Problem: Despite the efforts made by the Government of Tanzania since 1994 to reform the health sector, Tanzania is still facing a number of challenges: increasing morbidity and mortality rate due to HIV/AIDS and Malaria, increasing demand for health care due to population increase at a 2.032% growth rate and varying disease patterns, difficulties in forecasting demand fluctuations of medicines, shortfall in annual health sector budget allocations and increasing costs of essential health care medicines. These challenges hinder the achievement of quality health and weaken the nation. Objective: The aim of this research was to critically analyze the current challenges facing the pharmaceutical supply chain and distribution network, evaluate implications on access to medicine and quality health care and identify areas for application of process innovation to improve the performance and match demand and supply of pharmaceuticals. The case study focused on the Public Pharmaceutical Sector in Tanzania.Design/Methodology/Approach: This was an explanatory research design based on embedded multiple case studies. The unit of analysis was pharmaceutical supply chain and its participating organizations. The case study was based on “how” and “what” type of questions with a mixture of qualitative and quantitative data. Multiple sources of evidence “triangulation” were used to collect primary and secondary data. Worldwide pharmaceutical supply chain cases from the USA, India, China, Ghana and Zambia were selected for analysis to guide analytic generalization and recommendations. Cross-case and within case analysis techniques along with the conceptual framework and literature review were used to analyze the cases and case study protocol and database were developed.Key Findings: The study found critical challenges; significant delays of more than 3 months of government funding to MSD, medicines are expensive; more than 20 million US dollar expenditures per year on medicines, a staggering debt of approximately 24 million US dollar to government, lack of stock control, poor demand and stock information flow, errors in demand forecasting as a result causing delays in delivery, stock-out, medicine shortages at health facilities and demand-supply mismatching. Changing disease patterns was also contributing to unavailability of medicines. Conclusion: The poor performance of pharmaceutical supply chain and distribution network has negative implications on access to medicines and quality health care.Recommendations: Process innovation model was proposed for analyzing the pharmaceutical supply chain performance. It was recommended a need for integration of activities in the supply chain along with collaboration and coordination among participants at each stage.
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