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Effect of Medicine Availability on Patient Satisfaction in Primary Healthcare Centres in Nigeria

Abstract

Availability of essential medicines is a critical component of effective primary healthcare because patients depend on health facilities not only for diagnosis and treatment but also for access to medicines prescribed for their health conditions. Adequate availability of essential medicines can improve continuity of treatment, reduce the need for patients to purchase medicines from external sources, minimize additional healthcare expenses, and strengthen confidence in healthcare facilities. Medicine availability refers to the extent to which essential and commonly prescribed medicines are consistently present, adequately stocked, accessible, and dispensed to patients when required at primary healthcare centres. Patient satisfaction refers to the extent to which patients' expectations regarding healthcare services are met, including satisfaction with medicine availability, waiting time, provider interaction, cost of care, quality of services, and overall healthcare experience. In Nigeria, stock-outs and irregular availability of essential medicines remain potential challenges in some primary healthcare centres and may negatively affect patients' experiences and perceptions of healthcare quality. When prescribed medicines are unavailable, patients may be required to purchase them elsewhere, incur additional expenses, delay treatment, or leave healthcare facilities without completing recommended treatment. Such experiences may reduce confidence in primary healthcare centres and influence patients' willingness to return for future care. Against this background, this study investigates the effect of medicine availability on patient satisfaction in primary healthcare centres in Nigeria. The study is anchored on Donabedian's Structure-Process-Outcome Model, Andersen's Behavioral Model of Health Services Use, and Expectancy-Disconfirmation Theory. Donabedian's Model provides a framework for understanding how structural elements of healthcare delivery, including the availability of essential medicines, influence healthcare processes and patient outcomes. Andersen's Behavioral Model explains healthcare utilization and service experiences in relation to enabling healthcare resources, including the availability and accessibility of healthcare services. Expectancy-Disconfirmation Theory explains patient satisfaction as a comparison between patients' expectations and their actual experiences of healthcare services. Collectively, these theoretical perspectives provide a suitable framework for explaining how medicine availability may influence patient satisfaction in primary healthcare centres in Nigeria. The study will adopt a quantitative cross-sectional research design. Primary data will be collected from patients attending selected primary healthcare centres in Nigeria using a structured interviewer-administered or self-administered questionnaire, while facility-level medicine availability will be assessed using an essential-medicine availability checklist. A multistage sampling technique will be employed to select states, local government areas, primary healthcare centres, and eligible patients. Medicine availability will be assessed using indicators such as availability of selected essential medicines on the day of assessment, frequency and duration of medicine stock-outs, availability of commonly prescribed medicines, adequacy of medicine stocks, consistency of medicine supply, and the proportion of prescribed medicines dispensed within the facility. Where feasible, facility stock records, stock cards, dispensing registers, and pharmacy records will be reviewed to complement direct observation and provide objective evidence of medicine availability. Patient satisfaction will be assessed using indicators such as satisfaction with availability of prescribed medicines, quality of care, waiting time, provider communication, cost of healthcare, cleanliness of the facility, accessibility of services, and overall satisfaction with the primary healthcare centre. Descriptive statistics will be used to summarize facility characteristics, medicine availability patterns, patients' sociodemographic characteristics, and satisfaction levels. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple regression analysis, will be used to determine the effect of medicine availability on patient satisfaction. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, multicollinearity, and robustness of the findings. The study is expected to find that medicine availability has a significant positive effect on patient satisfaction in primary healthcare centres in Nigeria. Patients attending facilities with consistent availability of essential and commonly prescribed medicines are expected to report higher levels of satisfaction than patients attending facilities experiencing frequent or prolonged medicine stock-outs. Consistent access to prescribed medicines is expected to reduce the need for patients to purchase medicines from external sources, minimize additional transportation and financial costs, reduce treatment delays, and improve patients' perceptions of the quality and reliability of primary healthcare services. Medicine availability is also expected to strengthen patients' confidence in healthcare providers and increase their willingness to return to the facility when healthcare is needed. However, medicine availability alone may not fully determine patient satisfaction because other aspects of healthcare quality, including provider behaviour, waiting time, facility cleanliness, cost of services, infrastructure, staff availability, and communication, may also influence patients' experiences. Consequently, improvements in medicine supply should be accompanied by broader improvements in the quality and responsiveness of primary healthcare services. The study is expected to contribute to the literature on medicine availability, patient satisfaction, essential medicines, primary healthcare, healthcare quality, pharmaceutical supply systems, healthcare management, and public health in Nigeria by providing empirical evidence on the relationship between medicine availability and patients' experiences of primary healthcare services. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, state primary healthcare development agencies, local government health authorities, primary healthcare centre managers, pharmaceutical supply agencies, healthcare providers, public health practitioners, health administrators, development partners, and policymakers regarding strategies for improving medicine availability and patient-centred healthcare. The study will also provide evidence-based recommendations for strengthening medicine procurement and supply-chain systems, improving inventory management, reducing stock-outs, strengthening facility-level monitoring, ensuring timely distribution of essential medicines, and improving the overall quality and responsiveness of primary healthcare services in Nigeria.

Keywords: Medicine availability, patient satisfaction, primary healthcare centres, Nigeria, essential medicines, medicine stock-outs, healthcare quality, primary healthcare, pharmaceutical supply, healthcare services, patient experience, healthcare management, medicine supply chain, public health.