Background The supply of health products is a key determinant of both care continuity and the economic efficiency of health systems. In low- and middle-income countries (LMICs), supply chain failures remain major obstacles to accessing essential medicines. In Benin, empirical data on the economic viability of supply systems at the peripheral level remain limited. Methods A cross-sectional evaluative study was conducted from March to July 2025 in 17 public health facilities (50% of the total), selected by simple random sampling, including the district hospital and the zonal distribution depot. Economic viability was assessed according to three components (structure, process, and outcome) using the six fundamental criteria of economic performance, enriched by four original composite indicators: the Composite Logistics Efficiency Index (CLEI), the Six Rights Compliance Index (SRCI), the Economic Vulnerability Index (EVI), and the Storage Failure Opportunity Cost (SFOC). Results Sixteen out of 17 facilities (94.12%) were classified as economically viable. The process component reached the 80% threshold in all facilities (100%). The mean CLEI was 80.66% (6 facilities below threshold) and the mean SRCI was 86.51%. The EVI revealed moderate economic vulnerability in 82.35% of facilities, primarily due to the universal absence of a financial dashboard and inadequate transport means. The SFOC was estimated at FCFA 11.37 million per year for the 8 facilities at risk of storage deficiencies. Conclusions The Allada-Toffo-Zè health district shows overall satisfactory economic viability according to normative criteria, with performance comparing favourably to regional benchmarks. However, cross-cutting structural vulnerabilities, in transport, financial management, and storage conditions, identified by composite economic indicators underscore that this viability remains fragile and contingent on targeted and sustained investments
Salami et al. (Tue,) studied this question.