ORS/Zinc status – Nigeria

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NigeriaNigeria (1st)*

Population: 206.1m (2020)
Area: 923,768 sqkm

Diarrhoea deaths: 132,555 (2019)

ORS coverage: 40% (2018)

ORS + Zinc coverage: 26% (2021)

* Nigeria has highest number of diarrhoea deaths in the World

National EML download: National Essential Medicines List 2020 (7th Edition)

National policy
ORS+Zinc in National Clinical Guidelines
ORS included in the National Essential Medicines List
Zinc included in the National Essential Medicines List
Co-packaged ORS & Zinc included in the National Essential Medicines List (added in 2016)
Note: The first section of the Nigeria NELM only mentions ORS but the Primary Health Care Lists for Health Centres, Primary Health Care Clinics and Health Posts all specify that ORS should be co-packaged with Zinc as does the ‘List of products to be stocked by patent and proprietary medicine vendors’.

Zinc availability
✅ Zinc available “over the counter”
❌ Any retailer can sell Zinc.
Comment: Based on the regulatory framework for the sale of medicines in Nigeria, the Pharmacist Council of Nigeria requires all outlets (Pharmacies and other drug stores) to have an approval before selling medicines including all OTCs. However, this is not always complied with , hence some retail outlets sell some OTCs without having such approvals.

Outlets for Zinc tablets:
✅ Pharmacies
✅ Drug stores/shops
✅ Supermarkets(see comments)
✅General retail outlets (see comments)
✅ Community Health Workers
❌ Door-to-door sales people (see comments)
✅ Government hospitals/clinics
✅ Private hospitals/clinics
✅ Child Health Days/Special Campaigns (needs verification)
❌ Other

Co-pack availability
✅ Co-packaged ORS and Zinc available

Outlets for co-packaged ORS and Zinc tablets:
✅ Pharmacies
✅ Drug stores/shops
✅ Supermarkets (see comments)
✅ General retail outlets (see comments)
✅ Community Health Workers
❌ Door-to-door sales people (see comments)
✅ Government hospitals/clinics
✅ Private hospitals/clinics
✅ Campaigns and outreach
❌ Other
Comment: Door to door sales refers to unregulated street vendors found in Nigeria. They hawk OTCs like ORS/Zn from door to door in some areas in Nigeria, although, this practice is illegal.

Co-packaged ORS and Zinc brands (may not be exhaustive)

Oraldoz plus Zinc

Oraldoz-with-zinc (Nigeria)
Global Heathcare Limited (Nigeria)

Zinc Sulphate and Hydrolyte Co-pack

Hydrolyte Co-pack Nigeria

Archy Pharmaceuticals Limited

G-oral PLUS
G-Oral Plus - ORS Zinc co-pack
G-oral PLUS (Greenlife Pharmaceutical distributed by One Health NG)

CHI Pharma Zinc & ORS

CHI Pharma ORS:Zinc co-pack

CHI Pharma ORS/Zinc co-pack (CHI Pharma)

Emzolyte Plus Co-pack

Emzolyte Plus - co-packaged ORS and Zinc - Nigeria
Emzor

Motitec Co-pack

Motitec co-pack - Fidson - Nigeria
Fidson

Co-packaged ORS and Zinc manufacturers (may not be exhaustive)
Archy Pharmaceuticals Limited
CHI Pharma
Emzor
Evans
Fidson
Global Healthcare Limited
May and Baker
Olpharm Nigeria Limited on LinkedIn
OneHealthNG
Orange Drugs

Co-pack costs
Typical cost of a ORS/Zinc co-pack in the PUBLIC sector
NGN 200-600 (USD 1.44) – Mar/Apr-2022
Typical cost of a ORS/Zinc co-pack in the PRIVATE sector
From NGN 500 (USD 1.20) to NGN 1,300 (USD 3.13) (Mar-2022)

Diarrhoea programmes currently on-going
(may not be exhaustive)

Name Organisation Funder Diarrhoea specific Target area
Integrated Health Program etc.
(Feb 2022)
IHP, Nutrition International, Malaria Consortium, SFH Vitamin Angels, GF, USAID No Selected States
Zinc/LoORS Intervention in Northwest Nigeria
(Feb 2022)
Nutrition International GAC Yes Northwest (Kano and Sokoto states)
US President’s Malaria Initiative for States Project Management Sciences for Health USAID / PMI No Hard to reach communities in Benue, Zamfara and Ebonyi
Rotavirus research in under-5s ? WHO ? Gates Foundation Yes
Global Fund ICCM Project and CHIPS project in Niger state
Malaria Consortium
Global Fund and BMGF No
Malaria and maternal and child health

Additional information
Questionnaire comment (16-Mar-2022)
“The co- packaged formulation is not readily available and also costly.”

 

Information based on 7 questionnaires and 4 comments

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Making co-packaged ORS and Zinc the "go to" treatment for childhood diarrhoea

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