Affordability, Accessibility, and Utilization of Antimalarial Drugs in Nigeria’s Niger Delta: Emphasis on Artemisinin Combination Therapy (ACT)

Abstract

Background: Despite recommendations for artemisinin combination therapies as first-line malaria treatment, chloroquine, and other monotherapies continue to be widely used in Nigeria, primarily due to issues related to availability and affordability. Objectives: This study aimed to assess the affordability and availability of antimalarial treatments in the Niger Delta, evaluating key factors influencing their use. Methods: Structured questionnaires focused on affordability and availability were distributed across six local government areas in Delta and Bayelsa States, targeting individuals and various healthcare facilities, including pharmacies, medicine stores, and hospitals. Data were analyzed using SPSS. Results: Among the 582 respondents, 62.9% (366) were aware of ACTs; however, only 24.9% considered them affordable. Higher education attainment was positively correlated with affordability and preference for ACTs, with those holding tertiary education more likely to afford and prefer ACTs. The overall availability of ACTs was moderate, at 63.1%, but their presence in government-owned primary health centers was notably limited. As a result, there remains a strong preference for monotherapy, with only 28.9% of respondents choosing ACTs despite WHO recommendations. Conclusion: While ACTs are moderately available, their cost limits accessibility, favoring monotherapy use over the recommended ACT treatments. Enhanced affordability and availability of ACTs are essential to improving adherence to WHO malaria treatment guidelines in the Niger Delta region.