to the public as regards to the problem of fake drugs is a tip of the ice bag. The true situation is far from known or reported. The cause(s) of most deaths are not identified or confirmed through autopsy.
But how do these problems affect people’s perception of our health care delivery system? This question is what this study intends to answer.
Significance of the Study
It is my belief that this study will
- Increase the level of commitment of people to their health care needs.
- Motivate people to ensure that the quality of drugs, health care services and qualification of their health care providers are as prescribed and regulated by government.
- Encourage people to acquire self – care knowledge and skills that they need to participate more actively in fostering their own health and in shaping conditions that influence their own health.
Chapter Five
Discussion and Conclusion
Discussion
The study investigated the relationship between fake drug use in health care delivery system (HCDS) and people’s perception of health care delivery system. There was a significant relationship. This result was in an agreement with similar earlier works.
In the study on challenge of counterfeit drugs by Erhun and Babalola (2001), the availability of counterfeit drugs in HCDS was confirmed as over 71% of the respondents in the study indicated. Also, in the study by Odili, Osemwenkha and Okeri (2006), over 74% of the respondents considered counterfeit drugs as a major problem in Nigeria.
In 1998, a similar study by Ogori Taylor revealed that 49.6% of drugs sold in open market were fake, and that 12.8% of this number resulted in fatalities. The study also revealed that those drugs led to 10.8% therapeutic failures.
Looking at Pearson product-moment correlation coefficient study value, (r: 0.60), and Pearson critical value (r: 0.497; p < 0.05), there is a significant positive relationship between the use of fake drugs in HCDS and attitudes and behaviors of people towards HCDS.
Therefore, the hypothesis that there will be a relationship between fake drug use in HCDS and people’s perception of HCDS holds.
Also, the hypothesis, “Fake drugs as drugs with insufficient therapeutic benefits will have relationship with worsening of disease conditions” was confirmed. Furthermore, the third hypothesis, “There will be a relationship between disease complication because of fake drug use in HCDS and health care consumers’ confidence in HCDS” was supported by the results of the study.
Though the results of the study confirmed that people’s perceptions of the HCDS, disease complication and health care consumers’ confidence in HCDS were influenced by fake drugs, the relationships were not as high as expected. After all, fake drugs are both health risks and threats to life. People would be expected to react vigorously to HCDS where such drugs existed.
Perhaps, the amount information on fake drugs available to the public could be so low to push them to react significantly. The media coverage provided on the problem was inadequate. Most probably, they were denied such pieces information.
People have weaker schemas for fake drugs than for genuine ones because the general public has fewer experiences (and thus, fewer cognitive associations) with specific cases of fake drug problems. Thus people’s perceptions are more malleable and open to alteration. As such, this study implies that people are more likely to depend on peripheral information to form impressions of fake drugs.
Health care providers appeared to be highly knowledgeable on the negative effects of fake drugs. However, a good number of them have limited information on the observed effects. This could be because of poor or no reporting of such cases. Also, without formal documentation or report of cases of fake drugs to the appropriate government agencies by health care providers and consumers, the situation would be played down to the detriment of the health care users.
Furthermore, the inability of government to publicize incidences of fake drugs and counterfeiters could impinge on the attitude of people towards fake drugs.
Limitations: though positive relationships were established in the study, items in the questionnaire might not have tapped the true dispositions of the participants. Confounding variables might have influenced the observed relationships. Such third variables include tight work schedules for some of the participants, and doubt that the confidentiality they were assured of was true.
Recommendations
It has been observed in the study that with increase in the use of fake drugs in HCDS there is also a positive increase in the problems associated with them.
Therefore, the following recommendations will reduce the problems of fake drugs in HCDS:
- Governments (at local, state and federal levels) should on periodic basis make known to public health care facilities, institutions, organizations and individuals that use, supply and or produce counterfeit drugs.
- Information on incidences of adverse effects of counterfeit drugs should be disclosed to the public as they occur.
- A further study on the adverse effects of counterfeit drugs is necessary to generate research information on specific cases.
Conclusion
In a broader sense, more experimental quantitative research should be conducted to empirically verify what this descriptive qualitative study has found. In the meantime, this study provides an empirical perspective to the belief that fake drugs are health risks, poisonous and threats to life.


The Complete Material Will Be Sent to You in Just 2 Steps
Quick & Simple…
![]()
Make Payment (Through Transfer) of ₦5,000 to the Account Below
![]() | Acc No: 0811003731 |
| Samphina Academy | |
| Current Account |
Or CLICK HERE To Pay With Debit Card
| FOR STUDENTS OUTSIDE NIGERIA | |
| CLICK HERE To Pay With Card ($15) | |
| FOR GHANA STUDENTS (GHS 100) | |
![]() | MTN MoMo |
| 0553978005 | |
| Douglas Osabutey | |
![]()
Send the Following Details on WhatsApp ( 07062590260 ) After Payment
- Payment Details
- TOPIC: Relationship Between Fake Drugs And People’s Perception Of Healthcare Delivery System In Onitsha Urban
The Complete Material Will Be Sent To You On WhatsApp After Receiving Your Details
T & C Apply
Students Review
List of Related Works
The Effects Of Consumerism In Marketing Of Fake / Counterfeit Drugs In Nigeria
The Position Of Medical Personnel In The Prevention And Circulation Of Fake Drugs
The Impact Of NAFDAC On Marketing Of Drugs
The Press And Sensitization Of The Public On Fake Drugs In Nigeria
Assessment Of The Impact Of Therapeutic Communication On Patient Outcomes In FMC Daura
Development Of A PHP-Based Smart Healthcare Monitoring And Alert System Using IOT Data Integration
Effects Of Current Assets On The Profitability Of Listed Healthcare Sectors In Nigeria
Healthcare Management In Intensive Care Units
The Effect Of Stress On Efficient Nursing Care Delivery
The Impact Of The Emigration Of Nurses Of The Healthcare Delivery System
Assessment Of The Effect Of Poor Communication On Healthcare Delivery In Nigeria
Patronage Of Rural Dwellers Towards Primary Health Care Delivery System
Design And Implementation Of An Online ATM Card Request And Delivery System With Tracker
Impact Of Government Health Intervention On Infant Mortality In Calabar
An Evaluation Of The Knowledge Of Health Workers On Fetal And Maternal Factors As Causes Of Dystocia
Drug Addiction And It’s Academic Implication Among Secondary School Student
The Statistical Analysis Of The Curative Efficiency Of Drugs Against Malaria
Examination Of Risk Behavior From Acidic Drugs Amongst Novena University Students
Bacterial Contamination In Herbal Medicines And Its Public Health Implications
Health Hazard Associated With Excessive Drug Use Amongst Youth
Effects Of Drug Abuse Among The Youth (A Case Study In Oru Community)
Sample Survey On The Use Of Contraceptives Drugs Among Female Student Of Faculty Of Science
The Curative Efficiency Of Drugs And Herbs Against Malaria (A Case Study Of Aba – North L.G.A)
The Impact Of Toxic Drugs Among University Students


