Images from Health Facilities in Nicaragua - Medical Devices and Biomaterials for the Developing World - page 93

Challenges

1. Not every country has a detailed and up-to-date comprehensive inventory, and
those that do collect data in different ways.
2. Does this totally account for regional differences/population distribution? (Are
these already implicit in the distribution of health facilities, which are to some
extent de fi ned on an urban-rural continuum?)

How Do We De fi ne the Following?

1. Equipment? What do we call them?

- Equipment are identified using unique five-digit codes from the Global

Medical Device Nomenclature.

2. “Importance” of one device as compared to another?

- This will be captured using criteria of inclusion of medical devices, which

prioritizes them according to function, rate of use, risk involved, and mainte-
nance. There are three different models (WHO 2010a ):

Fennigkoh and Smith model (equipment management number):
1. EMN = Function + Risk + Required maintenance

Wang and Levenson's Equipment Management Rating:
2. EMR = “Mission Critical Rating” + 2 × Risk + 2 × Maintenance
3. Adjusted EMR = (“Mission Critical Rating” + 2 × Maintenance) × Utilizatio
n + 2 × Risk

For simplicity, the Fennigkoh and Smith model was used in this analysis.

3. Ideal inventory for a given facility?

- The WHO has published preliminary guidelines, entitled “Medical Devices

by Healthcare Facilities.”

4. Facility classi fi cations?

- The WHO and UNICEF classify health facilities based on size and services

provided. These guidelines should be used to make consistent assignments of
different facilities to appropriate categories.

5. Which diseases should be treatable in a given nation?

- This includes several conditions, but the focus is on the top causes of mortal-

ity for nations under study.

6. What equipment is required to treat a given disease?

- The WHO Availability Matrix provides information on which equipment is

required to adequately treat 15 major diseases.