Exploring the supply chain coordination dimensions for Artemisinin-based combination therapies in Uganda

Abstract

The aim of the study was to explore how the logistics, micro, market and macro coordination dimensions affect the availability of artemisinin-based combination therapies (ACTs) in general hospitals in Uganda. Following a qualitative approach, a multiple case study strategy was used. Specifically, four focus group discussions, each consisting of 8 respondents were conducted from four purposively selected hospitals. The respondents were selected using simple random sampling from representatives of the Drug Therapeutic Management Committee (DTMC) for the purpose of exploring the supply chain coordination. Thereafter, cross-case analysis was done to identify the key coordination mechanisms that could be incorporated into the existing framework. A number of coordination dimensions were identified from the focus group discussions and regrouped using hierarchical coding scheme. Whilst the study’s findings on micro dimensions and logistics dimensions are in accordance with previous scholars, the market and macro dimensions reveal valuable insight into the dimensions necessary for supply chain coordination of ACTs. Market dimensions such as joint training, monitoring and quarterly meetings with key stakeholders are highly regarded for enhancing better coordination of ACTs. The macro coordination dimensions such as verification of ACTs, policies, and regulation are enablers, yet political interference, poverty and donor funding, culture, and lack of appropriate technology affect the availability of ACTs. The novelty of this study is that it adopts a holistic approach to the supply chain coordination of multi-embedded distribution system and extends insight of coordination framework to include the market and macro dimensions that reflect practice.