Achieving sustainability and resilience in cold supply chain (CDSC) operations has lately attained prominence in healthcare amid climate change, natural catastrophes, and geopolitical crises. This study contributes to the literature by developing a comprehensive framework to establish a sustainable-resilient buyer-supplier relationship to enhance CDSC efficiency. In this context, a stratified fuzzy variant of the best-worst method (SFBWM) was proposed to assess the significance of key performance indicators (KPIs) under several future scenarios. Subsequently, the extended version of the fuzzy complex proportional assessment (EFCOPRAS) method was presented to assess incumbent suppliers' performance and classify them into three selection categories: retain, develop, and switch. Later, a Pakistani healthcare case study and extensive sensitivity and comparative analyses determined the practicality and accuracy of the suggested decision support framework. The case study results demonstrate that, regarding suppliers' capability, the “Timely delivery” KPI gained significant importance, whereas the KPI “Agility” acquired noteworthy importance in terms of suppliers' desirability.
Ali et al. (2026) studied this question.