Health commodity Supply Chain Performance and Challenges at public Health facilities in Addis Ababa City Administration: A Mixed Method Study
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Date
2025-06-17
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Addis Ababa University
Abstract
Background: Supply chain is a network of organizations that are involved through upstream, and
downstream linkages in the different processes, and activities that produce value in the form of
products and services in the hands of the ultimate customer. Performance measurement is the
process of quantifying and comparing the efficiency and effectiveness of action with pre-seated
goals by known standards. The efficient functioning of a health supply chain system is crucial for
delivering quality health care service, and ensuring the availability of medicine and medical
supplies.
Objective: This study aims to evaluate the performance of health commodity supply chain and to
assess the challenges at public health facilities in Addis Ababa, Ethiopia.
Methodology: A facility based cross sectional an explanatory sequential mixed study design were
employed from April to May 2024 in public health facilities of Addis Ababa, Ethiopia. The
performance in relation to health supply chain was described and challenges of supply chain were
explored. Both quantitative and qualitative data were collected. The quantitative data was collect
using researcher administered semi structured questionnaire, document review and observational
methods at public health facilities. The qualitative data was gathered through key informant
interviews with the responsible professional. The quantitative data were entered and analyzed
using SPSS version 25 and the results were presented using descriptive statistics. Whereas the
qualitative part of the study was transcribed, summarized manually and analyzed using thematic
analysis.
Result: Forecasting accuracy rate for key essential drugs for health centers under study was
62.35% and average order fill rate was 67.5%. Out of reviewed health centers RRF reporting rate
was achieved 100%. Ethiopian pharmaceutical supply service was sending products to health
facilities averagely within 19 days. Average wastage rate of the health centers under study was
1.24% and the availability of tracer drug was 89.18%. Only 47% of health centers met acceptable
storage criteria and 71% of health facility under study had unfit for use medicine which was not
disposed during last 12 month. Out of twenty-five key essential medicine assessed the overall stock
out duration was 25.3 days. The main cause of poor health supply chain was shortage of supply at
Ethiopian pharmaceutical supply service and in market, lack of trained human resource, budget
constraint, and transportation and waste disposal service limitation.
Conclusion and recommendation: In general the health commodity supply chain performance
of those health facilities was found to be poor. Except for RRF reporting rate, inventory accuracy
rate, and wastage rate which had relatively better results, the rest of the majority of the indicators
were below the national standard which was confirmed by poor forecasting accuracy, order fill
rate practices and poor storage condition and unfit for use practice. Availability and stock out of
tracer medicines were the main problem for major health facilities. Limited competent human
resource, inadequate management support and budget constraints, were other challenges for health
facilities. Public health facilities should work together with stakeholders to ensure uninterrupted
supply of key essential medicines.
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Keywords
Health supply Chain, performance, public health facilities and challenge.