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

Abstract: 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.