A decision-making framework for improving vaccine supply chain performance and sustainability

Purpose This study aims to develop a robust and integrated decision-making framework to enhance the performance, resilience and sustainability of digital vaccine supply chains (VSCs) in developing nations. Despite the growing interest in digital transformation of healthcare logistics, the existing literature on digital VSCs remains fragmented, lacking a comprehensive analysis of challenges. The study addresses this gap by systematically identifying and evaluating key barriers that hinder digital VSC effectiveness, thereby offering actionable insights for both researchers and policymakers. Design/methodology/approach A hybrid multi-criteria decision-making (MCDM) approach was employed, which combined factor prioritization and causal analysis to identify priority order and causal inter-relationship among challenges. Primary data were collected from diverse stakeholders across India, including health agencies, logistics providers and pharmaceutical manufacturers to ensure practical relevance and contextual validity. Findings The results reveal that high investment costs, digital infrastructure gaps and temperature control issues are the most important challenges that affect digital VSC performance. Moreover, financial and technological barriers were found to exert a strong influence over operational and regulatory issues. Research limitations/implications While this study focuses on the developing economy context, the methodological framework is both replicable and scalable for other developing countries facing similar logistical and infrastructural constraints. Future research can expand this work through cross-national validation. Practical implications The proposed framework provides a decision-support tool for policymakers and supply chain managers to assess systemic vulnerabilities and design more resilient and sustainable digital VSC strategies. It supports informed policymaking by highlighting priority intervention areas and enabling resource optimization, especially during public health crises. Originality/value To the best of the authors' knowledge, this study is an initial attempt to integrate performance management, sustainability and resilience perspectives in the domain of digital VSCs in developing economies. The study not only extends theoretical knowledge by identifying causal inter-relationships but also offers a replicable analytical model which can guide future empirical investigations and strategic planning in public health logistics.