Medicine policy is a critical determinant of healthcare delivery. In Nigeria, the development and implementation of such policy remains complex, with direct implications for maternal and reproductive health services. This study examines this landscape from an East African perspective, acknowledging shared regional challenges in obstetrics and gynaecology. This action research study aimed to critically analyse the formulation and execution of medicine policy in Nigeria. Its primary objective was to identify systemic barriers to effective policy implementation within the pharmaceutical sector, specifically regarding women's health, and to collaboratively develop strategies for improvement with stakeholders. The study employed a critical action research approach, using a participatory, cyclical model of planning, action, observation, and reflection. Data were gathered through in-depth, semi-structured interviews with policymakers, healthcare providers, and pharmacy personnel, alongside documentary analysis of policy texts. Stakeholder workshops were held to validate findings and co-create intervention strategies. The analysis revealed a significant disconnect between national policy intent and local practice. A predominant theme was the persistent fragmentation of medicine supply chains, which critically undermined the availability of essential obstetric and gynaecological drugs. Most interview participants reported routine stock-outs of key uterotonics at facility level. Medicine policy in Nigeria, while structurally defined, is substantially weakened by implementation failures that directly affect maternal care. The action research process successfully highlighted these operational disconnects and fostered stakeholder engagement towards practical solutions. Recommendations include establishing integrated, transparent medicine tracking systems and formalising multi-stakeholder forums for ongoing policy review. Policy should be adapted to empower local health facilities with greater autonomy in emergency procurement for essential women's health medicines. Action research, medicine policy, pharmaceutical policy, implementation, Nigeria, maternal health, obstetrics This study contributes a critical, practice-oriented analysis of medicine policy implementation in Nigeria. It provides a framework for collaborative problem-solving among stakeholders to address systemic barriers affecting the availability of essential medicines for women's health.
Bello et al. (Wed,) studied this question.