# Challenges and best practices in essential medicines supply and use in internally displaced persons (IDP) camps: A qualitative study

## TL;DR

This study explores challenges and solutions for providing essential medicines in Ethiopian IDP camps, highlighting systemic issues and community-based best practices.

## Contribution

The study identifies context-specific best practices to improve essential medicine access in protracted IDP settings through qualitative insights.

## Key findings

- Key challenges include fragile supply chains, stock-outs, and irrational medicine use.
- Best practices involve centralized distribution, coordination, and community engagement.
- Sustainable access requires resilient supply chains and rational medicine use strategies.

## Abstract

Despite the critical need for effective healthcare in internally displaced persons (IDP) camps in Ethiopia, a significant gap exists between the demand for and the actual provision and management of essential medicines. This challenge is rooted in systemic failures across the medicine supply chain and utilization practices, directly compromising the health and well-being of a highly vulnerable population. This study, therefore, explored the challenges and best practices related to essential medicines supply and use in IDP camps in Ethiopia.

An exploratory qualitative study was conducted among key informants, including healthcare providers, IDP site coordinators, representatives from donor organization and health bureue, and patients from selected IDP camps. Participants were purposively selected to capture diverse perspectives relevant to essential medicine supply and use. The contact information of all potential key informants was obtained through official camp records, IDP camp team leaders, and referrals from key stakeholders. Data were collected through in-depth interviews and analyzed thematically using OpenCode software.

The investigator conducted in-depth interviews with 17 key informants. Analysis identified 22 sub-themes grouped under 13 main themes. Key challenges identified included fragile supply chains and procurement process, persistent stock-outs, limited availability, inadequate storage and transportation, weak information management and reporting practices, financial constraints, donor-driven priorities, irrational prescribing and dispensing, fragmented service delivery, poor supervision and accountability mechanisms, and patient and community-level practices such as medicine sharing, self-medication, and incomplete adherence. Best practices that mitigated these challenges included patient identification initiatives, medicine-shifting systems, centralized distribution and cluster-level coordination, structured reporting, strategic allocation, and partnerships between humanitarian actors.

Ensuring sustainable access to essential medicines in IDP camps requires integrated strategies that strengthen supply chain resilience, promote rational medicine use, and actively engage communities. Contextually adapted best practices can enhance equitable access, improve treatment adherence, and support the resilience of health systems in protracted IDP camps.