The World Health Organization (WHO) has identified the shortage of functional medical equipment in low-income countries as a critical barrier to meeting the health-related Millennium Development Goals (MDGs). Hospitals in low-income countries frequently report the poor state of medical equipment as being a key challenge they face in delivering services.

Medical EquipmentMuch progress has been made to improve this situation in the past two decades.  Many countries have appointed medical equipment specialists (typically medical engineers) within the Ministry of Health to advise on medical equipment procurement and budgeting. Guidelines for good procurement and donation practices have been produced.  Maintenance teams have been established in many large hospitals and over wider referral networks, and many new innovative technologies have been designed that are more appropriate for use in developing countries.

However, much remains to be done.  Very few training programs exist to produce medical equipment technologists and engineers in Africa, for example.  Equipment maintenance personnel need more training prior to and while in post; they need better tools, equipment and reference materials in their workshops and need to be more effectively engaged in equipment decision-making in their hospitals.

Equipment donations should meet guidelines to ensure they are more sustainable and contribute positively to service delivery, and procurement should always include budgeting and training for maintenance activities.  Regulatory mechanisms should be in place to oversee the quality and safety of medical equipment, and there should be equipment management committees in hospitals and wider health systems to oversee medical equipment over its entire lifespan.

Key facts

  • the WHO estimates that between 50 and 80% of medical equipment is out of service in low-income countries
  • the estimated economic loss of 15% of medical equipment in the developing world being out of service is $12.8 billion USD annually, or 22% of the total health spending in the WHO’s AFRO region
  • it is estimated that up to 80% of the medical equipment in some sub-Saharan African countries is donated equipment; the majority of which is out of use
  • in a large study of medical equipment maintenance services in low-income countries, 85% of African hospitals reported difficulty finding qualified medical engineers locally (77% in Latin America and 60% in Asia)
  • A study of 20 developed and developing countries found that the appropriate selection of medical equipment could save up to 90% of the costs associated with the operation and maintenance of the equipment over its lifespan
  • 34% of 145 countries have a health technology national policy that is part of the national health programme, but only 9% of 145 countries have an independent health technology national policy