The promise and limits of medicine traceability in low-resource settings: Lessons from Ghana
DOI:
https://doi.org/10.38159/gpj.x6pndm37Keywords:
Substandard medicines, Adoption Gap Index, Diffusion of Innovations, post-market surveillanceAbstract
Background: Substandard and falsified medicines continue to compromise health systems in low- and middle-income countries. Ghana has introduced pharmaceutical traceability solutions, yet questions remain about adoption patterns across the pharmaceutical supply chain. This study applied the Diffusion of Innovations theory as an analytical lens to determine patterns of uptake, bottlenecks, and determinants of traceability implementation at the system level in Ghana.
Methods: We employed a mixed-methods exploratory approach drawing on regulatory documents, post-market surveillance reports published between 2019 and 2024, and semi-structured interviews with 150 stakeholders representing all levels of the pharmaceutical supply chain. Qualitative data were coded using Diffusion of Innovations constructs and inductive themes. Quantitative analyses included descriptive statistics, an Adoption Gap Index, correlation modelling, and stage-wise funnel analysis of transitions from awareness to trial and implementation; the usability of five traceability technologies was also tested.
Results: Surveillance data revealed fluctuating detection of non-compliant products, with failure rates reaching 17% in 2024. Awareness of traceability tools was universal among regulators and high among importers (88%), but fell sharply among pharmacies (41%) and consumers (22%), with full implementation of only 2% and 0.5%, respectively; Adoption Gap Index values exceeded 95% for both groups. Trial behaviour was strongly associated with eventual implementation (r = 0.997), and low-infrastructure solutions such as SMS-based authentication offered the simplest user experience.
Conclusion: Based on our Traceability Adoption and Diffusion Model, we propose enforcement, user-centred redesign, low-technology authentication, and feedback loops as interventions to close the adoption gap.
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The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Copyright (c) 2026 Priscilla Kolibea Mante, Nana Ofori Adomako, John Danquah
This work is licensed under a Creative Commons Attribution 4.0 International License.
