Itinerant vending of medicines inside buses in Nigeria: vending strategies, dominant themes and medicine-related information provided / Venta itinerante de medicamentos en autobuses en Nigeria: estrategias de venta, temas dominantes e información sobre medicamentos proporcionada

Objective: To determine vending strategies and marketing themes employed by itinerant bus vendors, and assess the accuracy and completeness of information provided on medicines being sold in an urban setting in Nigeria Methods: Cross-sectional study and content analysis of itinerant vending of medicines inside buses recorded with a mobile telephone on purposively selected routes in a mega city with an estimated 18 million residents in southwestern Nigeria over a 2-month period. Two coders independently assessed 192 vending episodes by 56 vendors for 147 OTC and prescription medicines. Inter-rater reliability (Gwet AC1 =0.924; p<0.0001). Results: Fourteen thousands and four hundred potential consumers encountered 192 recorded episodes of vending of medicines inside 192 buses within the study periods. Forty-four (78•5%) of the 56 vendors were females in the 30-45 years age bracket, were mostly (75%) attired in the local ‘Iro and Buba’ Ankara fabric and showed laminated identity cards (97.5%) issued by the local association for ‘marketers’ of medicines inside buses, markets, and motor parks. Of the 14400 consumers encountered inside buses during the study period, between 6.7% and 48.3% purchased the medicines promoted. Prayers against death from road traffic accidents and diseases of physical and / or meta-physical origins were the most frequently used (76•8%) ice-breaking opening statement / strategy to gain consumers’ attention. Hematinics, multi-vitamins, simple analgesic, NSAIDs and corticosteroids were the most frequently vended medicines. Consumers’ enquiries were related to dosing for children (51.8%), elderly (28.6%), and pregnancy (52.7%); and contraindications during pregnancy (8.9%). Factual medicines information such as dose, frequency, potential side effects and contra-indications were not provided in majority of vending episodes. Conclusion: Itinerant vending of medicines and the use of misleading and melodramatic themes to secure high consumer patronage appear considerable in Nigeria. Majority of the vendors did not correctly respond to consumers medicine- related enquiries, or provide detailed factual medicines information to guide appropriate use. These misleading promotional activities could potentially encourage inappropriate purchase and probable self-medication by consumers (AU)

Objetivo: Determinar las estrategias de venta y los temas de marketing empleados por los vendedores en autobuses itinerantes y evaluar la precisión y compleción de la información sobre medicamentos proporcionada durante la venta en un área urbana de Nigeria. Métodos: Estudio transversal y análisis de contenido de la venta itinerante de medicamentos en autobuses grabadas con un teléfono móvil en rutas seleccionadas a propósito en una mega-ciudad de 18 millones de habitantes en el suroeste de Nigeria durante un periodo de dos meses. Dos codificadores evaluaron independientemente 192 episodios de venta de 56 vendedores para 147 medicamentos OTC y de prescripción. Fiabilidad inter-evaluador (K de Cohen)=0.89 [IC95% 0.76- 0.92]. Resultados: 14.400 potenciales consumidores visitaron los 192 episodios grabados de venta de medicamentos en el interior de 192 autobuses en el periodo de estudio. 44 (78.5%) de los 56 vendedores eran mujeres entre los 30-45 años, estaban mayoritariamente (75%) con tejidos tradicionales ‘Iro and Buba’ Ankara y mostraban tarjetas identificativas plastificadas (97.5%) emitidas por las autoridades locales para ‘vendedores’ de medicamentos en autobuses, mercados y aparcamientos. De los 14.400 consumidores que visitaron el interior de los buses durante el periodo de estudio, el 6.7% y el 48.3% compró los medicamentos promocionados. Oraciones contra la muerte en accidentes de tráfico y enfermedades de orígenes físicos o metafísicos eran los mensajes para romper el hielo / estrategias para ganar la atención de los clientes más frecuentemente utilizados (76.8%). Los medicamentos más frecuentemente vendidos eran los hematínicos, multivitamínicos, analgésicos simples, AINE y corticoides. Las preguntas de los consumidores estaban relacionadas con las dosis para niños (51.8%), ancianos (28.6%) y embarazo (52.7%); y contraindicaciones durante el embarazo (8.9%). En la mayoría de los episodios de venta no se proporcionaba informaciones objetivas sobre los medicamentos, como dosis, frecuencia, efectos adversos potenciales y contraindicaciones. Conclusión: La venta itinerante de medicamentos y el uso de temas engañosos y melodramáticos para asegurar el elevado consumo aparecen frecuentemente en Nigeria. La mayoría de los vendedores no respondió correctamente a las preguntas sobre medicamentos de los consumidores, ni proporcionó información objetiva detallada para guiar en el uso adecuado. Estas actividades promocionales engañosas probablemente podrían animar a la compra y a la automedicación de los consumidores (AU)

Itinerant vending of medicines inside buses in Nigeria: vending strategies, dominant themes and medicine-related information provided.

OBJECTIVE: To determine vending strategies and marketing themes employed by itinerant bus vendors, and assess the accuracy and completeness of information provided on medicines being sold in an urban setting in Nigeria. METHODS: Cross-sectional study and content analysis of itinerant vending of medicines inside buses recorded with a mobile telephone on purposively selected routes in a mega city with an estimated 18 million residents in southwestern Nigeria over a 2-month period. Two coders independently assessed 192 vending episodes by 56 vendors for 147 OTC and prescription medicines. Inter-rater reliability (Gwet AC1 =0.924; p<0.0001). RESULTS: Fourteen thousands and four hundred potential consumers encountered 192 recorded episodes of vending of medicines inside 192 buses within the study periods. Forty-four (78•5%) of the 56 vendors were females in the 30-45 years age bracket, were mostly (75%) attired in the local 'Iro and Buba' Ankara fabric and showed laminated identity cards (97.5%) issued by the local association for 'marketers' of medicines inside buses, markets, and motor parks. Of the 14400 consumers encountered inside buses during the study period, between 6.7% and 48.3% purchased the medicines promoted. Prayers against death from road traffic accidents and diseases of physical and / or meta-physical origins were the most frequently used (76•8%) ice-breaking opening statement / strategy to gain consumers' attention. Hematinics, multi-vitamins, simple analgesic, NSAIDs and corticosteroids were the most frequently vended medicines. Consumers' enquiries were related to dosing for children (51.8%), elderly (28.6%), and pregnancy (52.7%); and contra-indications during pregnancy (8.9%). Factual medicines information such as dose, frequency, potential side effects and contra-indications were not provided in majority of vending episodes. CONCLUSIONS: Itinerant vending of medicines and the use of misleading and melodramatic themes to secure high consumer patronage appear considerable in Nigeria. Majority of the vendors did not correctly respond to consumers medicine-related enquiries, or provide detailed factual medicines information to guide appropriate use. These misleading promotional activities could potentially encourage inappropriate purchase and probable self-medication by consumers.