Involvement of medical personnel in medicines supply chain management in selected public health facilities in Kampala, Uganda

Abstract

Medicines supply chain management is essential for ensuring the availability, accessibility, and effective utilization of medicines in public health facilities. This study addressed a critical gap in understanding the specific roles, contributions, and challenges faced by medical personnel in medicines supply chain management, focusing on Naguru Hospital and Komamboga Health Centre III in Kampala City. The research aimed to determine the level of involvement of medical personnel, explore their roles, and assess their experiences in managing the supply chain. A cross-sectional research design was employed to provide a snapshot of participants' experiences, roles, and challenges at a particular point in time. Qualitative methods, including interviews with 20 key informants and extensive document reviews, were used to explore the complexities surrounding the involvement of medical personnel. Thematic analysis, guided by the Braun & Clarke framework, facilitated a detailed synthesis of participants’ lived experiences and contextual realities. Findings revealed that medical personnel actively contribute to localized activities, such as records management, supervision, and planning meetings, but are minimally involved in strategic decision-making. Decisions about medicine selection and distribution volumes remain centralized at the Ministry of Health and National Medical Stores (NMS). The study also identified significant challenges, including hierarchical power imbalances, irregular review meetings, insufficient training, logistical constraints, persistent stockouts, weak records management practices, and instances of unethical behavior. Despite these challenges, medical personnel have adapted by collaborating with health-focused development partners and implementing creative coping strategies to mitigate supply chain inefficiencies. The study concludes that optimizing supply chain systems requires strengthening stakeholder engagement, decentralizing decision-making, enhancing the capacity of medical personnel through targeted training, and addressing systemic structural barriers. These findings align with the Health Systems Theory, emphasizing the importance of a cohesive and inclusive approach to supply chain management for improving healthcare delivery.