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Toward A Systems-Level Framework for Healthcare Access, Affordability, and Supply Chain Resilience

Cindy Serwaa Asiedu

Abstract

Efforts to improve healthcare access, contain medication costs, and strengthen supply chain reliability are too often pursued as separate agendas, producing fragmented interventions that overlook their interdependence. This conceptual article proposes an integrative, systems-level framework that treats access, affordability, and supply chain resilience as mutually reinforcing dimensions of a single problem rather than as parallel objectives. Drawing on systems theory, supply chain management, and health-services research, the framework articulates the causal links among procurement and distribution performance, pricing and financing structures, and patient-level access outcomes, and it specifies the feedback loops through which weakness in one dimension propagates to the others. The model defines its core constructs and their relationships, identifies the leverage points where intervention is most consequential, and offers propositions to guide both analysis and intervention design. Rather than reporting new data, the article advances theory by organizing fragmented evidence into a coherent structure, and by reframing resilience not as redundancy alone but as the capacity of a system to sustain equitable access under stress. Illustrative applications show how the framework can be operationalized for diagnosis, prioritization, and evaluation in resource-constrained settings. The article closes with a research agenda for testing and refining the proposed model.

Keywords

health systems; access to medicines; affordability; supply chain resilience; systems thinking; conceptual framework; universal health coverage.

References

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