Problem and context
In Nigeria, patent and propriety medicine vendors (PPMVs) are a crucial component of the private sector heath system. PPMVs are defined as anyone without formal training in pharmacy who sells orthodox pharmaceutical products on a retail basis for profit. PPMVs often provide pharmaceutical products for poor and rural communities but are often not well supported in doing so. PPMVs therefore offer an opportunity to expand and strengthen primary health care and family planning services for the poor
NaijaCare aimed to improve the service delivery of PPMVs, whilst also meeting their business and financial needs. The program aimed to provide a digital service business for PPMVs that would improve their service delivery, whilst also meeting their business needs.
The initial Theory of Change (ToC) for NaijaCare was based on a ToC used in a similar project, UJoin in Kenya. Here the premise was that the needs of low-income households could be met by driving behavioral change through leveraging the relationships between the ‘duka owners’ (Kenyan shop-keepers) and their customers. For example, UJoin provided duka owners with a digital community, which they accessed using their mobile phone. The community provided education and mentoring and credit to buy stock to PPMVs, as well as a ‘loyalty scheme’ through which discount vouchers are sent to their customers’ mobile phones.
How did the program harness responsive feedback?
- Responsive feedback mechanisms (RFMs) can be used to iterate and improve Theories of Change, not just implementation methods. This case study demonstrates how RFMs can be used to improve the ToC underlying development programs, not just improve implementation designs and approaches. Here, the user feedback and landscape analysis highlighted additional stakeholders that had not been addressed within the initial ToC. The program was able to iterate at a small-scale and adapt its ToC according to this feedback.
- Program budgets should be structured in a way that enables ToC iteration In order to build their additional digital ordering facility, NaijaCare required additional budget to fund the necessary technology development. By structuring the budget in a way that facilitated theory change, the funder allowed the program to improve its Theory of Change and achieve effective change. The case study therefore shows that funding mechanisms need to be more flexible to allow such iteration and improvement.