Identification of environmental supply chain bottlenecks: a case study of the Ethiopian healthcare supply chain

The increasing rate of environmental concern and awareness by society has attracted attention from researchers and organisations to consider how to proceed towards green supply chains. The purpose of this paper is to identify operational bottlenecks in the multi-tier supply chain to guide organisations towards where to concentrate their efforts to address their supply chain environmental challenges.

This paper presents a literature review identifying green supply chain challenges of multi-tier supply chains. Following the literature review is a case study of the Ethiopian health supply chain with 11 interviews, 11 international and 6 national surveys and data from public health information systems. An analysis based on multi-tier supply chain modelling is used to identify environmental supply chain bottlenecks.

This research found that the supply chain actors face severe challenges towards enhanced green supply chain performance mainly because of poor inventory management (IN), inefficient tracking and tracing (TR) and fake or sub-standard products in the supply chain, especially counterfeit medicines (CO). Specific environmental bottlenecks within each of the challenge areas IN, TR and CO where identified serving as recommendations for where supply chain actors should focus their work towards greener supply chains.

The data come from participants in a single country, Ethiopia; although the supply chain challenges are common for developing countries in general.

This research presents a modelling approach to identify supply chain activities considered as environmental bottlenecks in multi-tier supply chains. The environmental bottlenecks pinpoint supply chain activities to focus on for a transition towards green supply chains for manufacturers, public and private health organisations, hospitals and health care units.

This paper contributes to the literature on GSCM by developing a multi-tier modelling approach for identifying environmental supply chain bottlenecks. The applicability of the model is demonstrated by the identification of environmental bottlenecks in a healthcare supply chain supporting decisions on what challenges a green supply chain strategy should address. It serves as a basis for future research on where to implement GSCM practices in supply chains (SCs).