CENTRAL MEDICAL STORES AND ESSENTIAL MEDICINE AVAILABILITY IN SUB-SAHARAN AFRICA: A SYSTEMATIC REVIEW WITH A FOCUS ON TANZANIA’S MEDICAL STORES

Kennedy John Ndetico; Lambert Philipo Barugahale; Rebecca Alex Mkama; Veronica Joseph Mbunda; Julieth Malifimbo; Edward Mwakatuma; Emmanuel Shabani Mandilindi; Edwin Charles Wambwe

doi:10.22270/ujpr.v11i5.1676

Kennedy John Ndetico Kitete Regional Referral Hospital Tabora, Tanzania.
Lambert Philipo Barugahale Kitete Regional Referral Hospital Tabora, Tanzania.
Rebecca Alex Mkama Kitete Regional Referral Hospital Tabora, Tanzania.
Veronica Joseph Mbunda Kitete Regional Referral Hospital Tabora, Tanzania.
Julieth Malifimbo Kitete Regional Referral Hospital Tabora, Tanzania.
Edward Mwakatuma Shelys Pharmaceuticals Limited, Dar es Salaam, Tanzania.
Emmanuel Shabani Mandilindi Shinyanga Regional Referral Hospital, Shinyanga, Tanzania.
Edwin Charles Wambwe Shinyanga Regional Referral Hospital, Shinyanga, Tanzania.

10.22270/ujpr.v11i5.1676

Keywords:

central medical stores, essential medicines, pharmaceutical supply chain, stock-out, sub-Saharan Africa

Abstract

Background: Central medical stores are the principal route by which many low- and middle-income countries seek to ensure that essential medicines reach public hospitals, yet the evidence on how they perform and how this affects patient care remains fragmented.

Objectives: To examine how the performance of central medical stores relates to the availability of essential medicines and patient outcomes in tertiary and referral hospitals across sub-Saharan Africa, with Tanzania as the focus and Kenya, Uganda, and Ghana as comparators.

Methods: This systematic review was conducted in line with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Open-access literature was searched, and only sources carrying a digital object identifier were kept.

Results: In Tanzania, the availability of essential health commodities increased by 12.6% (95% confidence interval 9.6 to 15.6) following Global Fund-supported reforms, and tracer medicine availability in a pilot region went from 69% to 94% once a prime vendor system was introduced. Central store order fulfillment stood at 58.6% in a Tanzanian baseline survey and between 51% and 60% at a Kenyan referral hospital. In Uganda, 84% of 128 facilities reported at least one stock-out during the previous six months, while introduction of an online ordering portal coincided with an increase in order fill rate from 72.6% to 81.4% across 54 hospitals. In Ghana, the availability of 65 essential medicines at a regional store declined from 100% to 52% after framework agreements were adopted (preprint). None of the studies used a randomized or matched comparator, and none recorded hospital mortality together with central store performance.

Conclusion: Reforms coincided with improved availability in Tanzania and Uganda but with reduced availability in Ghana, indicating that design and implementation both count. Evidence connecting central store performance to patient outcomes in tertiary hospitals is limited and indirect.

Peer Review History:

Received 25 July 2026; Reviewed 4 September 2026; Accepted 8 October; Available online 15 November 2026

Academic Editor: Dr. Tamer Elhabibi, Suez Canal University, Egypt, [email protected]

Reviewers:

Dr. Sangeetha Arullappan, Universiti Tunku Abdul Rahman, Malaysia, [email protected]

Dr. Sally A. El-Zahaby, Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, King Salman International University, Egypt, [email protected]