Healthcare supply chain resilience during the COVID-19 pandemic: PPE procurement challenges and strategies

Lima, Isabela Antunes de Souza; Alcantara, Beatryz de Almeida; Gomes, Henrique Costa; Samed, Márcia Marcondes Altimari

doi:10.1590/1806-9649-2025v33e1325

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ORIGINAL ARTICLE • Gest. Prod. 33 • 2026 • https://doi.org/10.1590/1806-9649-2025v33e1325 linkcopy

Healthcare supply chain resilience during the COVID-19 pandemic: PPE procurement challenges and strategies

Resiliência da cadeia de suprimentos hospitalar durante a pandemia de COVID-19: desafios e estratégias de aquisição de EPIs

Authorship SCIMAGO INSTITUTIONS RANKINGS

The COVID-19 pandemic exposed critical vulnerabilities in hospital supply chains, especially in developing countries with limited procurement agility. This study analyzes how public and private healthcare institutions responded to disruptions in the supply chain of pandemic personal protective equipment (PPE), based on a structured survey conducted with hospital managers and representatives from the regional health authority in southern Brazil. The findings reveal institutional asymmetries in demand forecasting, supplier diversification, and technological integration. Procurement resilience was influenced more by managerial flexibility and inter-institutional collaboration than using digital tools. By addressing local governance in public procurement under emergency conditions, this research offers an empirical contribution from a Global South perspective, highlighting adaptive and collaborative mechanisms as key factors for strengthening hospital supply chains during crises. The results contribute to the literature on humanitarian logistics and disaster preparedness, with implications for decentralized health systems. This study also supports progress toward Sustainable Development Goal 3 (Good Health and Well-Being), by promoting strategies that ensure equitable access to medical supplies in critical situations.

Keywords:
Humanitarian logistics; Healthcare supply chain; Supply chain resilience; Procurement strategies

Indicator	Issues	Question
Supply chain disruption	Was there a disruption in the supply chain of hospital PPE during COVID-19?	1
	Have incentives been made available to suppliers for faster deliveries and greater quantities of supplies?	2
	Was there an effective prediction of the possibility of product shortages?	3
	Has there been an optimal reallocation of financial resources for the COVID-19 response?	4
Supply chain resilience	Did the response from supply chain management happen in an agile way?	5
	Did the response of supply chain management happen in an aligned way?	6
	Has the supply chain management response been adaptive?	7
	Has the PPE supply chain been able to return to pre-pandemic standards?	8
	Has hospital PPE supply chain management responded to the pandemic efficiently?	9
Smart supply chain	Have smart contracts been adopted to manage orders and transactions in a decentralized way?	10
	Were technological devices used to access updated information from suppliers, such as price, inventory, and delivery status?	11
	Were technological devices used to predict bed occupancy or predict the number of infected?	12
	Were IT tools used for supply chain management? Ex: Just in time, quick response, continuous replenishment, collaborative plan, vendor-managed inventory)	13
	Have smart tools been adopted to improve procurement management? (Ex: big data analytics, IoT, Blockchain, machine learning, business intelligence.)	14
Demand	Were statistical or mathematical methods used to predict PPE demand?	15
	Were computational methods used to predict PPE demand?	16
	Was the demand forecast based on analyses of the demands of other countries?	17
	After the first wave of COVID-19, was there a stock higher than demand?	18
Acquisition	Was there planning and standardization of PPE kits?	19
	Was there a previous stock for a potential eventuality?	20
	Were safety stock systems used?	21
	Was there diversification of the sources of supply of hospital PPE? (Including purchases from local suppliers or direct manufacturer contracts)	22
	Was there competition with other institutions for suppliers?	23
	Was it possible to notice a variation in the price of products due to the variation in demand?	24
	Have regulations been relaxed to allow for faster decision-making by qualified personnel responsible for procurement?	25
	Was there flexibility in contracts with the main suppliers about the quantity purchased and guarantee of receiving extra quantities when necessary?	26
	Was an emergency supply strategy plan used?	27
	Was a purchase method planning used?	28
	Were offers analyzed by comparison?	29
	Were there collaborative purchases between hospitals?	30
	Was there standardization of materials and purchasing procedures to improve procurement performance?	31
	Were donations of hospital PPE received or partnerships with the municipal government established?	32
Public-private collaborations	Were donations of hospital PPE or financial resources received from the state and/or federal government?	33
	Were donations of hospital PPE or financial resources received from NGOs?	34
	Were philanthropic donations of hospital PPE or financial resources received?	35
	Were donations of hospital PPE or financial resources received from private institutions?	36
	Were unsolicited donations received?	37
	Did the institution follow coordinated actions for the acquisition and inventory of PPE?	38
	Was there cooperation from donors/partners other than the government or NGOs?	39

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Universidade Federal de São Carlos Departamento de Engenharia de Produção , Caixa Postal 676 , 13.565-905 São Carlos SP Brazil, Tel.: +55 16 3351 8471 - São Carlos - SP - Brazil
E-mail: gp@dep.ufscar.br

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