Modeling national health supply chain resilience in Sub-Saharan Africa: an integrated system dynamics approach to routine healthcare and emergency preparedness

Purpose This study aims to address important gaps in understanding public primary healthcare (PPHC) supply chain resilience in Sub-Saharan African (SSA) countries, with a focus on the complex interactions between routine healthcare delivery and emergency response during infectious disease outbreaks (IDOs). Design/methodology/approach The authors developed a system dynamics model, the health supply chain resilience (HSCR) model, to integrate epidemiological dynamics, supply chain operations and healthcare service delivery in SSA contexts. The model simulates the effects of IDOs on the interaction between routine and emergency healthcare delivery and evaluates supply chain preparedness strategies. Three types of interventions were assessed quantitatively: prepositioning of health commodities, local sourcing strategies and healthcare workforce expansion. Findings The analysis highlights the inherent trade-offs between emergency response and routine healthcare continuity. Combining complementary preparedness measures results in stronger resilience outcomes than individual interventions. The HSCR model supports the quantification of these trade-offs and the evidence-based prioritization of investments under resource constraints. Practical implications The model informs policymakers and healthcare professionals on how to design and prioritize supply chain preparedness strategies that balance emergency response and routine healthcare delivery. Originality/value This research contributes to the existing healthcare resilience literature as a novel tool to operationalize resilience, supporting evidence-based decision-making for health system stakeholders. It bridges theoretical and practical approaches to resilience-building in SSA national healthcare systems, offering a replicable model adaptable to diverse disease profiles and country settings, such as low- and middle-income countries with centralized PPHC systems.