Barriers to Pharmaceutical Service Delivery in Post-Conflict Yemen: A Qualitative Study from Aden

Background Post-conflict countries are those emerging from war or violent conflict and working to rebuild institutions, peace, and stability. These nations often face challenges such as infrastructure damage, political transition, and social trauma. In Aden, Yemen, persistent power outages, economic decline, institutional fragmentation, and governance breakdown have significantly hindered access to pharmaceutical services. Despite their critical role in health outcomes, few studies have examined the barriers to pharmacy practice in such contexts. This study aims to explore how conflict has affected pharmaceutical services in Aden and identify the unique challenges faced by pharmacists, providing evidence for targeted improvements in post-conflict healthcare delivery. Methods A qualitative study was conducted through semi-structured, in-depth interviews with twelve experienced pharmacists in Aden. Data collected between October 2024 and April 2025 were analyzed thematically using inductive, descriptive, and interpretive coding. Results Findings revealed severe infrastructure collapse, including damage to warehouses and frequent power outages affecting cold chain storage. Most patients pay out-of-pocket due to insufficient public funding. The market is saturated with smuggled medicines, posing safety risks. Pharmacists earn less than $30 per month, driving workforce depletion and migration. Additionally, population displacement has tripled Aden's population to nearly 3 million, overwhelming pharmacy services amid governance fragmentation. Conclusion This study highlights the multidimensional barriers to pharmaceutical care in post-conflict Yemen, including systemic breakdowns in infrastructure, governance, regulation, and finance. Strategic interventions are urgently needed, such as restoring infrastructure, regulating medicine supply, supporting the pharmacy workforce, and reforming governance. Further research should focus on resilient healthcare models and workforce retention strategies in fragile settings.