Introduction: Health Extension Workers (HEWs) play key roles in the health care system ofrnEthiopia. They do health promotion, prevention and curative activities as well as manage arnnumber of items including medicines at the community and health post level in which access tornhealth care is limited. Even though HEWs manage various medicines, they come acrossrnchallenges when they order, receive, store and distribute medicines to the community. The extentrnof challenges they face may vary from region to region and from time to time. However, inrnEthiopia few studies have conducted on supply chain management of medicines by HEWs andrnchallenges faced. rnMethod: A qualitative study design was used. In depth interview of HEWs, key informantrninterviews with pharmacy professionals, two focus group discussions among female communityrnmembers and observation were carried out. The data was coded and analyzed thematically, basedrnon objectives. rnResult: HEWs receive a list of drugs from the cluster health center by calculating for a month orrntwo months. And they put medicines on the shelf and cartons without being well arranged. Basedrnon Integrated community case management booklet, HEWs treat patients who are under 5 of agernand give medicines for the disease that defines. If it is out of their scope they refer them to thernHC. HEWs in North Shewa are dissatisfied with their job because of their salary scale, lack ofrnincentives, unable to upgrade their career. They also feel that they are not as beneficiary as otherrnhealth workers in terms of other job opportunities. They are also overloaded by nonprofessionalrnactivities. The overall HEWs training focuses on family planning whereas medicine managementrnpractice training is minimal. rnConclusion: HEWs are front line health workers in the rural community. From this study theyrnreceive, store and distribute or dispense medicines to consumers not in line with thernrecommended guidelines. This is due to lack of adequate training, transport, overload with otherrntasks, and resources limitation including medicines. So the woreda or zonal health offices need tornintervene by giving regular and detail medicine supply chain training and in turn improvingrnHEWs supply chain of medicine management practices.