Abstract
Background: Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and costeffectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems. Methods: We conducted 2 surveys in 117 selected health facilities. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at health facilities. The Temple-Bird Healthcare Technology Package System (TBHTPS), tailored to the context of Benin’s health system, was used as a conceptual framework. Results: The findings of the first survey show that 85% of key actors in Benin’s HTM sector characterized the system as failing in components of the TBHTPS framework. Biomedical, clinical, healthcare technology engineers and technicians perceived problems most severely, followed by users of equipment, managers and hospital directors, international organization officers, local and foreign suppliers, and finally policy-makers, planners and administrators at the Ministry of Health (MoH). The 5 most important challenges to be addressed are policy, strategic management and planning, and technology needs assessment and selection – categorized as major enabling inputs (MEI) in HTM by the TBHTPS framework – and installation and commissioning, training and skill development and procurement, which are import and use activities (IUA). The ability of each key actor to address these problems (the degree of political or administrative power they possess) was inversely proportional to their perception of the severity of the problems. Observational data gathered during site visits described a different set of challenges including maintenance and repair, distribution, installation and commissioning, use and training and personnel skill development. Conclusion: The lack of experiential and technical knowledge in policy development processes could underpin many of the continuing problems in Benin’s HTM system. Before solutions can be devised to these problems, it is necessary to investigate their root causes, and which problems are most amenable to policy development.
Highlights
Healthcare technologies offer many benefits and have greatly enhanced the ability of health professionals to prevent, diagnose and treat diseases.[1]
The 5 main problems prioritized by interview respondents were: (i) “ineffective and inefficient healthcare technology management (HTM) system”; (ii) “inappropriately selected equipment”; (iii) “high acquisition costs and origin of the equipment”; (iv) “uninstalled and un-commissioned equipment due to inadequate architectural and technical requirements”; (v) “low rate of equipment availability”; and (vi) “inadequate financial resource allocation for the life-cycle costs (LCC) of equipment” (Table 8)
It is pertinent in policy development to identify, at each level, the relevant key actors who are important as enablers towards more effective and efficient HTM processes ie, those actors that recognize the faults of the system and envision an improved system in the future
Summary
Healthcare technologies offer many benefits and have greatly enhanced the ability of health professionals to prevent, diagnose and treat diseases.[1]. Healthcare technology is defined as the application of organized knowledge and skills in the form of devices, medicine, vaccines, procedures and systems developed to solve health problems and improve the quality of lives.[1,4,5,6,7,8,9] When used in this paper, the term “healthcare technology” means the different types of devices or equipment used in health facilities which encompasses medical equipment for clinical use, hospital furniture, vehicles, service supplies, plant, communication equipment, firefighting equipment, fixtures built into the building, office equipment, office furniture, training equipment, walking aids and workshop equipment.[4] Healthcare technology management (HTM) is critical in developing countries due to many contextual challenges
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