Effectiveness of medical equipment donations to improve health systems: how much medical equipment is broken in the developing world?

Med Biol Eng Comput (2011) 49:719722 DOI 10.1007/s11517-011-0786-3

EDITORIAL

Effectiveness of medical equipment donations to improve health systems: how much medical equipment is broken in the developing world?

Lora Perry Robert Malkin

Received: 16 March 2011 / Accepted: 5 May 2011 / Published online: 20 May 2011 International Federation for Medical and Biological Engineering 2011

Abstract It is often said that most of the medical equipment in the developing world is broken with estimates ranging up to 96% out of service. But there is little documented evidence to support these statements. We wanted to quantify the amount of medical equipment that was out of service in resource poor health settings and identify possible causes. Inventory reports were analyzed from 1986 to 2010, from hospitals in sixteen countries across four continents. The UN Human Development Index was used to determine which countries should be considered developing nations. Non-medical hospital equipment was excluded. This study examined 112,040 pieces of equipment. An average of 38.3% (42,925, range across countries: 0.8347%) in developing countries was out of service. The three main causes were lack of training, health technology management, and infrastructure. We hope that the ndings will help biomedical engineers with their efforts toward effective designs for the developing world and NGOs with efforts to design effective healthcare interventions.

Keywords Healthcare Technology Infrastructure

Global health Medical equipment

Many authors in this publication and elsewhere have dramatically stated that most of the medical equipment in the developing world is broken. Some statements have been vague. In these pages, for example, Bracale and Pepino reported only that a great deal of equipment is out of order

in most of the health structures in developing countries [3]. Some have been more precise. For example, Frize and Cheng [7] stated, also in this journal, that up to 60% of medical equipment is out of service in developing countries. The World Health Organization Guidelines for Healthcare Equipment Donations states that 70% of medical equipment in sub-Saharan Africa is out of service. The Director General of the World Health Organization stated at the Medical Device Meeting in the fall of 2010 that about 70% of the more complex medical devices do not function when they reach their destination. Other papers state that up to...