Enhancing the health supply chain for non-communicable diseases management in Rwanda: A qualitative exploration of the perceptions from policy implementers.

Abstract

Abstract Background Efficient health supply chain management contributes significantly to the accessibility of medicines. Low and Middle-Income Countries (LMICs) face challenges in maintaining an uninterrupted health supply chain of health products including non-communicable diseases (NCDs) medicines and nutrition products where stock-outs and shortages are evident. This study aimed to gather perspectives of policy implementers on the supply chain of NCDs medicines and nutrition products in Rwanda. Methodology An observational cross-sectional study collecting qualitative data was structured. Purposive sampling was used to recruit 51 individuals involved in the supply chain of NCDs medicines at different levels including central institutions, peripheral level, and hospital level. All interviews were in English and after transcribing the recorded information, a thematic analysis was employed for the emerging theme. Results Policy implementers at the central level identified key challenges in the management of NCDs medicines, such as supplier delays, poor data quality from health facilities, and difficulties in handling unexpected donations. At RMS Ltd branches and district pharmacists, challenges included limited storage space for nutrition products, transportation issues, inconsistent availability of products, unforeseen additional costs, and data quality concerns. The healthcare professionals (HCP) addresses these challenges through effective stakeholders communication, available resource management, early planning, selecting reliable suppliers, increasing sponsorship, supervision and capacity building of the staff at health facilities. Conclusion The management of NCD drugs and nutrition products in Rwanda's health supply chain faces challenges related to medicine stock-outs, budget constraints, and inadequate inventory data recorded by health facilities, hindering informed decision-making. Policy implementers showcased various approaches to mitigate these challenges. However, investment in the quality of inventory data is crucial, as it can inform a risk-based inventory approach and foster the optimal utilization of available funds.