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The use of smart locker technology has been beneficial for patients with chronic diseases who require regular medication and face challenges accessing healthcare facilities due to distance, time, or mobility issues. This study aimed to assess preferences for utilizing Smart Lockers in accessing and dispensing chronic disease medication among healthcare workers (HCWs) and patients in Nigeria. A descriptive cross-sectional survey was conducted between November 8th and December 4th, 2021, across secondary healthcare facilities in five states of Adamawa, Akwa Ibom, Cross River, Benue, and Niger. Among 1,133 participants included in the analysis, 405 were HCWs and 728 were patients with chronic illnesses. Descriptive statistics, including frequencies and percentages, were used to summarize the data, while chi-square tests were employed to assess significant differences between healthcare workers (HCWs) and patients. Results indicated a strong preference among both HCWs and patients for one-on-one counseling as the preferred method for orientating patients on using Smart Lockers, with 53.8% of HCWs and 58.1% of patients expressing this preference (p = 0.25). Additionally, there was a shared preference for hospitals or clinics as secure locations for Smart Lockers, with 68.9% of HCWs and 71.6% of patients preferring this option (p < 0.05). The majority of participants favored receiving notification of drug delivery via phone call, with 49.1% of HCWs and 48.8% of patients expressing this preference (p = 0.63). There was a significant difference in preferences for access hours, the majority (HCWs: 65.4% and patients: 52.6%) favored 24-hour access (p < 0.05). Participants identified patients with HIV within the age range of 18-40 as the most suitable population to benefit from using Smart Lockers for medication dispensing. These findings offer insights into healthcare policies aimed at enhancing medication access and adherence among patients with chronic diseases in Nigeria. The development of models for using smart lockers to dispense chronic disease medications to chronically ill persons in Nigeria and other populations is recommended.

This study aimed to describe the prevalence and predictors of a positive VIA (visual inspection with acetic acid) cervical cancer screening test in women living with human immunodeficiency virus (HIV). We retrospectively analysed data from women aged ≥15 who accessed VIA screening from health facilities in the Lubombo and Manzini regions of Eswatini. Sociodemographic and clinical data from October 2020 to June 2023 were extracted from the client management information system (CMIS). VIA screening outcome was categorised into negative, positive, or suspicious. A logistic regression model estimated the adjusted odds ratio (AOR) of the predictors of a positive VIA screen at p

Smart lockers are automated delivery machines. They have been used in dispensing ARVs and Tuberculosis medication to chronically ill patients in South Africa, Kenya, and Eswatini. However, there is no evidence of smart lockers in dispensing chronic disease medication in Nigeria. This study aimed to assess the acceptability of smart lockers in dispensing chronic disease medication and to describe the barriers to accessing care among patients with chronic diseases medication in 5 states in Nigeria. We conducted a cross-sectional study among healthcare workers and patients living with chronic diseases in five Nigerian states of Adamawa, Akwa Ibom, Cross River, Benue, and Niger between November and December 2021. A total of 1,133 participants were recruited (728 patients and 405 healthcare workers). The results revealed that most patients and healthcare workers agreed that using smart lockers for drug dispensing will lead to reduced transportation costs, hospital waiting times, the workload of healthcare workers, and decongestion of health facilities. The majority of the patients living with chronic diseases (43%) and healthcare workers (51%) showed high acceptability for the use of smart lockers. The use of smart lockers in dispensing chronic disease medication in Nigeria is feasible, and patients and healthcare workers are willing to accept the smart lockers, provided that a patient-centred implementation strategy is developed.

Objectives: This article describes the implementation of an automated medication dispensing system (AMDS) in Eswatini to increase medication access and presents the early lessons from this implementation.Methods: The AMDS was installed at four health facilities across two regions through collaborative stakeholder engagement. Healthcare workers were trained, and clients who met the inclusion criteria accessed their medications from the system. Each step of the implementation was documented and summarised in this article.Results: Early lessons suggest that implementation of the AMDS is acceptable and feasible to clients and healthcare workers and that phased introduction of medication classes, commencing with antiretroviral therapy (ART) and incorporating other medications in later phases is feasible. Additionally, improved client-centred messaging and communication, consistent power supply and internet network connectivity, and scheduling medication pickup with other services increase AMDS system utilisation.Conclusion: Eswatini has many clients living with HIV and non-communicable diseases (NCDs). Easy, convenient, quick, non-stigmatising and client-centred access to ART and medication for NCDs is critical in addressing retention in care and achieving optimal treatment outcomes.

Evidence that the private health sector is a key player in delivering health services and impacting health outcomes, including those related to HIV/AIDS, underscores the need to optimize the role of the private health sector to scale up national HIV responses in lower-income countries. This article reviews findings on the types of HIV/AIDS services provided by the private health sector in developing countries and elaborates on the role of private providers of HIV services in Ethiopia. Drawing on data from the nation's innovative Private Health Sector Project, a pilot project that has demonstrated the feasibility of public-private partnerships in this area, the article highlights the potential for national governments to scale up HIV/AIDS services by leveraging private health sector resources, innovations, and expertise while working to regulate quality and cost of services. Although concerns about uneven quality and affordability of private sector health services must be addressed through regulation, policy, or other innovative approaches, we argue that the benefits of leveraging the private sector outweigh these challenges, particularly in light of finite donor and public domestic resources.