Antibiotic Shortages among Public Sector Hospitals across Sub-Saharan Africa: Findings and Implications from a Pilot Study

Introduction: Antibiotic shortages in public hospitals across Sub-Saharan Africa (SSA) have emerged as a critical public health challenge. Data on antibiotic shortages are well documented in Europe but remain limited in SSA. This pilot study forms part of a larger project aiming to evaluate the scope, causes and potential mitigation strategies and to address antibiotic shortages among public sector hospitals across SSA. Materials and Methods: Descriptive cross-sectional survey among public hospital healthcare professionals across SSA. Descriptive statistics were calculated using Jamovi. Results: Fifteen participants from 3 SSA countries completed the survey. Shortages occurred 1–3 times in 2024 for 80% (12/15) of participants, lasting mostly less than 2 weeks. Shortages included amoxicillin/clavulanic acid, cefotaxime, piperacillin/tazobactam, linezolid and colistin, covering Access, Watch and Reserve groups. Main causes for shortages were increasing demand (53.8%; 7/15), financial constraints (38.5%; 5/15) and supply-chain problems (38.5%; 5/5). Two-thirds of hospitals had essential antibiotic lists, 53.3% (8/15) used electronic inventory systems and 66.7% (10/15) had therapeutic substitution policies. Two-thirds of respondents reported negative impacts of shortages on patient care (66.7%; 10/15). Pilot testing identified issues with skip logic and question complexity, which are being addressed in the main study to improve clarity and consistency. As a result, enhancing the robustness of future suggestions to alleviate future antibiotic shortages among public hospitals and the implications across SSA. Conclusion: Findings demonstrate the feasibility of the survey approach and highlighted recurrent shortages of essential antibiotics and their impact. A much larger multi-country survey is now being conducted across SSA to inform future strategies.