Medical technology innovation for a sustainable impact in Low- and Middle-Income countries: a holistic approach.

Abstract

<p>Technologies that have been designed for use in high-income countries often fail to deliver their full potential when transposed to Low and Middle-Income Contexts (LMICs). The health sector is a case in point, as medical devices, whether donated or purchased, are generally short lived in those contexts. The mismatch between needs and available solutions originates from the inadequacy of both the technology and the business models. Essential medical technologies such as oxygen concentrators, neonatal incubators, anesthesia machines or diagnostic X-ray systems are classic examples. The case of diagnostic X-ray imaging is particularly striking: 125 years after its invention, up to two thirds of the world population still does not have access to radiology services, according to the World Health Organisation. This is despite the fact that X-ray radiology is one of the cornerstone of healthcare and a crucial instrument for diagnosing a variety of health issues ranging from trauma to tuberculosis and other lung diseases.We are presenting an integrated methodological approach, to develop innovative solutions adapted to the context of LMICs. The approach relies on three crucial pillars: cooperation, interdisciplinarity and entrepreneurship with a long-term sustainability perspective. We propose a set of four complementary tools that increase the chances of successfully developing and deploying the technologies at scale. The tools, while very practical, allow striking a balance between economic viability, environmental and social impact. We illustrate the use of these tools with the case of diagnostic X-ray imaging. We propose that using the approach and tools presented here could allow to rethink other complex technologies that have the potential to address social challenges, in the perspective of making them suitable for LMICs. We also believe that this approach to developing solutions addressing the needs of poorer communities, may lead to better products in industrialized contexts as well.</p>

Ending Neonatal Deaths From Hypothermia in Sub-Saharan Africa: Call for Essential Technologies Tailored to the Context

“…Access to solid and performing technologies may significantly reduce the burden of neonatal disease and mortality ( 53 ). Infant medical devices are in fact core components of healthcare development and represent unavoidable building blocks for sustainable health progress.…”

Design Approaches for Creating Person-Centered, Context Sensitive, and Sustainable Assistive Technology with the Global South

“…It is crucial to ensure that the developed technology remains sustainably available. This means the creation of a complete value chain in parallel to the technology development and a business model which will allow the creation of a social business to industrialize the technology or the transfer of the intellectual property to an existing company interested in deploying and scaling up the technology (Makohliso et al, 2020). These models often promote cooperation between the North and South, enabling collaboration between communities and worldwide experts.…”

Academic-humanitarian technology partnerships: an unhappy marriage?

“…Truly "experimental" projects rarely fulfill the requirements of HDO fieldwork in remote settings. For example, building prototype hardware that can function in a lab environment is far removed from the reliability and ruggedness required for long deployments in humid and dusty remote locations-often with poor electricity supply and connectivity (11). Failure to plan for these kinds of differences in operating conditions frequently leads to proof-of-concepts that, although scientifically "interesting," do not reach the HDO's beneficiaries, resulting in little overall positive impact.…”

“…This approach, with clear deliverables for both parties, forces the partnership to reflect and debate over ownership and how to implement an effective technological solution sustainably over time, avoiding unnecessary frustrations. The HDO view in these discussions can run afoul of the basic view that profitability is inherently bad, rather than understanding that profitability can be a means to a self-sustaining solution (8,11). HDOs need to better understand technology innovation/development and its associated aspects (intellectual property, the value chain, and distribution models, etc.).…”