Strengthening healthcare supply chains: a social–ecological perspective on resilience

Purpose This paper aims to contextualise the resilience of the healthcare supply chain (HSC) from a social–ecological (S–E) perspective, with the dual aim of investigating S–E resilience principles reflected in HSC resilience literature and identifying actions and barriers that affect HSC's capabilities to persist, adapt and transform in response to disturbances. In doing so, the study addresses the fragmentation in current conceptualisations of HSC resilience. Design/methodology/approach A contextualised literature review systematically analysing a corpus of 89 peer-reviewed articles, guided by a S–E resilience framework, was employed to identify key actions, barriers and applied resilience principles in the HSC context. Findings Key S–E resilience elements, such as collaboration, flexibility and agility, are already present in the HSC resilience literature. Actions enhancing HSC resilience were identified and categorised by implementation phase and enabled S–E resilience capability. Most resilience actions align with persistence and adaptation; only a few cases of transformative resilience are documented. The identification of contextual factors, such as regulatory rigidity, resource constraints and fragmentation, hindering adaptation and transformation, as well as progress towards a desirable post-disturbance state, is another key finding of this study. Social implications Enhancing these capabilities improves the system's ability to withstand and recover from disturbances, ensuring continuous access to healthcare services, and allows the HSC to transform, exploiting disturbances as opportunities to evolve to a new, better post-disturbance state. Such transformation can lead to more equitable healthcare delivery, reduce vulnerabilities and improve long-term outcomes. Originality/value This study examines HSC resilience through the lens of S–E resilience, which emphasises transformation to a stronger state after disturbances rather than merely restoring stability, overcoming the engineering resilience conceptualisation.