<b>An Analysis of the Drivers Contributing to Operational Inefficiencies in Zambia’s Pharmaceutical Supply Chain System: A Case Study of the University Teaching Hospital (UTH) Lusaka</b>

Abstract

This study examined the drivers contributing to operational inefficiencies in Zambia’s pharmaceutical supply chain system, with a specific focus on the University Teaching Hospital(UTH) in Lusaka. Efficient pharmaceutical supply chains are critical for ensuring the consistent availability of essential medicines, improving healthcare delivery, and minimizing wastage. However, persistent inefficiencies such as stock-outs, delays, and resource mismanagement continue to affect the performance of healthcare systems in Zambia. This research aimed to analyse the key factors influencing these inefficiencies and propose strategies for improvement. A mixed methods approach was adopted, guided by a pragmatic research philosophy. The study utilized a convergent parallel design, combining both quantitative and qualitative data collection methods. Quantitative data were gathered through structured questionnaires administered to pharmacists, pharmacy technologists, and supply chain managers, while qualitative insights were obtained through semi-structured interviews with key informants. A sample size of 110 respondents was selected for the quantitative component using simple random sampling, while 15 participants were purposively selected for the qualitative aspect. Data were analysed using descriptive and inferential statistics, including the chi-square test of independence and linear regression, alongside thematic analysis for qualitative responses. The findings revealed that operational inefficiencies in the pharmaceutical supply chain at UTH are driven by multiple interconnected factors. Key challenges identified include procurement delays, inaccurate demand forecasting, unreliable supplier performance, insufficient funding, inadequate storage infrastructure, and limited use of information technology systems. Additionally, human resource constraints, such as staff shortages and limited- decision making authority, further exacerbate inefficiencies. The study also found that while the supply chain system is functional, its effectiveness is often undermined by logistical and systemic constraints. The study also found that 35.5% reported that their role involved forecasting medicines, 16.4% indicated they were responsible for distributing medicines, 13.6% reported involvement in placing orders. The study concludes that addressing these inefficiencies requires a comprehensive and integrated approach. Recommended strategies include strengthening procurement processes, improving forecasting and inventory management practices, enhancing staff capacity through training, increasing funding efficiency and adopting advanced digital systems for real-time tracking and decision-making. These interventions have the potential to improve the reliability, responsiveness and overall performance of the pharmaceutical supply chain system. This research contributes to the existing body of knowledge by providing context specific insights into pharmaceutical supply chain inefficiencies in Zambia. It also offers practical recommendations for policymakers, healthcare managers and stakeholders aiming to enhance medicine availability and healthcare outcomes in public health institutions.