Submitted in fulfilment of the requirements of the degree of Doctor of Technology: Public Management, Durban University of Technology, 2017. / The world over, countries are burdened with existing and emerging diseases and while that affected all nations, sub-Saharan Africa carried the heaviest portion. This filtered to Zimbabwe where a myriad of health challenges are faced. Unavailability of medicines coupled with poor inventory management of these medicines has been prevalent. Insufficient financial resources and increasing cost of healthcare costs is one of the pressing matters. It is also important to note that these challenges are occurring at a time when government is realising the crucial role of procurement in addressing health challenges. Due to the extent, depth, breadth and nature of the health challenges and their criticality in establishing sustainable and affordable health system in Zimbabwe, a case study approach has been adopted where data from questionnaires, interviews, documents and observations were corroborated and triangulated in an effort to bring to the surface deep-seated procurement matters and how they are related to the challenges provided. Thus, in terms of the research findings, it was first revealed that the procurement legislative frameworks and processes are fragmented and not in one place resulting in multiple accountabilities. It was further shown that the framework is inappropriate in a healthcare set-up where issues of speed and flexibility in addressing requirements are paramount. It was also shown that procurement planning being a critical aspect is regrettably and detrimentally missing in procurements. In addition, the selection criteria as set out in the regulations and practiced by individual state health facilities indicated over-reliance on price and that being the case, key aspects such as quality and supply-lead time are missed and yet are very necessary in terms of evaluation among other factors. In the findings, the peripheral role of procurement staff with clinicians being also at the epicentre of purchasing decisions was presented. Perhaps related to that was the inadequacy of procurement skills and competences from the procurement personnel. Last on the findings, financing and the frequency of disbursement was unmatched with hospital requirements and thus resulting in unavailability of adequate medicines and equipment. / D