The document discusses several operational issues faced by nonprofit supply chains. It notes that unlike commercial supply chains, nonprofits lack clear performance metrics and often have inadequate funding. This leads to limited resources, demand exceeding supply, poor demand forecasting, and high costs of stockouts. Additionally, the decentralized structure involving multiple stakeholders can hamper collaboration. Suggested solutions include using multi-objective optimization techniques, ensuring efficiency to improve trust with donors, adopting revenue-generating strategies, and increased information sharing through technology.