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Health care provision is generally designed to serve a longstanding role in delivering high-quality services at the point of use. To provide a required service, the health care sector needs a huge investment that should constantly improve as it is associated with human life. The availability of pharmaceutical and medical supplies through the pharmaceutical supply chain is a matter of life or death to the patients (Abukhousa et al. 2014). When the healthcare and pharmaceutical sector functions properly, more patients will be taken care of and more lives will be saved which results in improved quality of life of the society (Tetteh 2009). For this reason, the need for improving the provision of health care services through enhancing the quality of service, and patient safety and satisfaction is now highly required (Papalexi, Bamford, and Dehe 2016). However, health-care organizations have been required to be more effective using the same or similar levels of resource (Papalexi, Bamford, and Dehe 2016), which is a huge setback to the health care sector and it is more challenging especially in developing countries like Ethiopia in which health care sector functions with a very limited resource. To cope up with this challenge, they are looking for cost-saving, waste elimination, and better services through implementing innovative programs such as lean philosophy (Papalexi, Bamford, and Dehe 2016) which is still challenging for the countries like Ethiopia where the scarce resource is not properly managed.
As the fundamental aims behind the lean philosophy are cost reduction, quality improvement, and faster delivery via waste elimination and employee empowerment (Abdulmalek, Rajgopal, and Needy 2006), it can hugely help healthcare provision which is under restricted resource to improve its services. Lean application in healthcare focuses on quality of service to the patient and considers cost and satisfaction of the patient as the key performance indicators of the healthcare system (Spagnol, Min, and Newbold 2013; S. Kumar and Chakravarty 2015). JIT is one of the lean tools (Jorge Luis García-Alcaraz 2016) which specifically focuses on waste reduction (Spagnol, Min, and Newbold 2013). Kanban is one of the most popular tools of JIT, and it is useful to enhance visibility and inventory control systems at different stages in the supply chain (Jorge Luis García-Alcaraz 2016). Kanban can also improve the predictability and stability in inventories and help to reinforce supply chain responsiveness (Kwabena Tetteh 2008). It is stated in the research work of (Papalexi, Bamford, and Dehe 2016) that ABC analysis and the Kanban system are some of the tools to achieve lean objectives. It is also indicated in a webpage published work of (Marion 2020) that Kanban system is a scheduling system that is used in lean processes and just-in-time inventory replenishment programs to help companies improve their production and reduce their overall inventory.