Current Procurement Processes for Medicines and Medical Supplies in Zambia’s Public Health Sector: Evidence from the Ministry of Health

The procurement of medical supplies and medications is essential for the delivery of public health services. It tends to convert allocated budgets into essential commodities that are accessible at the facility level. The Ministry of Health in Zambia operates within a regulated procurement framework. The Public Procurement Act No. 8 of 2020 governs this framework. Sector-specific institutions that are responsible for governance and supply coordination support it. Despite the implementation of electronic government procurement (e-GP) and regulatory reforms, planning delays, approval bottlenecks, and partial digital integration continue to be a major concern. This study examines the current procurement processes for medicines and medical supplies within the Ministry of Health using a mixed-methods design. Qualitative data from 30 Key Informant Interviews and 3 Focus Group Discussions were used to map the end-to-end procurement workflow, while quantitative data from 131 procurement-relevant respondents were analysed using correlation and multiple regression techniques. The findings affirm that procurement adheres to a legally compliant and formally structured cycle. While this is the case, operational constraints are primarily concentrated in the planning and approval phases. Qualitative data from key informant interviews further revealed that these constraints are largely due to the strong interdependence between procurement planning and budget approvals, which delays initiation of procurement activities, combined with multi-layered approval hierarchies that slow decision-making, and partial digitalization of procurement systems beyond the tendering stage. Correlations indicate that there are significant positive correlations between enhanced health care delivery and procurement planning and processes (r = 0.923), supplier relationship management (r = 0.875), procurement policies and systems alignment (r = 0.861), and procurement staff competence (r = 0.715). Regression analysis further demonstrate that procurement planning and processes have the most significant predictive influence (β = 0.394), followed by supplier relationship management (β = 0.283), procurement staff competence (β = 0.217), and procurement systems alignment (β = 0.195).