Building Resilient Healthcare Supply Chains in Uganda: Improving Access to Essential Medicines and Health Supplies

and the quality and resilience of health systems.

In Uganda, strengthening access to EMHS remains an important national health priority. The Essential Medicines and Health Supplies List for Uganda (EMHSLU) 2023 provides the national framework for the procurement of safe and effective medicines, health products and laboratory supplies required for treating common health conditions (Ministry of Health Uganda, 2023a). More recently, the Government of Uganda has continued to strengthen pharmaceutical-sector planning, quantification, accountability and last-mile delivery of essential health commodities (Ministry of Health Uganda, 2023b; 2024a; 2024b).

Despite these developments, significant challenges remain within Uganda's health supply chain. A nationwide assessment involving 128 health facilities across 48 districts found that 84% of surveyed health facilities had experienced stock-outs of Essential Medicines and Health Supplies during the preceding six months. Reported causes included sudden increases in demand, delayed deliveries and discrepancies between orders and deliveries (Mugisha et al., 2022). More recent government assessments continue to identify stock-outs, data inaccuracies and inefficiencies in last-mile distribution as important challenges to the reliable availability of essential medicines (Ministry of Health Uganda, 2024a).

The challenge extends beyond the availability of individual medicines. Uganda's health supply chain operates as a complex network involving government ministries and agencies, national and private medical stores, healthcare facilities, pharmaceutical suppliers, development partners, non-governmental organisations (NGOs), community health workers and patients. Ensuring effective coordination across these actors requires accurate forecasting, reliable information flows, adequate financing, appropriately skilled personnel, effective inventory management and visibility across different tiers of the supply chain.

Recent policy developments highlight the importance of addressing these systemic vulnerabilities. Uganda's National Health Supply Chain Risk Register identifies risks relating to governance, financing, forecasting, logistics, human resources, information systems and external disruptions across the national health supply chain. It emphasises improved visibility, accountability, coordination and proactive risk management as important mechanisms for protecting the availability of EMHS (Ministry of Health Uganda, 2024c/2026).

These challenges may be particularly significant for disadvantaged, low-income, rural and hard-to-reach populations, who may have fewer alternatives when medicines or health services are unavailable through the formal public healthcare system. Understanding health supply chains from an equity perspective is therefore essential: improving overall supply chain efficiency alone may not ensure that essential medicines reach populations facing the greatest barriers to healthcare.

Proposed Research

This interdisciplinary PhD project will investigate the challenges, barriers, drivers and opportunities associated with Uganda's medical and healthcare supply chain, with particular emphasis on improving access to Essential Medicines and Health Supplies for disadvantaged populations.

The project will initially develop a comprehensive map of the existing health supply chain, examining the movement of medicines, health products, information and resources from procurement and national distribution through health facilities and community-level services to patients.

The research will identify and engage key stakeholders, potentially including:

• government ministries and agencies;
• National Medical Stores and other procurement and distribution organisations;
• public and private healthcare facilities;
• pharmaceutical suppliers and distributors;
• NGOs and development partners;
• healthcare professionals and supply chain personnel;
• community health workers; and
• patients and communities, particularly those experiencing socioeconomic or geographical disadvantage.

The project will then investigate the factors influencing supply chain performance and equitable access to EMHS. Potential research areas include procurement and sourcing, demand forecasting, inventory management, medicine stock-outs, supply chain integration, information sharing, digitalisation, last-mile distribution, supply chain resilience, affordability, geographical accessibility and stakeholder coordination.

Particular attention will be given to understanding how supply chain challenges affect disadvantaged populations and whether existing supply chain structures adequately respond to differences in geographical location, socioeconomic circumstances and healthcare needs.

The research may adopt a mixed-method and interdisciplinary approach, potentially combining supply chain mapping, document and policy analysis, quantitative supply chain or health-facility data, stakeholder interviews, focus groups and case studies. Working directly with stakeholders in Uganda will enable the researcher to identify practical interventions and develop solutions that are appropriate to the country's institutional, socioeconomic and healthcare context.

Ultimately, the project aims to develop an evidence-based framework and recommendations for creating a more resilient, integrated, responsive and equitable medical supply chain in Uganda. The findings may also provide lessons for strengthening healthcare supply chains in other low- and middle-income countries and resource-constrained settings.

Research Environment and Collaboration

This interdisciplinary research opportunity will be based within the Business School at Edinburgh Napier University, in collaboration with the Department of Design, Manufacturing and Engineering Management at the University of Strathclyde.

The researcher will also have the opportunity to collaborate closely with an NGO in Uganda, which will facilitate engagement with relevant stakeholders and support fieldwork and data collection.

The project would be particularly suitable for candidates interested in healthcare supply chains, supply chain resilience, public health, health inequalities, humanitarian and development logistics, operations management, sustainable development, or healthcare systems in low- and middle-income countries.

If you are interested in this opportunity, please contact us to discuss your research interests and ideas, and how you might develop the project within the Ugandan context.

Academic qualifications

A first degree (at least a 2.1) ideally in Health, Social Sciences, Business, Economics, Management and Engineering studies or related disciplines with a good fundamental knowledge of different research methods.

English language requirement

IELTS score must be at least 6.5 (with not less than 6.0 in each of the four components). Other, equivalent qualifications will be accepted. Full details of the University’s policy are available online.

Essential attributes:

• Experience of fundamental health related and interdisciplinary research.
• Competent in qualitative data collection techniques and quantitative data analysis.
• Knowledge of supply chain and sustainable development goals.
• Good written and oral communication skills
• Strong motivation, with evidence of independent research skills relevant to the project
• Good time management

Desirable attributes:

Passionate about the subject matter, experienced in mixed method, excellent presentation and communication skills, project management and networking skills.

References

Beaulieu, M. and Bentahar, O. (2021). Digitalization of the healthcare supply chain: A roadmap to generate benefits and effectively support healthcare delivery. Technological Forecasting and Social Change, 167, 120717. https://doi.org/10.1016/j.techfore.2021.120717

Kamba, P.F., Mulangwa, J., Kaggwa, B., Kitutu, F.E., Sewankambo, N.K., Katabira, E.T., Byakika-Kibwika, P., Adome, R.O. and Bollinger, R.C. (2020). Compliance of private pharmacies in Uganda with controlled prescription drugs regulations: A mixed-methods study. Substance Abuse Treatment, Prevention, and Policy, 15, 23. https://doi.org/10.1186/s13011-020-00261-x

Ladwar, D.O., Sembatya, M.N., Amony, N.M., Seru, M., Ross-Degnan, D., Garabedian, L.F. and Trap, B. (2021). Impact assessment of supervision performance assessment and recognition strategy (SPARS) to improve supply chain management in health facilities in Uganda: A national pre and post study. Journal of Pharmaceutical Policy and Practice, 14. https://doi.org/10.1186/s40545-020-00290-8

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Luzze, H., Badiane, O., Ndiaye, E.H.M., Ndiaye, A.S., Atuhaire, B., Atuhebwe, P., Guinot, P., Fry Sosne, E. and Gueye, A. (2017). Understanding the policy environment for immunization supply chains: Lessons learned from landscape analyses in Uganda and Senegal. Vaccine, 35(17), 2141–2147. https://doi.org/10.1016/j.vaccine.2016.10.089

Ministry of Health Uganda (2023a). Essential Medicines and Health Supplies List for Uganda (EMHSLU) 2023. Department of Pharmaceuticals and Natural Medicines, Ministry of Health, Kampala, Uganda.

Ministry of Health Uganda (2023b). Report for the Integrated Quantification for Essential Medicines and Health Supplies for Financial Years 2023/24–2025/26. Department of Pharmaceuticals and Natural Medicines, Ministry of Health, Kampala, Uganda.

Ministry of Health Uganda (2023c). Uganda Essential Medicines and Health Supplies Management Manual. 3rd ed. Department of Pharmaceuticals and Natural Medicines, Ministry of Health, Kampala, Uganda.

Ministry of Health Uganda (2024a). Last Mile Assurance Guidelines for Essential Medicines and Health Supplies. Pharmaceutical Department, Ministry of Health, Kampala, Uganda.

Ministry of Health Uganda (2024b). FY 2024/2025 Integrated Quantification for Essential Medicines and Health Supplies. Department of Pharmaceuticals and Natural Medicines, Ministry of Health, Kampala, Uganda.

Ministry of Health Uganda (2026). National Health Supply Chain Risk Register. Ministry of Health, Uganda/UNFPA Uganda.

Mugisha, J.F. et al. (2022). Health supply chain system in Uganda: Assessment of status and performance of health facilities. Journal of Pharmaceutical Policy and Practice, 15, 71. https://doi.org/10.1186/s40545-022-00452-w

Muyingo, S., Etoori, D., Lotay, P., Malamba, S., Olweny, J., Keesler, K., Wiersma, S., Jjemba, P. and Settaala, R. (2022). The procurement and supply chain strengthening project: Improving public health supply chains for better access to HIV medicines, Uganda 2011–2016. Journal of Pharmaceutical Policy and Practice, 15. https://doi.org/10.1186/s40545-022-00467-3

Mwesigwa, D. et al. (2024). Cost and availability of selected medicines after implementation of increased import verification fees. BMC Health Services Research, 24.

Oteba, M., Wagner, A.K., Seru, M., Embrey, M. and Trap, B. (2018). Pharmaceutical system strengthening in Uganda: Implementing a holistic, evidence-informed, long-term strategy. Journal of Pharmaceutical Policy and Practice, 11. https://doi.org/10.1186/s40545-018-0150-1

Republic of Uganda, Ministry of Health (2000). National Medicines Policy 2000. Ministry of Health, Kampala, Uganda.

USAID (2018). Uganda National Supply Chain Assessment: Capability and Performance. USAID, Kampala, Uganda.

World Health Organization (2017). Towards Access 2030: WHO Medicines and Health Products Programme Strategic Framework 2016–2030. World Health Organization, Geneva.