Towards a National Pharmaceutical Care Policy in Nigeria: A Policy Analysis Using the Policy Triangle Framework Across Multiple Stakeholder Perspectives

A formal, nationally endorsed pharmaceutical care policy is foundational to standardizing pharmacist practice roles, securing workforce investment, and institutionalizing pharmaceutical care as an integral component of Nigeria's health system. Despite decades of professional advocacy, no such national policy has been adopted. This study analyzed the barriers, enablers, and pathways to developing a national pharmaceutical care policy in Nigeria using the Policy Triangle Framework, which examines content, context, process, and actors as interacting policy determinants. A qualitative policy analysis was conducted using purposive maximum-variation sampling to recruit 64 key informants comprising federal ministry of health officials, National Agency for Food and Drug Administration and Control directors, Pharmacists Council of Nigeria leadership, pharmaceutical society executives, health economists, pharmacy academics, and international technical assistance partners. Data were collected through in-depth interviews and triangulated with document analysis of national health policies, pharmacy practice reviews, and comparative pharmaceutical care policy documents from Ghana, South Africa, and Kenya. Thematic analysis using the Policy Triangle categories revealed that content-related barriers included the absence of a consensus pharmaceutical care service definition adapted to Nigerian practice levels. Context barriers included health sector fragmentation, inadequate pharmacy workforce density, and low policymaker pharmaceutical literacy. Process barriers encompassed weak professional advocacy coalitions and insufficient pharmacoeconomic evidence. Actor analysis identified critical ally and opponent configurations. A policy development roadmap was synthesized from findings, detailing sequenced advocacy, evidence-building, and coalition-formation actions necessary for policy adoption. Keywords: pharmaceutical care policy, Policy Triangle Framework, Nigeria, health policy analysis, pharmacy profession