Innovative technologies provide emerging technologies and digital tools, such as 3-D printing, blockchain, and robotics. Single organizations depend on contributions from key stakeholders to develop and capitalize on benefits 1, 2. These stakeholders include institutional leaders who influence the purchasing decision-making process within their organizations, as well as professional supply chains 3, 4. However, limited research currently involves stakeholders in the subject-matter discussion of 3-D printing, blockchain, the Internet of Things, and robotics for the public use of experimental technologies.

The health and humanitarian sectors play a crucial role in the lifesaving of patients and populations. Global and local initiatives work towards increasing the impact by increasing supply chain system performance. In this investigation, we aim to understand how the adoption of new technology in the health and humanitarian sector can support supply chain performance and achieve its tactical and operational benefits. We used the systematic review methodology to gather, analyze, find gaps, and report all relevant literature, as previous work has been limited to understanding and use primarily focused on specific or emerging technology in the supply chain domain. The limited comprehensive systematic exploration of all innovations and how the domain can fully take advantage of IT has prevented the full alignment of the industry leap towards the health and humanitarian supply chain successors.

Levers relate to the general class of drivers of the adoption and use of emergent technologies or digital tools, guided by their institutional and environmental setting where supply chains operate. They can take the form of several comprehensive and inclusive typologies, such as the WTO and SMF classification of terms and the ATNS Health Supply Chain Adoption Model. These typologies were used with key informant interviews to expand their coverage of the breadth of leveraging factors. Thus, our consideration of levers is predefined, such that all enabling and impelling factors encountered in this framework shall be included in the data synthesis. So, more prospective work is discussed in the same chapter. Then, these lists are integrated together and organized into four categories that reward contrasting types of interventions. They are assigned measures that can be employed to detect them in the text of vitality.

We adapted the international process of thematic evaluation to produce the Alan Patent process to develop a set of practical interconnected resources for the three stages of evaluation, preparation, and decision-making 5, 6. Our set of items useful for selection represents the contributions of vendors to the verification and validation of data, suggestions to consider during the decision-making process, other internal and external aids, and a set of techniques to implement emerging technologies during the three stages 7. Furthermore, we identified four organizational components involved in the purchase decision-making process and analyzed the influence of these components throughout several key stages 8, 9.

The objective of this pandemic-supported study is to use a systematic review methodology to collect, explore, and report on emerging workforce technologies in the health and humanitarian supply chain. The generated knowledge aims to advance both domain practice and academic research on sector technology maturity and provide implementation support for stakeholder decision-makers. It also aims to consolidate a view of the current leverage points and provides a future roadmap of emerging technology levers and actions to be taken at an individual, organizational, and sector level.

Characterization of the background: Emerging technologies, such as 3-D printing, blockchain, the Internet of Things, and robotics, offer the potential to revolutionize public health and humanitarian supply chains.

This article is based on a comprehensive narrative review of the existing body of literature focusing on the adoption of emerging technologies in health and humanitarian supply chains [HHSC]. The review aims to identify key trends and the implications of adopting technologies such as artificial intelligence, the Internet of Things [IoT], blockchain, and 3D printing, specifically within the domains of Humanitarian Logistics Management [HLM], Humanitarian Logistics Operations [HLO], and Healthcare Supply Chain Management [HSCM].

A targeted literature search was conducted, focusing on peer-reviewed academic journals and relevant reports published between January 1, 2010, and December 31, 2020. The databases used included Scopus, Web of Science, PubMed, and IEEE, alongside general search engines such as Google Scholar. Studies were selected based on their relevance to the health and humanitarian sectors and their focus on the technological innovations mentioned above.

The search employed broad keywords related to emerging technologies, digitization, and their specific application in supply chain management. Studies were included if they discussed any aspect of technology integration within HHSC, covering areas such as logistics, warehousing, planning, monitoring, and operational optimization. No restriction was placed on the type of study or its methodology, as the goal was to capture diverse perspectives and insights from a wide range of sources.

Emerging technologies are often referred to as those on the innovation curve, progressing from a conceptual stage into an area that is close to potential market impact 10. Given the dynamics driven by market forces, technological innovation has the potential to further drive the productivity agenda and, in the case of cross-cutting issues such as health supply chains, could have a significant effect on the availability and efficiency of supply chain infrastructures 11. As already noted, technological innovation will play a leading role in the future of health and humanitarian supply chains 12. As demonstrated in other sectors, the use of technology can be transformational for supply chain dynamics, leading to enhanced visibility, responsiveness, flexibility, and control of operations, thus, better service delivery 13.

Over the past 15 years, technological innovation has led to the development and use of personal digital tools, mobile computing, the Internet of Things, intelligent automation, and cloud computing and storage as they increasingly enable advanced, data-driven insights and decision support for improving supply chain management 14. As a result, they are transforming traditional supply chain systems into digital supply networks, with the potential to significantly enhance levels of integration, visibility, and quality and to improve modal shifts and processes for storage and delivery 15.

Implementation of disruptive technologies could also be essential in strengthening health supply chains to better react to public health emergencies, such as those posed by the recent SARS-CoV-2 pandemic, and to ensure adequate vaccine distribution 16. In the humanitarian context, innovative applications of artificial intelligence, blockchain, 3D printing, and other emerging technologies have the potential to boost the quality and agility of relief actions, better inform decision-making, and improve the quantity and quality of services rendered to beneficiaries 17. Consequently, it would be of interest for the research community at large to investigate the potential of these technologies to promote public health and act as game changers for supply chain and logistics activities within health and humanitarian settings and to carefully balance their adoption and acceptance by local markets 18.

Digital tools are considered applications using software or technology platforms serving a specific purpose or set of activities. Choudhury et al. [2021] explain that the use of digital solutions is gaining momentum in several aspects of work, including supply chain management 47. These digital tools vary some are powered by IoT sensors that gather data on location, environmental conditions, and performance 48, while others use mobile applications to streamline communication 49. Most leverage cloud or blockchain technology to protect secure information sharing across entities [Feng et al., 2022]. We are now entering the era of leveraging AI and machine learning tools that can predict, inform, and/or instruct decisions on better outcomes 50. Recent literature reviews on Health Supply Chain Management Systems [HSCMS] or Supply Chain Optimization and its tools cover useful information but have not given a complete picture of the use of digital solutions, in particular emerging technologies and their implications for HHS networks 51. Hence, the purpose of this systematic review is to identify the extent of the usage and potential impacts of these digital tools for health and humanitarian supply chains.

There is a growing number of commercial supply chain management systems targeting humanitarian operations, such as Aidmatrix, Flexisphere, Em-Dat, and NomaDesk, or the World Food Programme's [WFP] Stock Visibility System. There is also a growing number of software tools like mSupply, SupplyOK, Sq. Hardware, or Microsoft InfoPath, specialized supply chain management systems, and increasingly, enterprise resource planning systems. Attempts to integrate these tools further with financial management and accounting [e.g., QuickBooks] and human resource management functions might also become possible. Household and community or patient and clinic supply chain monitoring can be used with IT systems to track exactly what goods are actually being delivered. Supply chain performance monitoring and evaluation have been developed and can track improvements and highlight necessary adjustments.

Leveraging technological improvement and application in performance management and operational research, Six Sigma, total quality management, and increasing supply chain management focus on core goals of operational efficiency, driving out inventory and production costs. Operational research initiatives like Banar and Schwabe in Tanzania demonstrated the impact of process performance improvement on vaccine wastage rates and, hence, cost-effectiveness. In some cases, no special software or IT infrastructure is necessary. Their application can leverage whatever specialist software has been developed. On the other hand, they draw supply chain managers' attention to the core areas where specialist system support can have the biggest impact.

The implications of the burgeoning field of technology adoption are multilateral in nature but predominantly result in behavioral, organizational, and societal facets. Kabra et al. [2023] highlight that with the current discursive threshold analysis, we are mainly focusing on the implications from the perspective of the supply chain, especially emphasizing the health and humanitarian categories. Argumedo-García et al. [2021] emphasize that this exploratory review deliberates and presents an in-depth reflective understanding of the indicated implications of adoption from an array of mixed-technology use patterns. The findings should serve as a useful guide, with a comprehensive knowledge of the consequences of technology adoption, not only for managers in health and humanitarian supply chains but also for external entities who are contributing to this burgeoning field. Dohale et al. [2024] provide insights into the thematic analysis, which revealed the organized classification of the implications in eight valuable categories.

There is an ever-growing need to support those in humanitarian emergencies and medical supply struggles across the globe during all sorts of unfavorable conditions, especially when building physical infrastructure is less preferred. Marić et al. [2022] point out that this reality has led to increasingly digitally aware solutions that are an explicit focus of this study. This study should allow for efficient decision-making of technological innovations in the setting of humanitarian and health supply chains by incorporating both humanitarian and health sectors and digitizing supply chain management. The insights may also be valuable to others in the humanitarian sector who are interested in understanding the potential implications of investing in technology-related initiatives.

Most humanitarian and public health organizations have limited resources that might limit the supply of goods in the network from manufacturers to beneficiaries. However, this specific impediment should not negatively affect supply chain responsiveness under normal conditions when those organizations should minimize the last-mile cost and performance deviations from the customer needs through optimization of stock positioning, financial supply chain setting, and mode choice, resulting in last-mile fitting management. Despite limitations for a human sustainable and major cost strategy in relation to private sector supply chains, the focal reduction of the discrepancy between customer needs and delivery of the desired service is important to guarantee the social mission urgency in conflict and natural disaster situations. The main hurdle related to the last mile in critical situations is access to the appropriate people; access should be ensured not only to make supplies available but also to guarantee plausible storage and distribution conditions. Health supply chains usually use new technologies, such as digital tools and emerging technologies, in different areas, although the humanitarian supply chain does not.

Supply chain resilience emerged as a strategy that needs to plan how these organizations will act in the face of new contextual threats, such as pandemics and terrorist attacks. One of the few aspects that can be used to guarantee supply chain resilience in humanitarian operations using emerging technologies is digitalization. All requirements and technologies, such as the Internet of Evident, Big Data Analytics, and Machine Learning, provide a reactionary mechanism for the potential supply chain vulnerabilities of the humanitarian risk that the majority of public health organizations are currently creating despite all the limitations that lie in the use of these for long-term risk alleviation. Supply chain resilience will come from the adaptability of the systems, and this could occur with an emerging product life cycle, digital technologies, and levers.

Several challenges and barriers to the adoption of emerging technologies and digital tools were identified in empirical studies. Discomfort with the digital transformation process is one of those barriers. While the benefits of digital transformation are well recognized and received, reports indicate that humanitarian supply chain professionals remain uncomfortable with the extent and speed of digitization. Reluctance to abandon traditional, face-to-face practices emerged as a persistent theme, especially concerning tension in the field that occurs when engaging with communities. Uncomfortableness with the speed and pace of digitalization was compounded by the fast development and technology turnover in the private sector, which challenges the relevance and quality of many existing humanitarian solutions. Furthermore, a lack of knowledge of digital tools was identified as another barrier, where some respondents were not fully aware of all the digital tools associated with their organization.

Technological barriers were also a point of concern in the literature. Existing systems that are not smart enough to collect and report data need to be upgraded within the next few years to align with the wider ICT4D ecosystem. The incompatibility of systems across partners limited the viability of potential emerging solutions. Technological limitations like slow internet or the non-availability of technology solutions in certain locations were described in numerous studies. A lack of privacy infrastructure to keep the systems secure and protect data ownership was highlighted. However, despite barriers of privacy and ownership, many humanitarian supply chain professionals still rely on key stakeholders—advocacy groups, private sector partners, citizens, and more—to offer a multifaceted perspective in the decision-making process. Likewise, the lack of coordination and standards did not help humanitarian agencies coherently harness the potential of technology for data collection and analysis, adaptation, and follow-up services. Information technology infrastructure and investment form a major barrier to adoption by many humanitarian agencies. Organizations are handicapped by outdated IT programs that cannot integrate or bequeath data between the office and field locations. As new technologies emerge and the needs of clients change, so must the technology. Many respondents reported a lack of knowledge, investment, and resources to commit to these technologies, although a number were advocating for donor funding to help overcome this.

Organizations are discouraged from adopting digitalization as they tend to face major challenges in change management if staff are not comfortable with new technologies. To keep the team motivated and enthusiastic about adopting digital tools, managers have to adapt and learn about these tools and promote a learning-by-doing approach to increase awareness. Capacity-building is required at every level in the organization’s hierarchy to create an understanding and proficiency in digital collection, analysis, quality control, and database management. Finally, it is proposed not to place ICT specialists in a silo but to promote partnerships between ICT and humanitarian specialists, drawing on expertise from other industries and sectors to help drive change. This shared collaboration presents an opportunity to create market-viable and scalable solutions for both the humanitarian users and the digital market.

The coronavirus outbreak confronted health and humanitarian supply chains with unprecedented challenges. Facing these challenges on a larger scale [e.g., due to population growth or further health issues] asks for innovative solutions. We answer the research question "How are emerging technologies and digital tools applied in health and humanitarian supply chains, and what are the implications of the adoption of these technologies?" by performing a systematic review of 50 papers, which have been thoroughly scrutinized and content coded. Our study is the first to consolidate the different technologies and digital tools across both domains of health and humanitarian supply chains, as well as their characteristics, techniques, and technology-performance effects. Based on the findings, existing as well as future trends are established with practice and theory.

Until a few years ago, humanitarian, and commercial supply chains existed distinctly as two separate entities, each characterized by different drivers, technologies, and regulations. However, the increasing global demand for emergency relief put humanitarian operations under the spotlight with growing awareness and focus. Despite significant differences that continue to exist in some domain-specific features, supply chains for the medical sector and humanitarian relief are increasingly overlapping in terms of strategic focus and often face similar characteristics. Indicators that stress the importance of collaboration in the two domains for the benefit of their evolution include, for example, distinct industry-specific research initiatives started by reputable academic production and public-private partnerships among the healthcare industry and humanitarian organizations.