An assessment of the prevalence and determinants of medicine stockouts and shortages in the public healthcare system of South Africa
1
Pharmaceutical Sciences, Tshwane University of Technology, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1230
ABSTRACT
BACKGROUND:
Medicine stockouts present a challenge to the public healthcare system of South Africa1,2. Limited availability of medicines compromise the continuity of patient therapy and therefore resulting in poor outcomes and reduced health system efficiency2,3. Despite substantial budget allocations, recurring shortages suggest that systemic inefficiencies, rather than financial constraints alone, lead to supply disruptions4. A comprehensive, nationwide analysis of stockout patterns, provincial variations, and underlying determinants is essential to inform targeted policy and supply chain reforms. This study aimed to assess the prevalence and primary determinants of medicine stockouts in all nine (9) provinces of South Africa.
METHODS:
A quantitative, cross-sectional design was employed. Secondary data from the National Department of Health and the Stop Stockouts Project, over 12 months, was used to conduct the study. Data on stockout incidents, therapeutic classes, duration and provincial health budgets were analysed using descriptive statistics, Chi-square tests for seasonal variation and regression analysis to evaluate associations between budget parameters and stockout rates.
RESULTS:
Stockout prevalence varied significantly in the provinces, with Mpumalanga (57.8%), North West (48.9%), and KwaZulu-Natal (37.8%) most severely affected. Antibacterials, antiretrovirals, and analgesics were the most frequently unavailable medicines, with significant seasonal variation (χ²(84)=162.23, p<0.001). Regression analysis revealed a weak inverse correlation between provincial health budgets and stockout incidence, indicating that higher expenditure did not guarantee better medicine availability. Instead, procurement inefficiencies and poor supply chain coordination emerged as stronger predictors of shortages.
CONCLUSIONS:
Medicine stockouts in South Africa are prevalent and driven more by systemic and operational challenges than by inadequate funding. Effective financial management, transparent procurement processes, and strengthened supply chain oversight are necessary to mitigating the shortages. These findings indicate the need for integrated policy interventions that link budgetary discipline with logistics management to ensure reliable access to essential medicines and improve public health outcomes.
Medicine stockouts present a challenge to the public healthcare system of South Africa1,2. Limited availability of medicines compromise the continuity of patient therapy and therefore resulting in poor outcomes and reduced health system efficiency2,3. Despite substantial budget allocations, recurring shortages suggest that systemic inefficiencies, rather than financial constraints alone, lead to supply disruptions4. A comprehensive, nationwide analysis of stockout patterns, provincial variations, and underlying determinants is essential to inform targeted policy and supply chain reforms. This study aimed to assess the prevalence and primary determinants of medicine stockouts in all nine (9) provinces of South Africa.
METHODS:
A quantitative, cross-sectional design was employed. Secondary data from the National Department of Health and the Stop Stockouts Project, over 12 months, was used to conduct the study. Data on stockout incidents, therapeutic classes, duration and provincial health budgets were analysed using descriptive statistics, Chi-square tests for seasonal variation and regression analysis to evaluate associations between budget parameters and stockout rates.
RESULTS:
Stockout prevalence varied significantly in the provinces, with Mpumalanga (57.8%), North West (48.9%), and KwaZulu-Natal (37.8%) most severely affected. Antibacterials, antiretrovirals, and analgesics were the most frequently unavailable medicines, with significant seasonal variation (χ²(84)=162.23, p<0.001). Regression analysis revealed a weak inverse correlation between provincial health budgets and stockout incidence, indicating that higher expenditure did not guarantee better medicine availability. Instead, procurement inefficiencies and poor supply chain coordination emerged as stronger predictors of shortages.
CONCLUSIONS:
Medicine stockouts in South Africa are prevalent and driven more by systemic and operational challenges than by inadequate funding. Effective financial management, transparent procurement processes, and strengthened supply chain oversight are necessary to mitigating the shortages. These findings indicate the need for integrated policy interventions that link budgetary discipline with logistics management to ensure reliable access to essential medicines and improve public health outcomes.
| eISSN: | 2654-1459 |
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