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…"

St. Francis Hospital in Ifakara, Tanzania, faces;

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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.

Cleft before Cleft after

Overcrowding wards more thank

one patient per

bed.

•Outdated

technology.

•Non function

equipment.

�Need efficient, more

effective and easy to

handle

Equipment.

Monitor

Suction machine

EMO anaesthetic machine

Human resource requirement.

“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.

www.who.int/surgery

Global burden of surgical disease.

WHO Global Initiative: Emergency and Essential Surgical Care Forum.

Global initiative cont...: Analysis / monitor within the health system including Med.Dev.

www.who.int/surgery/publications/imeesc/en/index.html

Global initiative cont...:Global Snap

shot with the Situational Analysis Tool.

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

The way forward cont...

www.who.int/surgery/publications/imeesc/en/index.html

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

THANKSand welcome to the Land of

Kilimanjaro