A Context-Specific Design of an Electrosurgical Unit and Monopolar Handheld to Enhance Global Access to Surgical Care: A Design Approach Based on Contextual Factors

Oosting, R.M.; Ouweltjes, Koen; Hoeboer, M.D.B.; Hesselink, Larissa; Madete, June; Diehl, Jan Carel; Groen, Reinou S.; Wauben, L.S.G.L.; Dankelman, Jenny

doi:10.1115/1.4045966

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…We observe that these principles aimed at product longevity were intended to ensure that medical devices are available to provide healthcare. This is, for example, demonstrated in one of the studies reviewed in this study whereby an electrosurgical unit which is often lacking in LRS, is designed to be durable, repairable, upgradable, and reusable over time even in conditions of electrical failures (Oosting et al, 2020). In the event of electrical failures, this electrosurgical unit can be repaired and upgraded by using local foot-paddle power technology to keep it functioning and thus provide surgical healthcare service for people in LRS in SSA.…”

Section: Resultsmentioning

confidence: 95%

The extent to which circular economy principles have been applied in the design of medical devices for low-resource settings in Sub-Saharan Africa. A systematic review

et al. 2023

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Healthcare facilities in low-resource settings in Sub-Saharan Africa are plagued with issues of non-functional and obsolete medical devices, which ultimately end up prematurely disposed of as waste. With increasing healthcare demands, stopping medical device disposal is imperative. One way to achieve this is to leverage circular economy principles in designing medical devices. Circular economy principles aim to retain products and their constituent materials to be reused over time in the economic system. However, to what extent this has been applied in designing medical devices specifically for low-resource settings in Sub-Saharan Africa is missing in literature. Based on a systematic review of 29 out of 1,799 screened scientific papers, we identified the use of circular economy principles of durability, maintenance, repair, and upgrade in designing medical devices for this setting. Whether these principles were intentionally applied from a circular economy approach could not be inferred in this study. The motivational basis for using these principles was to ensure medical device longevity to providing healthcare. No attention was given to the circular economy principles of refurbishment, remanufacturing, and recycling, ensuring that device components and constituent materials are recovered. These study findings serve as a launchpad for exploring how circular principles can be used to support the design of medical devices for low-resource settings in Sub-Saharan Africa. Academicians and designers of medical devices can leverage this research to contribute towards developing medical devices that support access to healthcare for people in low-resource settings and preserve earth's finite resources.

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Section: Resultsmentioning

confidence: 95%

The extent to which circular economy principles have been applied in the design of medical devices for low-resource settings in Sub-Saharan Africa. A systematic review

et al. 2023

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“…However, high equipment cost is not the only challenge to overcome. The lack of health personnel and proper training, inconsistent power supplies, unavailability of spare parts and high cost of operation (maintenance and consumables) all hinder the implementation and operation of advanced medical equipment [8] [14].…”

Section: A Ugandamentioning

confidence: 99%

The embodiment of low-field MRI for the diagnosis of infant hydrocephalus in Uganda

Diehl

Doesum

Bakker

et al. 2020

2020 IEEE Global Humanitarian Technology Conference (GHTC)

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Compared to other parts of the world, the incidence of hydrocephalus in children is very high in sub-Saharan Africa. Magnetic resonance imaging (MRI) would be the preferred diagnostic method for infant hydrocephaleus. However, in practice, MRI is seldom used in sub-Saharan Africa due to its high prize, low mobility, and high power consumption. A low-cost MRI technology is under development by reducing the strength of the magnetic field and the use of alternative technologies to create the magnetic field. This paper describes the embodiment design process to match this new MRI technology under development with the specific characteristics of the healthcare system in Uganda. A context exploration was performed to identify factors that may affect the design and implementation of the low-field MRI in Ugandan hospitals and Ugandan healthcare environment. The key-insights from the technology-and context-exploration were translated into requirements which were the starting point for the design process. The concept development did have a focus on Cost-effective design, Design for durability & reliability, and Design for repairability. The final design was validated by stakeholders from the Ugandan Healthcare context.

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“…Other initiatives further leverage context-driven approaches to consider factors critical to the healthcare system in LRS throughout the medical device design process. This is demonstrated in the context-driven design of an electrosurgical unit ( 49 ) or the context-driven design of a retractor for abdominal insufflation-less surgery ( 50 ).…”

Section: Introductionmentioning

confidence: 99%

Design of a syringe extension device (Chloe SED®) for low-resource settings in sub-Saharan Africa: a circular economy approach

Samenjo,

Ramanathan,

Gwer

et al. 2023

Front. Med. Technol.

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Underfunded healthcare infrastructures in low-resource settings in sub-Saharan Africa have resulted in a lack of medical devices crucial to provide healthcare for all. A representative example of this scenario is medical devices to administer paracervical blocks during gynaecological procedures. Devices needed for this procedure are usually unavailable or expensive. Without these devices, providing paracervical blocks for women in need is impossible resulting in compromising the quality of care for women requiring gynaecological procedures such as loop electrosurgical excision, treatment of miscarriage, or incomplete abortion. In that perspective, interventions that can be integrated into the healthcare system in low-resource settings to provide women needing paracervical blocks remain urgent. Based on a context-specific approach while leveraging circular economy design principles, this research catalogues the development of a new medical device called Chloe SED® that can be used to support the provision of paracervical blocks. Chloe SED®, priced at US$ 1.5 per device when produced in polypropylene, US$ 10 in polyetheretherketone, and US$ 15 in aluminium, is attached to any 10-cc syringe in low-resource settings to provide paracervical blocks. The device is designed for durability, repairability, maintainability, upgradeability, and recyclability to address environmental sustainability issues in the healthcare domain. Achieving the design of Chloe SED® from a context-specific and circular economy approach revealed correlations between the material choice to manufacture the device, the device's initial cost, product durability and reuse cycle, reprocessing method and cost, and environmental impact. These correlations can be seen as interconnected conflicting or divergent trade-offs that need to be continually assessed to deliver a medical device that provides healthcare for all with limited environmental impact. The study findings are intended to be seen as efforts to make available medical devices to support women's access to reproductive health services.

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A Context-Specific Design of an Electrosurgical Unit and Monopolar Handheld to Enhance Global Access to Surgical Care: A Design Approach Based on Contextual Factors

Cited by 4 publications

References 22 publications

The extent to which circular economy principles have been applied in the design of medical devices for low-resource settings in Sub-Saharan Africa. A systematic review

The extent to which circular economy principles have been applied in the design of medical devices for low-resource settings in Sub-Saharan Africa. A systematic review

The embodiment of low-field MRI for the diagnosis of infant hydrocephalus in Uganda

Design of a syringe extension device (Chloe SED®) for low-resource settings in sub-Saharan Africa: a circular economy approach

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