Adoption and utilization of the electronic logistics management information system and supply chain performance in public health facilities in the Greater Kampala Metropolitan Area, Uganda: a cross-sectional study

Abstract Background Electronic logistics management information systems (eLMIS) are central to efforts to strengthen health supply chains in low- and middle-income countries, yet national reports from Uganda indicate that installation has outpaced routine use. Evidence linking the intensity of system use to measurable supply chain outcomes remains limited. This study assessed the extent of eLMIS adoption, the patterns of its utilization, and the association between utilization and supply chain performance in public health facilities in the Greater Kampala Metropolitan Area (GKMA). Objective To assess the adoption, utilization, and effect of Electronic Logistics Management Information System on supply-chain performance among public health facilities in the Greater Kampala Metropolitan Area. Methods A cross-sectional study was conducted between May and July 2025. All 75 eligible public health facilities in the four GKMA districts were approached, and 60 participated (response rate 80%). Data were collected with a pretested structured facility assessment checklist that combined direct observation, key informant interview, and abstraction of facility records. A composite utilization score (range 0 to 5; Cronbach’s alpha = 0.81) and a composite supply chain performance index integrating objective indicators (stock-outs, expiries, and order lead time) with staff-perceived performance (Cronbach’s alpha = 0.78) were computed. Analyses in SPSS version 28 included chi-square tests, independent samples t tests, Pearson correlation, and multiple linear regression fitted on all 60 facilities, with non-adopters assigned a utilization score of zero and facility level as a covariate. Results Thirty-three of 60 facilities (55.0%; 95% CI 41.6–67.9) had adopted eLMIS, including all five hospitals, 8 of 11 (72.7%) health centre IVs, and 20 of 44 (45.5%) health centre IIIs. Mean utilization scores were higher at higher facility levels (hospitals 4.8, health centre IVs 4.2, health centre IIIs 3.2) and with staff training (4.0 versus 3.2). Compared with non-adopting facilities, eLMIS facilities reported fewer tracer commodity stock-outs (21.2% versus 51.9%; p  = 0.013), fewer expired batches (mean 3.1 versus 7.4; p  = 0.005), and shorter order lead times (3.2 versus 4.6 weeks; p  = 0.033). Utilization was independently associated with composite performance after adjustment for facility level (β = 0.61; p  < 0.001; model R ² = 0.44; N = 60), and performance was progressively higher across non-adopters, low utilizers, and high utilizers. Conclusions eLMIS adoption was moderate and unevenly distributed, and supply chain performance was better where the system was used intensively. Scale-up strategies should prioritize infrastructure, training, and supportive supervision at health centre IIIs so that installation translates into routine use and measurable performance improvement.