The evolution of medical device development in South Africa was investigated for the period 2001-2013. Collaboration networks for four sectors-academia, healthcare, industry, and science and support-were derived from a bibliometric study. Centrality measures identified dominant institutions. New actors entering the networks either exhibited preferential attachment to these institutions, or joined the network as part of an isolated cluster. Of the new institutions, foreign collaborators seldom stayed beyond five years, while local institutions seldom left after entering the field. Over the 13-year period, local collaboration activity persisted, while local-foreign collaborations were seen to decline. Over time, the network topology became more akin to that of a small-world network. The findings of the study may support innovation management by guiding institutional strategies for effective collaboration. OPSOMMING Die ontwikkeling van mediese toestelle in Suid-Afrika is ondersoek vir die periode 2001 tot 2013. Samewerkingsnetwerke vir vier sektore, naamlik die akademici, gesondheidsorg, die industrie en wetenskap en ondersteuning, is afgelei vanuit ʼn literatuurstudie. Sentraliteitmaatstawwe het die leidende instansies identifiseer. Nuwe rolspelers wat die netwerke betree het, het ʼn voorkeur getoon om saam met hierdie instansies te werk of het by die netwerk aangesluit as ʼn geïsoleerde groep. Onder die nuwe rolspelers het buitelandse medewerkers selde vir langer as vyf jaar betrokke gebly. Daarteenoor het plaaslike medewerkers selde die veld verlaat. Plaaslike samewerking het oor die verloop van die 13 jaar volgehou, maar internasionale samewerking het afgeneem in die tydperk. Met die verloop van tyd het die netwerk-topologie tot ʼn netwerk soortgelyk aan ʼn klein-wêreld netwerk ontwikkel. Die bevindinge van hierdie studie mag die bestuur van innovasie ondersteun deur institusionele strategieë vir effektiewe samewerking te begelei. 1 INTRODUCTION Developing countries such as South Africa rely heavily on the importation of medical devices [1]. However, many of their citizens lack access to these devices due to various environmental, financial, and societal barriers [2]. Local development and production of context-appropriate medical devices, based on identified needs, is considered a way to overcome these challenges, increase access to devices, and ultimately, to improve health [3, 4, 5]. Medical device innovation is a cross-disciplinary endeavour, often involving collaboration across different sectors. The World Health Organization [5] has suggested that the development of health products for local needs relies on the combination of identifying health needs, providing a research base, and gaining support from industry. This aligns with the findings of Hicks and Katz [6], in which