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Medical Device Needs in a
Developing Country
byDr. Pascience Kibatala
Ministry of Health and Social Welfare
Tanzania
WHA60.29 Health Technologies
"Recognizing that health technologies equip health-care providers with tools that are indispensable for effective and efficient prevention, diagnosis, treatment and rehabilitation and attainment of internationally agreed health-related development goals, including those contained in the Millennium Declaration…"
0
5
10
15
20
25
30M
alar
ia
HIV
Pn
eum
on
ia
CB
I
AW
D
Sep
tica
mia
CC
F
An
aem
ia
Men
ing
itis
PT
B
Ren
al F
ailu
re
G/E
Ecl
amp
sia
Children < 1 year
Children > 1 year
Adult
At SFH in 2007
NB-HIV/AIDS leading.
The leading cancer for females is cervical cancer, accounting for 40% of all cancer cases.
The leading cancer for males is Kaposi’s sarcoma, accounting for 15% of all cancer cases fueled by HIV/AIDS.
The leading cancer for children is Burkitts lymphoma.
35,000 new cancer cases occur each year.
27,000 patients die each year.
All these require robust diagnostic equipment technology which is easily available and accessible.
•Outdated
technology.
•Non function
equipment.
�Need efficient, more
effective and easy to
handle
Equipment.
“Some country hospitals are unable to carry out sometimes even basic emergency surgical interventions due to lack of continuous oxygen supply and anaesthesia equipment, which explains the difficulty of patient referral especially in urgent situations, resulting in death and disability.”
Meeting Report, A Joint WHO-Ministry of Health and Social Welfare Meeting on Integrated Management of Emergency and Essential Surgical Care, http://www.who.int/surgery/activities/ReportTanzania07.pdf
• In Tanzania only 10 pathologists / Cytologists are present!.
• 6 of them are at the National Hospital.
• Biopsy results takes 3-4 weeks.
• CT scan only in major hospitals and MRI only at two Hospital.
• Medical imaging is expensive to most people!.
Medical Device Needs for Provision of
Surgical Care
• Laboratory Equipment– 80% of the world's population has access to 20% of
the supply blood products, of which little is
consistently safe.– Reference: Emmanuel, JC. Material & equipment, procurement & maintenance: Impact on
blood safety. Biologicals. 2010 Jan; 38 (1):78-80.
• Intensive Care Units
– Few hospitals in developing countries have
ICUs.– Reference: Baker T. Critical care in low-income countries. Trop Med Intl Health. 2009
Feb;14(2):143-8.
Global initiative cont...: Analysis / monitor within the health system including Med.Dev.
www.who.int/surgery/publications/imeesc/en/index.html
Belle J, Cohen H, et al. Influenza preparedness in low-resource settings: a look at oxygen delivery in 12 African countries. J Infect Dev Ctries 2010; 3(4):e-pub ahead of print.
Reg
ion
al o
utlo
ok
Note: These
are all
LDCS with the
same needs
for
support
with Med.
Equipment,
Instruments
and
Technology.
Access to Oxygen in 12 African Countries
• 75 (34.3%) had at least one face mask and tube set always available.
• 66 (29.1%) had regular access to at least one oxygen cylinder.
• 55 (24.6%) possessed a fully functioning oxygen concentrator.
Belle J, Cohen H, et al. Influenza preparedness in low-resource settings: a look at oxygen delivery in 12 African countries. J Infect Dev Ctries 2010; 3(4):e-pub ahead of print.
The way forward
www.who.int/surgery/publications/imeesc/en/index.html
Save the children lives in the LDCs
Quality
Efficiency
Capacity
building
through
Training on
Technology.
Maintenance
and care of
equipment.
Research
The way forward cont...
Effective
References
• Baker T. Critical care in low-income countries. Trop Med Intl Health. 2009 Feb;14(2):143-8.
• Belle J, Cohen H, et al. Influenza preparedness in low-resource
settings: a look at oxygen delivery in 12 African countries. J Infect Dev
Ctries 2010; 3(4):e-pub ahead of print.
• Emmanuel, JC. Material & equipment, procurement & maintenance:
Impact on blood safety. Biologicals. 2010 Jan; 38 (1):78-80.
• Kingham TP, Kamara TB, Cherian MN, Gosselin RA, Simkins M,
Meissner C, Foray-Rahall L, Daoh KS, Kabia SA, Kushner AL.
Quantifying surgical capacity in Sierra Leone: A guide for improving
surgical care. Arch. Surg. 144(2): 122-127; Feb. 2009.
• Kushner AL, Cherian MN, Noel L, Spiegel D, Groth S, Etienne C.
Addressing the Millenium Development Goals from a surgical
perspective: Essential surgery and anesthesia in 8 low- and middle-
income countries. Arch. Surg. Vol. 145 (No.2). Feb. 2010.
• www.who.int/surgery
• Stoeckle M, Mchomvu R, Hatz C, et al. Moving up from 3 by 5. The Lancet
Infectious Disease. 2006 August; 6 (8): 460-461
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