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Healthcare clinic and pharmacy chains in Kenya and Nigeria: A qualitative exploration of the opportunities and risks they present for healthcare regulatory systems

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Listed:
  • Francis Wafula
  • Chima Onoka
  • Anita Musiega
  • Arnold Okpani
  • Dosila Ogira
  • Ufuoma Ejughemre
  • Rosalind Miller
  • Catherine Goodman
  • Kara Hanson

Abstract

Background Regulating fragmented healthcare markets is a major challenge in low‐ and middle‐income countries. Although a recent transformation towards consolidation could improve regulatory efficiency, there are concerns over risks to client safety and market functioning. We investigated market consolidation through the emergence of clinic and pharmacy chains in Kenya and Nigeria and explored resultant regulatory opportunities and risks. Methods The study was conducted in Nairobi Kenya and Abuja Nigeria. Data were collected through document reviews and 26 interviews with chain operators, professional associations and regulators between September and December 2018. A thematic analysis was conducted. Results We characterised two broad types of chains: organic chains that started as single business locations and expanded gradually, and investor‐driven chains that expanded rapidly following external capital injection. In both countries, chains and independents were regulated similarly, with regulators failing to both capitalize on opportunities and guard against risks. For instance, chains' brand visibility and centralised management systems made them easier to regulate and more suitable for self‐regulation. On the other hand, chains were perceived to pose the risks of market dominance, commercialisation of healthcare, and regulatory capture. Conclusion As healthcare chains expand, regulators should build on opportunities presented and guard against emerging risks.

Suggested Citation

  • Francis Wafula & Chima Onoka & Anita Musiega & Arnold Okpani & Dosila Ogira & Ufuoma Ejughemre & Rosalind Miller & Catherine Goodman & Kara Hanson, 2022. "Healthcare clinic and pharmacy chains in Kenya and Nigeria: A qualitative exploration of the opportunities and risks they present for healthcare regulatory systems," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(6), pages 3329-3343, November.
    • Handle: RePEc:bla:ijhplm:v:37:y:2022:i:6:p:3329-3343
    DOI: 10.1002/hpm.3560
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    References listed on IDEAS

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    1. Daniel Bennett & Wesley Yin, 2019. "The Market for High-Quality Medicine: Retail Chain Entry and Drug Quality in India," The Review of Economics and Statistics, MIT Press, vol. 101(1), pages 76-90, March.
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