Healthcare Supply Chain Fragility and Medicine Availability in Secondary Health Facilities in Kaduna State

This study examines healthcare supply chain fragility and its effects on medicine availability in secondary health facilities in Kaduna State, North West Nigeria. Secondary health facilities, including general hospitals and specialist centres, serve as critical points of care for patients referred from primary health centres. Persistent medicine stock-outs, irregular supply schedules, and cold chain failures at this tier significantly undermine treatment outcomes and patient trust in public health services. Using a descriptive analytical design, data were gathered through structured questionnaires, medical records review, and key informant interviews with 80 pharmaceutical store managers, medical officers, and supply chain officers across 20 general hospitals in Kaduna State. Supply chain fragility is assessed through supplier concentration, lead time variability, emergency procurement frequency, and disruption recovery time. Medicine availability is measured by stock-out frequency per essential medicine category, fill rate, and days-out-of-stock per quarter. Regression analysis and chi-square tests are employed. The study draws on recent health supply chain resilience frameworks and essential medicines distribution literature from sub-Saharan African health systems. Findings are expected to identify fragmented procurement, centralised warehousing delays, and poor demand forecasting as the dominant fragility drivers. Recommendations address the Kaduna State Ministry of Health, the National Health Insurance Authority, and supply chain partners on building integrated health supply chains with improved demand sensing capabilities. Keywords: healthcare supply chain, medicine availability, fragility, Kaduna State, secondary health facilities.