A dynamic modelling approach to reduce revolving fund medicine stockouts in Nigeria

Essential medicine stockouts have deleterious effects on healthcare delivery, as medicines become unavailable during life-threatening situations at the point of care for the majority of a country’s population. The increasing availability of essential medicines ensures that patients receive treatment for diseases, leading to improved health outcomes. The Drug Revolving Fund Program has been reported to increase access to funds and improve medicine availability. This study uses system dynamics modelling of an integrated essential medicine programme in Kaduna, Nigeria to identify policies that reduce stockouts and increase order fill rates. The four policies that increase fill rates include minimising medicine expiries, increasing the frequency of receivables payments, information dissemination through digital platforms, and improved digital infrastructure to build network trust with suppliers.