Background: Essential medicines shortages pose a serious challenge for health care rnfacilit ies in Southern Nat ions, Nat ionalit ies and Peoplesâ€Ÿ Region, often affecting healthrncare system. The objectives of the study were to identify the causes of essentialrnmedicines shortages and to point out solutions to prevent this problem in public healthrnfacilities of the Region.rnMethods: A mixed methods design was applied to assess stock outs of essentialrnmedicines and its contributing factors in 30 public health facilities. The quantitative datarnwere analyzed using SPSS version 20; while the qualitative data was categorized intornthemes based on the study objectives and analyzed manually. rnResults: The average stock out on the day of visit was 9(30%) with the 4(24%) of thernitems were with below minimum stock level., 6(38%) were in safe stock level ,andrn3(16%) were in overstock level. The average stock out duration of selected essentialrnmedicines was 74 days. Sub-optimal use of the Logistics information system, poorrnquantification and distribution practices, limited number of human resources for supplyrnchain management and inadequate skills, insufficient budget and irrational prescribingrnand dispensing practices were raised by the key informants as contributing factors for thernmedicines shortages in the Region. rnConclusion: - Southern Nations, Nationalities and Peoplesâ€Ÿ Region has experiencedrnshortages of essential medicines. Factors such as poor logistic management informationrnsystem, lack of skill in logistics activities, less commitment, weak monitoring andrnevaluation systems, irrational prescribing and dispensing practices and insufficient budgetrnallocation and its mismanagement contributed to the shortages.