Malaria Service Delivery Quality Assessment in Community Pharmacies in Rivers State, South South Nigeria

Community pharmacies are critical malaria treatment access points in urban South South Nigeria, yet service delivery quality in terms of diagnostic confirmation, drug selection, and patient counselling remains variable. This study assessed the quality of malaria service delivery in 90 randomly selected registered community pharmacies in Port Harcourt and Obio-Akpor local government areas, Rivers State. A triangulated approach combined structured questionnaire administration to pharmacists, exit interviews with 270 pharmacy clients, and simulated client mystery shopping exercises. Service quality domains assessed included diagnostic confirmation before treatment, artemisinin-based combination therapy dispensing adherence, dosage counselling quality, and referral practices. Malaria rapid diagnostic testing before dispensing was conducted by only 18.9 percent of pharmacists. Artemisinin monotherapy was dispensed in 22.4 percent of client interactions observed through mystery shopping. Adequate dosage counselling was provided in 46.3 percent of client exits. Pharmacies accredited under the Malaria Consortium-supported programme showed significantly higher quality scores. The study recommends a scaled-up accredited pharmacy dispensing programme model with performance-based incentive structures and regulatory accountability mechanisms for community pharmacies in Rivers State. Keywords: pharmacy service quality, malaria treatment, community pharmacy, Rivers State, artemisinin-based combination therapy.