Peer-reviewed article

Sustainability practices and their impact on child immunisation vaccine supply chain performance in India using structural equation modelling

Ambuj Kumar, Om Ji Shukla, Shailesh Mani Pandey, Naveen Kumar, P. K. Mall et al. · 29 Aug 2026

Abstract

Abstract This study examines sustainable practices in the child immunisation vaccine supply chain (VSC) in Uttar Pradesh, India, to support the UN’s Sustainable Development Goals (SDGs). This analysis examines the impact of social, economic, and environmental sustainability practices on the VSC’s efficacy and efficiency, as well as their contribution to achieving SDG goals, including improved healthcare access and enhanced community resilience. This study employs Structural Equation Modelling (SEM) to analyse the relationships between sustainability practices and vaccine supply chain performance. Data were collected through a structured survey from different stakeholders, including healthcare workers, supply chain managers, and policymakers involved in vaccine distribution, storage, and delivery. A total of 180 valid responses were analysed to assess the direct and indirect effects of sustainability practices on the VSC. The findings highlight the interrelated nature of sustainability factors across the VSC. Social sustainability emerged as the most influential component (path coefficient: 0.868), emphasising the importance of fair labour practices, community well-being, and ethical leadership. Economic sustainability had a moderate-to-high impact (0.666), highlighting the importance of profit optimisation and cost reduction. Meanwhile, environmental sustainability had a smaller effect (0.542), indicating that, while important, it must be supported by social and economic policies for maximum benefit. The study emphasises the value of external collaboration and integrated sustainable practices in building the VSC. The research provides evidence for developing targeted interventions and policies that improve vaccine supply chain sustainability, supporting broader healthcare goals and sustainable development. Unlike previous research, which has mostly focused on logistical issues in vaccine delivery, this study incorporates sustainability factors into the examination of vaccine supply chains. This study provides policymakers, healthcare professionals, and stakeholders with valuable guidance for developing sustainable immunisation strategies in Uttar Pradesh and other similar regions worldwide, offering a comprehensive framework that connects sustainability practices to improved healthcare outcomes.