Which stage of pharmaceutical procurement is perceived to be most vulnerable to corruption in public tertiary hospitals in Enugu State, Nigeria?

Pharmaceutical procurement in public tertiary hospitals is a critical component of healthcare delivery but may be vulnerable to corruption because it involves large financial flows, complex technical decisions and multiple actors. In Nigeria, corruption in health sector hinders access to essential medicines, drives up costs, increases circulation of falsified products and compromises patient care. This study examined which procurement stages staff involved in pharmaceutical procurement in two public tertiary hospitals in Enugu State perceived as most vulnerable to corruption. A cross-sectional quantitative study was conducted in two public tertiary hospitals in Enugu State, Nigeria. Data were collected from 122 hospital staff directly or indirectly involved in pharmaceutical procurement. Trained research assistants administered the structured questionnaire face-to-face and recorded participants’ responses. Descriptive statistics summarised respondents’ characteristics and the proportions identifying each procurement stage as vulnerable. Exploratory binary logistic regression examined associations between reported indicators of potentially problematic procurement practices and perceived vulnerability at different procurement stages. Supplier selection was the stage most frequently perceived as vulnerable, identified by 50.8% of respondents, followed by bidding (22.1%). Logistic regression analysis confirmed significant associations between corruption and both supplier selection (OR = 6.65, p = 0.007) and the bidding process (OR = 3.74, p = 0.037). Other stages, such as drug distribution and tender advertisement, showed lower incidences and weaker associations. In this perception survey of staff in two public tertiary hospitals, supplier selection and bidding were most frequently identified as vulnerable stages. The findings identify perceived vulnerabilities, not verified instances or the prevalence of corruption. They indicate priorities for further investigation, triangulation with procurement documents and qualitative evidence, possible governance strengthening, adoption of e-procurement systems and adherence to international procurement ethical standards.