Purpose: This paper targets the relationship between different dimensions of the supply chain systems. Specifically, it scrutinizes the link between top management support and external integration to describe operational performance. The study further explores how supply chain resilience affects the relationship between external integration and operational performance.

Design: Data was collected through a survey questionnaire responded by Ghanaian cold pharmaceutical suppliers with multiple-informants sample of 170 middle-to-large size firms. The data was analysed using partial least squares structural equation modelling (PLS-SEM) version three. The relationship suggested in the advanced theoretical model were described through hypothesis: H1 – there is significant relationship between top management support and operational performance; H2- there is significant relationship between top management support and external integration; H3- there is significant relationship between external integration and operational performance; H4- external integration mediates the relationship between top management support and operational performance; and H5- supply chain resilience moderates the relationship between external integration and operational performance.

Findings: The findings of this study indicate that, top management support significantly affected both operational performance and external integration (H1 and H2 supported). External integration again significantly affected operational performance (H3 supported). Also, external integration partially mediates the relationship between top management support and operational performance (H4 supported). However, supply chain resilience did not moderate the relationship between external integration and operational performance (H5 not supported).

Originality and Value: This study is one of the very first supply chain researches on cold pharmaceutical products on the Ghanaian supplies sector, notably, in relation to the practices that, supplying firms in Ghana need to embrace to make their supply chain a strong ambitious mechanism for their advancement. The findings have extensive supplying and improvement of unified supply chains which are major steps in economic evolution.

Keywords: top management support, external integration, supply chain resilience, supply chain systems, pharmaceutical suppliers and operational performance,

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