Incorporation of cultural competencies ensured achievement of project goals across multiple states supported by Howard University Global Initiative, Nigeria

Abstract

Introduction

Howard University has served as the technical lead for ensuring best practices in pharmacy services and systems across multiple projects over the last two decades across all 36 + 1 states in Nigeria. Experiences and studies have shown that implementing projects without making allowances for local contexts and cultures can lead to failure. Howard University Global Initiative, Nigeria (HUGIN) incorporated cultural competencies into the design and implementation of training and care packages used in project implementation. In this paper, we share a review of the influence of cultural competency in the achievement of desired project goals in Nigeria.

Methodology

The approaches used involved stakeholders profiling and a co-creation mechanism to formulate appropriate level-adjusted training and care packages for healthcare providers and Recipients of Care (RoC) that reflected their educational and knowledge levels and accounting for their location, ethnicity, gender, age, literacy level, and religious beliefs. HUGIN developed instructional materials focusing on drug dispensing, patient counseling, ARV drug refilling, drug therapy monitoring, patient adherence, referral process, education programs, health team interaction, drug control, data production, collection, and verification.

Results

HUGIN trained 17,368 health care providers in various categories of service provision under various projects using different training packages. HUGIN developed the capacity of 113 top government personnel as Master Trainers on Pharmaceutical Care in HIV/AIDS who trained additional HCWs that served 163,901 recipients of care on antiretroviral therapy (ART), 96,041 women to prevent mother-to-child transmission of HIV and 3595 children who were exposed to HIV infection. HUGIN provided HIV testing services to 3000 Adolescents and Young People who were first time testers. HUGIN used culturally competent (Community ART Refill Clubs) CARC and (Community ART Refill Groups) CARG models to refill 5296 clients who could have interrupted treatment. Between January 2023 to December 2023, 10 clients on antiretroviral drugs in rural areas in Delta, Ekiti and Osun states were able to access Drug Information Services in areas with suboptimal HRH (Human Resources for Health). HUGIN also provided supervision to 36 pharmacy interns as well as experiential training for interns from the West African Health Organization and for students undertaking postgraduate courses in Health Management from Benue State University. The GHAIN project also trained 213 volunteer pharmacists to support pharmacy services in 93 supported healthcare facilities.

Lessons learned

The co-creation of training with stakeholders enabled the sustainability and ownership of programs implemented in Nigeria. For example, the Community Pharmacy ART Refill Program (CPARP) model now has global appeal with other countries especially in Africa such as Kenya and Liberia, South Africa replicating the framework. The Level-adjusted training for participants helped to achieve desired program objectives.

Conclusions

The incorporation of cultural competence into program design and implementation contributed to the achievement of project goals and the attainment of health care objectives. It is therefore recommended that it should be mainstreamed into education packages for healthcare givers and project implementation.

Keywords

Cultural competencies

Capacity building

Pharmacy best practices

Co-creation

Discrimination

Sustainable financing initiative

Howard University Global Initiative Nigeria