Healthcare supply chain challenges in developing countries: Implications for older people—A narrative review
Populations in low- and middle-income countries (LMICs) are ageing rapidly, and older adults in these countries frequently experience multimorbidity, frailty, and functional decline, increasing their need for continuous access to medicines, diagnostics, rehabilitation, and assistive devices. However, healthcare supply chains in many developing countries remain fragile, characterised by procurement delays, stock-outs, inefficient distribution systems, inadequate financing, weak information systems, and workforce shortages. This review examines healthcare supply-chain challenges in developing countries and their implications for older populations, drawing on evidence from peer-reviewed studies, systematic reviews, meta-analyses, and reports from international health agencies. The review focuses on population ageing, essential medicines, healthcare access, multimorbidity, functional limitation, health inequality, supply-chain performance, and health-system resilience. Weak supply chains compromise the availability, affordability, and continuity of healthcare, with particularly serious consequences for older adults who require sustained treatment for chronic conditions and may experience preventable deterioration when care is interrupted. Poverty, geographical barriers, disability, frailty, limited health literacy, and dependence on caregivers further restrict access to essential services. Across LMICs, medicine stock-outs persist, income and education shape healthcare utilisation, and geriatric and palliative care services remain underdeveloped. Health emergencies further intensify these existing vulnerabilities. Strengthening healthcare supply chains should therefore be recognised as a fundamental component of healthy ageing and universal health coverage. Improvements in procurement, demand forecasting, inventory management, last-mile delivery, financing, information systems, and workforce capacity can improve both continuity of care and equitable access to essential healthcare. Ultimately, supply-chain resilience should be assessed not only by a health system’s ability to respond to crises but also by its capacity to sustain routine care for older adults.
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