Nigeria’s Community Pharmacies Already Provide Primary Healthcare Services. Why Are Integration Gaps Persisting?

Community pharmacies in Nigeria already provide a range of services related to primary healthcare, including medicine supply, patient counselling, disease prevention and support for people managing common health conditions. However, published research has identified challenges involving integration with the wider health system, financing, staffing and coordination between healthcare providers.

The findings have renewed interest in how community pharmacists could contribute more systematically to Nigeria’s primary healthcare services and efforts to achieve universal health coverage (UHC).

In July 2026, the Association of Community Pharmacists of Nigeria (ACPN) called on the Federal Government to integrate registered community pharmacists into the National Health Insurance Authority (NHIA) scheme. In August, the association called for community pharmacies to be integrated into the country’s primary healthcare system, arguing that this could improve access to basic healthcare and reduce pressure on secondary and tertiary hospitals.

These are proposals advanced by the professional association, not evidence that a nationwide integration programme has been approved or implemented.

The central question is how existing pharmacy services could be connected more effectively to other healthcare providers, referral systems and appropriate financing arrangements.

Nigerian research documents existing pharmacy services

A mixed-method study published in the International Journal of Health Policy and Management examined community pharmacy participation in primary healthcare services in Nigeria.

The researchers surveyed 321 community pharmacies and 642 clients between April and August 2019. They found that participating pharmacies offered services across eight primary healthcare domains, with medicine supply for endemic diseases and disease prevention among the most prominent areas.

The study also examined the use of technology in pharmacy services. Blood glucose screening devices were the most commonly adopted technology assessed, and their use was associated with better reported service quality.

However, the researchers identified several barriers to the management of primary healthcare services in community pharmacies. These included limited awareness of pharmacists’ roles among other healthcare professionals, inadequate integration with primary healthcare infrastructure, financial constraints, technology limitations and shortages of skilled personnel.

The researchers concluded that integrating community pharmacists into the national primary healthcare framework, alongside appropriate financial incentives, could strengthen their contribution to universal health coverage.

The findings provide evidence that community pharmacies already undertake activities relevant to primary healthcare. However, the survey data were collected in 2019 and cannot establish the current level of service provision across Nigeria.

Kaduna study identifies integration and teamwork challenges

A separate mixed-method study published in the Nigerian Journal of Clinical Pharmacy and Therapeutics on 18 July 2025 examined community pharmacy participation in primary healthcare delivery in Kaduna State.

The study received questionnaire responses from 96 participants and included qualitative interviews. Assessment and treatment of common diseases recorded the highest reported service-involvement score, at 4.48 out of five, while COVID-19 vaccine administration recorded the lowest, at 1.85.

The researchers identified inadequate integration of community pharmacies with the primary healthcare system and ineffective teamwork in patient care as significant barriers. Interviews also highlighted workforce capacity, training, trust, financing, accessibility and infrastructure as factors affecting integration.

The study suggests that pharmacists’ existing skills and accessibility could support primary healthcare delivery, but that effective collaboration with other healthcare professionals remains important.

Its findings must be interpreted within the study’s geographical and sample limitations. They do not establish how widespread these barriers are across Nigeria or demonstrate that a particular national policy would necessarily resolve them.

Referral and continuity of care remain important

Integrating community pharmacies into primary healthcare involves more than expanding the range of services offered. It also requires clear arrangements for referring patients to other healthcare facilities when their conditions need further assessment or treatment.

A 2024 paper published in Health Sciences Reports examined barriers to effective care transitions involving community pharmacies in Nigeria. It discussed challenges involving referral arrangements, communication, documentation and coordination between healthcare providers.

The authors recommended a more inclusive referral framework that accommodates community pharmacies within primary healthcare delivery, supported by clearer guidance and collaboration.

Effective referral arrangements can help ensure that patients receive appropriate care when their needs exceed the services available at a pharmacy. They can also support continuity when patients move between community pharmacies, primary healthcare centres and hospitals.

However, the paper should not be interpreted as a national measurement of referral failures. It provides evidence and policy recommendations concerning care transitions rather than a comprehensive estimate of how frequently referrals fail across the country.

For policymakers, the findings raise practical questions about how pharmacists can communicate with other healthcare providers, document referrals and receive feedback when patients are transferred to another facility.

What do existing regulations and health-insurance arrangements provide?

The Pharmacy Council of Nigeria (Establishment) Act 2022 provides the statutory framework for regulating pharmacy practice and pharmaceutical premises in Nigeria. The council also publishes regulations and guidelines governing registration, licensing and pharmacy practice.

Any proposal to expand or formally integrate community pharmacy services must therefore be considered alongside the applicable regulatory requirements, professional responsibilities and patient-safety standards.

The National Health Insurance Authority Act 2022 establishes a framework for accrediting healthcare providers and sets out provisions relating to their functions and quality assurance.

These legal frameworks are relevant to discussions about community pharmacy participation in healthcare delivery and health-insurance arrangements. However, their existence does not establish that every community pharmacy is eligible for reimbursement for every proposed primary healthcare service.

The specific services that pharmacies may provide, the conditions for accreditation, the applicable benefit packages and the arrangements for payment require verification against current rules and implementation procedures.

A key question for the NHIA is how registered community pharmacies can participate in relevant accreditation and reimbursement arrangements, where permitted, and whether additional operational guidance or contractual arrangements are required.

Similarly, clarification from the Pharmacy Council of Nigeria and relevant primary healthcare authorities would help establish which services can be integrated under existing rules and which proposals would require further regulatory or policy action.

Financing and workforce capacity could affect implementation

The Nigerian studies identify financial and workforce constraints among the factors affecting community pharmacy participation in primary healthcare.

Providing additional services may require trained personnel, suitable space, equipment, digital systems, record-keeping procedures and time for patient assessment and counselling. The extent of these requirements will depend on the services being proposed.

Financing is therefore an important consideration. If community pharmacies are expected to provide additional services as part of a coordinated primary healthcare system, policymakers would need to establish how eligible services would be funded, which providers could participate and how service quality would be assessed.

Any proposed expansion would also need to define the limits of pharmacists’ responsibilities, appropriate referral thresholds, documentation requirements and safeguards for patient information.

Without clear arrangements, expanding the range of services offered by pharmacies would not automatically guarantee better coordination or improved patient outcomes.

What greater integration could mean for patients

Community pharmacies can provide accessible points of contact for people seeking medicines, counselling and advice about common health concerns. Their contribution could be strengthened by clearer links with other healthcare providers and appropriate referral pathways.

For patients, better coordination could support continuity of care and help them navigate the health system. For other healthcare facilities, an appropriately designed model could create additional opportunities for health education, disease prevention and medicine-related support.

These potential benefits depend on implementation. They should not be presented as established outcomes of a nationwide community pharmacy integration programme, which has not been demonstrated by the evidence reviewed for this report.

Any programme would need appropriate standards, trained personnel, effective referral arrangements, sustainable financing and monitoring of patient outcomes.

What happens next?

The ACPN’s calls for greater integration of community pharmacies into primary healthcare and health-insurance arrangements provide a basis for further policy discussion. The published research also identifies practical barriers that authorities and professional stakeholders would need to address.

The next step is to establish the current position of the relevant agencies. The Pharmacy Council of Nigeria can clarify the regulatory requirements for proposed services; the NHIA can explain the applicable provider accreditation and reimbursement arrangements; and the relevant primary healthcare authorities can clarify whether community pharmacies are included in existing programmes or implementation plans.

Responses from these bodies would help determine whether the main obstacles concern regulatory scope, implementation, financing, coordination or a combination of factors.

The evidence reviewed shows that community pharmacies already provide services relevant to primary healthcare in Nigeria. It also identifies barriers that researchers believe limit their contribution. What remains unresolved is how existing services can be connected more effectively to the wider health system, with clear responsibilities, appropriate financing and safeguards for patients.