E-drug: Needs of district hospitals (cont'd)
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Dear all,
Following on to the posting by Richard Laing, while at ECHO
International (2000- 2001), we began addressing the issue of creating
an Essential Equipment List, along the same lines as essential drugs.
We also approached the issue of equipment standardisation again as
we have for essential drugs. Unfortunately, due to lack of resources,
we were unable to pursue the subject. We had consulted WHO
(physical assets/medical devices cluster),but did not meet much
enthusiasm for such a list, although we collaborated in other areas. It
was suggested by many of our contacts and partners that the
numerous standards that affect equipment (eg, CE marking,
manufacturing standards, raw material requirements, ISOs, Electricity
standards, etc) presented a great challenge for standardising.
Equally, the lack of emphasis at national level for essential equipment
list has resulted in this area being consumer- driven (ie, doctors,
specialists order what they are used to rather than what the MoH may
have dictated as essential list). As long this aspect of equipment is
left to individuals to decide, we shall continue to see great waste in
this aspect of healthcare.
On many of our visits to clients we noticed major (eg, blood cell
counter) and minor (eg, surgical tools) equipment discarded because
the expert who ordered them had left the hospital, and there was no
one else trained to use that machine. Alternatively, the machine was
not used due to a lack of spare parts. A few clients suggested that
there was always (global) funds available to procure equipment, with
less constraints than there was for essential drugs. Only two clients
we served showed indications of developing a standard equipment list
at province and district level; one of these had developed a global
monitoring system to check use, repair, replacement, spare parts
availability at both levels.
Philippa Saunders (Essential Drugs Project), when on the ECHO
Board of Directors, was driving this call for an equipment list, both at
ECHO and at WHO. We ended up publishing a second edition on
procurement and maintenance of equipment ("Medical Supplies and
Equipment for Primary Health Care". This should be available at the
WHO library), which pointed towards having a basic essential list of
equipment.
It is interesting to note that GTZ (see posting by Beverley Snell) had a
similar book published earlier on. This points to a need for such a list.
Regards,
Bonnie
Bonnie Fundafunda
Contracts Officer
UNICEF - Supply Division (Immunisation)
Copenhagen, Denmark
e-mail: bfundafunda@unicef.org
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