Enhancing Pharmaceutical supply chain efficiency of medicine through the utilization of lean practices: A survey of hospitals and clinics in Ndola District, Zambia

The efficiency of pharmaceutical supply chains is critical for ensuring timely access to essential medicines in healthcare facilities. This study examines inefficiencies in Ndola District’s pharmaceutical supply chain and evaluates the impact of lean practices such as Value Stream Mapping (VSM), Just-in-Time (JIT) inventory management, Kanban systems, and Lean Six Sigma (LSS). Findings reveal inefficiencies from bureaucratic procurement, poor inventory management, stock-outs, and inadequate storage. A mixed-methods approach combining quantitative survey data and key informant interviews was used. Results show that 74.5% of respondents (26.6% strongly agreeing, 47.9% agreeing) reported a positive impact of VSM, with regression analysis indicating a statistically significant effect (B = 0.572, p = 0.000), meaning a unit increase in VSM improves efficiency by 0.572 units. LSS was noted for enhancing medication safety, with 68.4% agreeing it reduces medication errors and 66.2% recognizing its role in improving material flow and minimizing dispensing delays. However, 23.5% remained neutral and 8.1% disagreed on its effectiveness, with regression analysis showing a positive but less pronounced effect (B = 0.252, p = 0.073). Kanban systems improved medication flow, with 64.7% agreeing they improved product movement and 66.9% recognizing their role in reducing pharmaceutical waste and expired medications. However, 30.9% were neutral, indicating inconsistent implementation. JIT, while explored, showed minimal effects compared to VSM and LSS. Overall, regression analysis confirmed that lean practices significantly enhance supply chain efficiency, explaining 47.7% of its variance (R² = 0.477, adjusted R² = 0.461), with ANOVA confirming the model's significance (F-statistic = 29.895, p = 0.000). VSM had the greatest positive impact, followed by LSS, while JIT and Kanban had lesser effects. The reliability analysis showed excellent internal consistency, with a Cronbach’s alpha of 0.962. Despite the positive impact of lean practices, challenges such as inconsistent supplier reliability, staff resistance to change, and inadequate training hinder full implementation. In conclusion, strengthening the adoption of lean practices—particularly VSM and LSS—alongside policy reforms and infrastructural improvements is essential for enhancing pharmaceutical supply chain efficiency in Ndola District. These findings offer valuable insights for policymakers, healthcare administrators, and supply chain managers aiming to optimize pharmaceutical distribution and improve patient outcomes.