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

About the project

About the Project PROJECT DESCRIPTION Access to high-quality health services, essential medicines, vaccines and other health supplies is fundamental to achieving Universal Health Coverage (UHC) and the United Nations Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-being. Reliable access to Essential Medicines and Health Supplies (EMHS) depends on multiple interconnected factors, including availability, affordability, geographical accessibility, effective procurement and distribution, appropriate use, and the quality and resilience of health systems. In Uganda, strengthening access to EMHSremains 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 acrossdifferent tiers of the supplychain. 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 acrossthe national healthsupply chain. It emphasises improved visibility, accountability, coordination and proactive risk management as important mechanisms for protecting the availability of EMHS (Ministryof 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 throughthe formal publichealthcare 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 suppliersand 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, supplychain 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 NapierUniversity, 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 contactus to discuss your researchinterests and ideas, and how you might develop the project within the Ugandan context. Academic qualifications A first degree (at least a 2.1) ideallyin Health, SocialSciences, Business, Economics, Management and Engineering studies or related diciplines 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 healthrelated and interdisciplinary research. Competent in qualitative data collection techniques and quanitative data analysis. Knowledge of supply chainand sustainable development goals. Good written and oral communication skills Strong motivation, with evidenceof independent researchskills relevant to the project Good time management Desirable attributes: Passionate about the subject matter,experienced in mixedmethod, excellent presentation and communication skills, project management and networking skills.

Research areas