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This study examines innovation configurations (i.e. sets of product/service, social and business model innovations) and configuration linkages (i.e. factors that help to combine innovations) across six organizations as contingent upon organizational structure.

Using semi-structured interviews and available public information, qualitative data were collected and examined using content analysis to characterize innovation configurations and linkages in three local/private organizations and three foreign-led/public-private partnerships in Repiblik Ayiti (Haiti).

Organizations tend to combine product/service, social, and business model innovations simultaneously in locally founded private organizations and sequentially in foreign-based public-private partnerships. Linkages for simultaneous combination include limited external support, determined autonomy and shifting from a “beneficiary mindset,” and financial need identification. Sequential combination linkages include social need identification, community connections and flexibility.

The generalizability of our findings for this qualitative study is subject to additional quantitative studies to empirically test the suggested factors and to examine other health care organizations and countries.

Locally led private organizations in low- and middle-income settings may benefit from considering how their innovations are in service to one another as they may have limited resources. Foreign based public-private partnerships may benefit from pacing their efforts alongside a broader set of stakeholders and ecosystem partners.

This study is the first, to our knowledge, to examine how organizations combine sets of innovations, i.e. innovation configurations, in a healthcare setting and the first of any setting to examine innovation configuration linkages.

This paper aims to explore the impact of fourth-party logistics (4PL) adoption on the agility, adaptability and alignment (AAA) capabilities within humanitarian supply chains (HSCs).

Semi-structured interviews with individuals from a large non-government organisation were combined with secondary data to assess the influence of 4PL adoption on AAA capabilities in HSCs.

The results indicate that HSCs exhibit some of the AAA antecedents but not all are fully realised. While 4PL positively affects the AAA capabilities of HSCs, its adoption faces challenges such as the funding environment, data security/confidentiality and alignment with humanitarian principles. The study suggests an AAA antecedent realignment, positioning alignment as a precursor to agility and adaptability. It also identifies three core antecedents in HSCs: flexibility, speed and environmental uncertainty.

The study shows the positive impact 4PL adoption can have on the AAA capabilities of HSCs. The findings have practical relevance for those wishing to optimise HSC performance through 4PL adoption, by identifying the inhibiting factors to its adoption as well as strategies to address them.

This research empirically explores 4PL’s impact on AAA capabilities in HSCs, highlighting the facilitating and hindering factors of 4PL adoption in this environment as well as endorsing a realignment of AAA antecedents. It also contributes to the growing research on SC operations in volatile settings.