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This study aims to enhance storage and distribution operations at a pharmaceutical supply center (PSC) in primary health care (PH) using lean health care (LH) tools. Supply centers for health products, medications and supplies have unique characteristics compared to centers for other goods due to complex processes, specific services, diverse stakeholders and multiple interactions. The authors adapt LH tools to address these complexities and meet industry-specific needs.

The investigation unit is a PSC in a large southern Brazilian city, and the processes analyzed are the storage and distribution of medications. The authors performed action research from June 2019 to February 2020. Data collection and problem diagnosis involved the development of a value stream mapping.

The authors adapted the overall equipment effectiveness calculation, efficiency analysis, and loss classification for PSC operations. Eighteen core issues were found: waiting, movement, transport, stock, inadequate processing, defects and human potential losses. The authors proposed waste reduction tools and practices. Inadequate storage conditions may compromise medicine quality, efficacy and safety. This can result from lacking physical structures or noncompliance with procedures. Next, the authors recommend simulating scenarios for validation before implementation.

The study explored ways to enhance layout and medicine distribution at the PSC, focusing on reducing loss and cost impact.

Originality lies in LH application in a PSC of PH, often applied in secondary or tertiary health levels like hospitals. The novelty necessitated adaptations of tools for future PSC applications.

We present a critical literature review debating Brazilian research on social and environmental accounting (SEA). The aim of this study is to understand the role of politics in the construction of hegemonies in SEA research in Brazil. In particular, we examine the role of hegemony in relation to the co-option of SEA literature and sustainability in the Brazilian context by the logic of development for economic growth in emerging economies. The methodological approach adopts a post-structural perspective that reflects Laclau and Mouffe’s discourse theory. The study employs a hermeneutical, rhetorical approach to understand and classify 352 Brazilian research articles on SEA. We employ Brown and Fraser’s (2006) categorizations of SEA literature to help in our analysis: the business case, the stakeholder–accountability approach, and the critical case. We argue that the business case is prominent in Brazilian studies. Second-stage analysis suggests that the major themes under discussion include measurement, consulting, and descriptive approach. We argue that these themes illustrate the degree of influence of the hegemonic politics relevant to emerging economics, as these themes predominantly concern economic growth and a capitalist context. This paper discusses trends and practices in the Brazilian literature on SEA and argues that the focus means that SEA avoids critical debates of the role of capitalist logics in an emerging economy concerning sustainability. We urge the Brazilian academy to understand the implications of its reifying agenda and engage, counter-hegemonically, in a social and political agenda beyond the hegemonic support of a particular set of capitalist interests.

From the perspective of business history, this chapter presents an overview of the development of the tourism sector in South America, placing special emphasis on the Peruvian case. The chapter explores various topics related to the tourism chain, such as hotel networks, the role of the state, tour operators, micro- and small enterprises, linkages between tourism and sustainability, the formation of clusters in the sector, and interactions between different entrepreneurs in the chain. Special emphasis is placed on the Peruvian case, especially when it comes to discussing the role of micro- and small enterprises in the sector.