The path to performance of public versus private healthcare supply chains: case study of Uganda

Purpose Improving performance of healthcare supply chains (HCSCs) remains a priority in low- and middle-income countries (LMICs). Studies highlight the importance of inter-organizational collaboration for superior HCSC performance, a challenge still faced by LMICs due to fragmented practices. Therefore, this study aims to explore the interrelationships between different dimensions of collaboration and supply chain (SC) performance. Design/methodology/approach This study built upon an embedded multiple-case design, encompassing both public and private HCSCs with high-level and low-level health facilities in Uganda, a LMIC. Data was collected from documents, archival records and 39 interviews and thematically coded in NVivo. Findings Monitoring supply chain flow and stock accumulation provided alerts for stockout and expiration, which are the commonly tracked SC performance indicators in both public and private HCSCs. Significant frequent stockouts occurred in public and low-level health facilities in comparison to the private and high-level ones. Increased presence of collaboration dimensions such as shared benefits, SC relationships, adherence to government guidelines, information technology, inventory management and order processing resulted in higher performance in both public and private HCSCs in Uganda. Research limitations/implications Empirical data stems from one country focusing on the main medicines used for prevention and treatment of hemorrhage; further research could include other LMIC settings and medicines to explore how specific dimensions of collaboration affect specific SC performance indicators. Originality/value A holistic framework for SC collaboration is proposed to complement fragmented collaboration practices and enable more effective interventions in HCSCs in LMICs.