Determinants, Models, performances, and strategies of supply chain to address medicine stockouts in primary health care: a scoping review

Background: Medicine stockouts (MSOs) remain a significant challenge to delivering quality health services in primary care, primarily due to inefficiencies in Medicine Supply Chain Management (MSCM). This study reviewed existing MSCM models and key factors to develop strategies for strengthening their implementation in primary care settings. Methods: A scoping review was conducted, including original studies published in the PubMed, Scopus, and EBSCO databases between January 2010 and January 2025. The included studies assessed pharmaceutical supply chain models or interventions addressing MSO in primary health care. Studies focused on industry supply chains, wholesalers, vaccines, or reviews were excluded. The Antecedent, Decision, and Outcome (ADO) method was used to lead a systematic scoping review. Antecedents were defined as factors associated with MSCM, decisions referred to the MSCM models, and outcomes represented their performance. Data were thematically analysed using the Pharmaceutical Management Framework, and the reported study followed PRISMA-ScR guidelines. Results: Out of 307 identified articles, 28 met the inclusion criteria. Some countries adopted digital solutions, such as stock tracking tools and Geographic Information Systems. At the same time, those with limited infrastructure focused on strengthening governance and supervision, such as through the Supervision, Performance Assessment, and Recognition Strategy. Contributing factors to MSOs include weaknesses in medicine management, inadequate managerial support, policy gaps, and external disruptions to the supply chain. Conclusion: Successful models for MSOs integrate key factors such as digital technology, strengthened human resource capacity, and supportive governance structures. Future strategies should prioritise systems that are adaptable, data-driven, and backed by strong government commitment.