The design of medical equipment for low income countries: dual standards or common sense

Neighbour, Roger; Eltringham, Roger

doi:10.1049/cp.2012.1462

Cited by 8 publications

(14 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Future (re)design should consider that equipment is operated in environments with high temperatures, altitudes, local voltage outlets and humidity [23]. Furthermore, manuals should be provided in the major local languages.…”

Section: Discussionmentioning

confidence: 99%

Equipment for essential surgical care in 9 countries across Africa: availability, barriers and need for novel design

et al. 2018

View full text Add to dashboard Cite

Shortages of medical equipment in low-and-middle income countries (LMICs) have been found by several previous studies that assessed surgical capacity. To increase surgical capacity, there is a need to identify the availability of specific types of surgical equipment on a local, regional and national level. A survey was conducted among surgeons attending the annual meeting of the College Of Surgeons of East, Central and Southern Africa (COSECSA) in December 2016. General information of the facilities, availability of surgical equipment, reasons for limited availability, daily usage of equipment and equipment that could benefit from redesign were assessed. Forty-two respondents participated in this study, representing 33 individual healthcare facilities (14 public referrals, 9 public district and 10 private (for-profit and non-profit)). The respondents worked in 9 countries in East, Central, Western and Southern Africa. A deficiency in availability of basic surgical equipment was found, especially in public district hospitals. Electrosurgical units, endoscopes, defibrillators, infusions pumps and electrocardiogram monitors were of limited availability. Reasons indicated for this limited availability were: no need, too costly, no training, no disposables and no repair. Lack of maintenance and old/overused equipment were identified as major reasons for failure of equipment. Equipment that could benefit from redesign were for example: electrosurgical units, laparoscopic equipment and theatre lights. Availability of surgical equipment should be increased, especially in public district hospitals. Novel context appropriate redesign that is adapted to fit the context in LMICs could decrease the barriers to availability and to failure of surgical equipment.

show abstract

Section: Discussionmentioning

confidence: 99%

Equipment for essential surgical care in 9 countries across Africa: availability, barriers and need for novel design

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Surgical equipment is not always available in LMICs, which results in delays of surgeries that are urgently needed by the population.. Other studies have identified synergies in the barriers to medical equipment between different LMICs. [10][11][12][13] This study offers insights from frontline BMETs providing maintenance on a daily basis on why these barriers exist, by identifying the journey during the life span of surgical equipment. Participants worked in 6 different hospitals in Kenya.…”

Section: Discussionmentioning

confidence: 99%

“…10 Limited access to maintenance, spare parts, and inappropriate donations have been documented before as barriers to functioning equipment in LMICs. [10][11][12][13] However, to design successful strategies for increasing the availability of surgical equipment, the root causes of these problems need to be understood. Installation and maintenance of equipment are often provided by biomedical equipment technicians (BMETs), which makes their perspective on surgical equipment very valuable.…”

Section: Introductionmentioning

confidence: 99%

Barriers to availability of surgical equipment in Kenya

Oosting

Wauben

Mwaura³

et al. 2019

GlobalCE

View full text Add to dashboard Cite

Background & Objective:The need for surgery is currently not met in Sub-Saharan Africa, requiring both extra workforce and surgical equipment. Currently, there is a gap in the availability of surgical equipment which, among others, limits the provision of safe surgery. To design strategies to increase availability, the use of surgical equipment in this context needs to be understood. This study aims to: 1) identify the different phases surgical equipment goes through during its lifespan (i.e. the surgical equipment journey) in Kenya, and to 2) identify barriers that are perceived by biomedical equipment technicians (BMETs). Material & Methods:Seven semi-structured in-depth interview sessions were conducted with a total of 17 BMETs working in Kenya. Participants worked in six different hospitals (four public, one private and one mission). Interviews were conducted between December 2016 and December 2018. Participants were asked to describe or draw the surgical equipment journey and describe the perceived barriers during this journey. Results:The surgical equipment journey consists of three phases: procurement, usage, and disposal. Stakeholders involved in the surgical equipment journey are users, BMETs, procurement officers, local distributors and in case of donations, donation agencies. Bureaucracy during procurement, difficulties to obtain consumables and spare parts (especially for donated equipment), cleaning with heavy chemicals, and usage in challenging environments were identified as barriers during the surgical equipment journey. Conclusion:Sustainable interventions at multiple organisational levels are required to optimize the surgical equipment journey in hospitals in Kenya. Different strategies that can be applied in parallel to increase availability of surgical equipment in Kenya were identified by the participants in this study: policies on donations, procurement of durable equipment, more well-trained BMETs and university-trained biomedical engineers, and designs and business models that fit the local use in Kenya and presumably other countries in Sub-Saharan Africa.

show abstract

“…Limitations. This study is limited by the fact that it took place indoors, at room temperature in a nonhumid environment, and therefore, not directly comparable to LMICs [31]. The effect of high temperature on PLA is anecdotally described to weaken the material, and high humidity levels may also cause moisture absorption and weakening of the material.…”

Section: 4mentioning

confidence: 97%

The Effect of Chemical Cleaning on Mechanical Properties of Three-Dimensional Printed Polylactic Acid

Fleischer

Diehl

Wauben

et al. 2020

Journal of Medical Devices

View full text Add to dashboard Cite

Three-dimensional (3D) printing may be a solution to shortages of equipment and spare parts in the healthcare sector of low-and middle-income countries (LMICs). Polylactic acid (PLA) for 3D printing is widely available and biocompatible, but there is a gap in knowledge concerning its compatibility with chemical disinfectants. In this study, 3Dprinted PLA tensile samples were created with six different printer settings. Each of these six batches consisted of five sets with five or six samples. The first set remained untreated, the others were soaked in Cidex OPA or in a chlorine solution. These were applied for seven consecutive days or in 25 short cycles. All samples were weighed before and after treatment and subjected to a tensile test. Results showed that a third of the treatments led to an increase of the median weight with a maximum of 8.3%, however, the samples with the best surface quality did not change. The median strength increase was 12.5% and the largest decrease was 8.8%. The median stiffness decreased 3.6% in one set and increased in three others up to 13.6%. When 3D printing PLA medical tools, surface porosity must be minimized to prevent transfer of disinfectants to people. The wide variability of mechanical properties due to 3D printing itself and as a consequence of disinfection must be considered when designing medical tools by selecting appropriate printer settings. If these conditions are met, reusing 3D-printed PLA medical tools seems safe from a mechanical point of view.

show abstract

The design of medical equipment for low income countries: dual standards or common sense

Cited by 8 publications

References 0 publications

Equipment for essential surgical care in 9 countries across Africa: availability, barriers and need for novel design

Equipment for essential surgical care in 9 countries across Africa: availability, barriers and need for novel design

Barriers to availability of surgical equipment in Kenya

The Effect of Chemical Cleaning on Mechanical Properties of Three-Dimensional Printed Polylactic Acid

Contact Info

Product

Resources

About