Research Article
Centralized Faith-based Pharmaceutical Supply Chain Performance in Cameroon: A System-level Audit
Issue:
Volume 12, Issue 3, June 2026
Pages:
39-53
Received:
16 June 2026
Accepted:
30 June 2026
Published:
22 July 2026
DOI:
10.11648/j.ejcbs.20261203.11
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Views:
Abstract: Background: Centralized pharmaceutical procurement can strengthen medicine quality assurance and reduce exposure to substandard and falsified medicines in low- and middle-income countries. However, medicine availability depends on how well procurement, forecasting, warehousing, inventory management, information systems, and distribution function as an integrated system. This study assessed the system-level performance of a centralized, faith-based pharmaceutical supply chain in Cameroon to identify operational strengths, performance gaps, and governance-related risks that affect sustained access to quality-assured medicines. Methods: A cross-sectional pharmaceutical supply chain audit was conducted over a 1-year period using the Pharmaceutical Supply Chain Initiative tripartite audit framework. Performance was assessed across forecasting, procurement, supplier sourcing, warehousing, inventory management, use of logistics management information systems, and distribution, using adapted USAID-recommended indicators. Quantitative benchmarking was complemented by participatory root-cause analysis using the Ishikawa framework. Results: Procurement-level quality assurance was strong: all products underwent quality testing, and 94.6% met pharmacopoeial standards. Internal warehouse handling accuracy and electronic order processing through the logistics management information system also met benchmark targets. In contrast, major downstream gaps were identified. Forecasting discrepancies reached 49.5%; supplier on-time delivery was low; warehouse storage utilization exceeded recommended capacity; inventory accuracy remained below target; and order-filling performance was poor at 38%. These gaps were associated with high stockout rates of 49.7% and inconsistent medicine availability across service delivery points, indicating misalignment between governance functions and downstream operational performance. Conclusions: Centralized procurement strengthened upstream quality assurance but did not ensure reliable availability of medicines when downstream supply chain functions were weak. Persistent gaps in forecasting, supplier performance, warehousing, inventory management, and distribution were associated with reduced service readiness and greater reliance on emergency or decentralized procurement pathways, which may increase risks to medicine quality. Strengthening pharmaceutical supply chains requires integrated end-to-end performance management, supported by routine system-level audits, to align governance and operational functions and sustain access to quality-assured medicines.
Abstract: Background: Centralized pharmaceutical procurement can strengthen medicine quality assurance and reduce exposure to substandard and falsified medicines in low- and middle-income countries. However, medicine availability depends on how well procurement, forecasting, warehousing, inventory management, information systems, and distribution function as...
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,
Gerald Ngo Teke
