Stakeholder Engagement, Ethical Standard and Supply Chain Performance of Public Health Facilities in Uganda.
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Date
2025-10-01
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Makerere University Business School
Abstract
Public health facilities in Uganda face significant challenges in managing their supply chains effectively. Timely access to medical supplies, medications, and equipment is critical for patient care. However, many facilities experience frequent delays and shortages, which disrupt service delivery and increase mortality rates. For instance, over 40% of health facilities report shortages of essential medicines, such as antimalarials and antibiotics, within any given six-month period. This study aimed to establish the relationship between stakeholder engagement, ethical standards, and supply chain performance in Uganda's public health facilities. Specifically, it sought to: (1) examine the relationship between stakeholder engagement and supply chain performance; (2) assess the relationship between ethical standards and supply chain performance; (3) evaluate the mediating effect of ethical standards on the relationship between stakeholder engagement and supply chain performance; and (4) establish the moderating role of ethical standards on this relationship. A cross-sectional survey design, utilizing a quantitative approach, was employed. The study focused on 91 public health facilities in Kampala, comprising 4 National Referral Hospitals, 23 general hospitals, 11 Health Centre IVs, and 53 Health Centre IIIs. Using simple random sampling, 88 questionnaires were distributed; 80 were completed and returned, resulting in a 90.9% response rate. The findings revealed a statistically significant positive correlation between stakeholder engagement and supply chain performance. Regression analysis further confirmed stakeholder engagement as a significant predictor and identified it as the most influential factor driving performance. Regarding ethical standards, the analysis indicated a statistically significant positive association with supply chain performance. However, despite this correlation, regression analysis revealed that ethical standards alone made an insignificant contribution to predicting performance, raising questions about their independent impact on supply chain outcomes. Furthermore, the analysis showed that ethical standards did not significantly mediate the relationship between stakeholder engagement and performance, which was instead characterized by a strong direct effect of stakeholder engagement. Finally, ethical standards were also found not to play a significant moderating role in this relationship. Based on these findings, the study concluded that stakeholder engagement is a critical contributor to the performance of public health facilities, as active involvement enhances service delivery and operational efficiency. In contrast, while ethical standards are essential for fostering trust and providing a framework for responsible practices, their direct influence on supply chain efficiency appears minimal. Consequently, the study recommends that policymakers create and promote regulations that emphasize ethical standards within public health supply chains. By establishing policies that support both ethical procurement practices and robust stakeholder engagement, policymakers can help ensure that public health initiatives are sustainable, transparent, and accountable, ultimately enhancing overall supply chain performance.
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This is a master's thesis.
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Citation
Nuwasiima, O. (2025). Stakeholder Engagement, Ethical Standard and Supply Chain Performance of Public Health Facilities in Uganda. (Unpublished master's dissertation). Makerere University Business School, Kampala, Uganda.