The Effect of Pharmaceutical Supply Chain Risk Management on Building Resilience in Public Health Facilities across Four Wollega Zones, Ethiopia: A Mixed -Method Approach

Background Ensuring consistent availability of essential medicines is a critical public health challenge, as pharmaceutical supply chains are vulnerable to disruptions, demand uncertainties, and infrastructure limitations. This study assessed the effect of pharmaceutical supply chain risk management practices on operational resilience within public health facilities. Method This study used an explanatory sequential mixed-methods design: a cross-sectional quantitative phase followed by a phenomenological qualitative phase exploring respondents’ lived experiences. The study included 38 health facilities, comprising 18 hospitals and 20 health centers, with 228 respondents. It was conducted from February to March 2025. Quantitative data were collected through self-administered structured questionnaires from supply chain managers, druggists, pharmacists, health facility administrators and system bottle neck focused reform members. Qualitative data were gathered through semi-structured in-depth interviews from health facility administrators and supply chain experts to understand the practices of supply chain risk management. Quantitative data was analyzed using descriptive analysis and Structural Equation Modeling, while qualitative data were analyzed by thematic analysis to identify key themes related to risk management and resilience-building. Result Key pharmaceutical supply chain risks demand, supply, infrastructure, catastrophic, financial, and bureaucratic all demonstrated high severity (mean > 3.5). SCRM practices and resilience indicators were also reported positively. Path analysis revealed that SCRM practices had a significant, strong positive effect on supply chain resilience (β = 0.78, p < 0.001), explaining 61% of its variance. Risk assessment was the most influential SCRM component (β = 0.59, p < 0.001). Qualitative findings identified key barriers to full implementation, including limited awareness, human and financial resource constraints, and a lack of formal guidelines.by limited awareness, human and financial resource constraints, and a lack of guidelines. Conclusion The adoption of structured pharmaceutical supply chain risk management practices significantly enhances operational resilience in public health facilities.