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Health-care technology is central to boosting the productivity and quality of health-care systems. In many sub- Saharan African countries, however, medical device management systems are weak or absent. The aim of this article is to illustrate, using a case study, how policy reforms can help ensure policy on health-care technology is translated into everyday practice and how an integrated systems approach can enhance the operation of medical device management. Between 2011 and 2023, a plan to improve medical device management systems in the United Republic of Tanzania was developed and implemented through Swiss-Tanzanian cooperation within the Health Promotion and System Strengthening Project. The availability of biomedical engineers was increased through new training courses and the creation of permanent positions in government. Moreover, additional district and regional maintenance and repair workshops were built, and a National Centre for Calibration and Training was established to ensure the correct functioning of medical devices. The introduction of an electronic medical device management system provided health facilities and the health ministry with data on the operational status of medical devices and the need for repairs and spare parts. Every level of government was encouraged to allocate more human and financial resources to medical device management. Following this decade-long effort, the percentage of functioning equipment increased substantially, and costs were reduced by repairing rather than replacing equipment. The project also demonstrated the value of an integrated, system-strengthening approach that considered personnel, maintenance and repair facilities, documentation and management, and government policy and budgeting. Les technologies jouent un role crucial dans le renforcement de la productivite et de la qualite des systemes de sante. Pourtant, dans de nombreux pays d'Afrique subsaharienne, les systemes de gestion des dispositifs medicaux sont limites, voire inexistants. Cet article a pour but d'illustrer, au moyen d'une etude de cas, comment les reformes peuvent contribuer a faire en sorte que les politiques en matiere de technologies sanitaires soient appliquees au quotidien, et comment une approche integree peut ameliorer la gestion des dispositifs medicaux. Entre 2011 et 2023, un plan visant a developper les systemes de gestion des dispositifs medicaux en Republique-Unie de Tanzanie a ete defini et mis en reuvre en collaboration avec la Suisse, dans le cadre du Projet de Promotion et de Renforcement du Systeme de Sante. De nouvelles formations et la creation de postes permanents au sein du gouvernement ont permis d'accroitre la disponibilite des ingenieurs biomedicaux. En outre, des ateliers supplementaires d'entretien et de reparation ont ete construits dans differentes regions et districts, tandis qu'un Centre National d'Etalonnage et de Formation a ouvert ses portes pour assurer le bon fonctionnement des dispositifs medicaux. Lintroduction d'un systeme electronique de gestion des dispositifs medicaux a fourni aux etablissements de soins de sante et au Ministere de la Sante des donnees concernant le statut operationnel de ces dispositifs, ainsi que les reparations et pieces detachees requises. Chaque niveau de pouvoir a ete encourage a attribuer davantage de ressources humaines et financieres a la gestion des dispositifs medicaux. Au terme de dix ans d'efforts, le pourcentage d'equipements en etat de marche a considerablement augmente et les couts ont diminue grace au recours a la reparation plutot qu'au remplacement. Le projet a egalement demontre l'importance d'une approche integree, qui consiste a renforcer le systeme en tenant compte du personnel, de l'entretien et des installations de reparation, de la documentation et de la gestion, mais aussi de la politique gouvernementale et du budget. La tecnologia aplicada a la atencion sanitaria es fundamental para impulsar la productividad y la calidad de los sistemas sanitarios. Sin embargo, en muchos paises del Africa subsahariana los sistemas de gestion de los productos sanitarios son deficientes o inexistentes. El objetivo de este articulo es ilustrar, mediante un estudio de caso, como las reformas politicas pueden ayudar a garantizar que la politica sobre tecnologia de la atencion sanitaria se convierta en una practica cotidiana y como un enfoque de sistemas integrados puede mejorar el funcionamiento de la gestion de los productos sanitarios. Entre 2011 y 2023, se elaboro un plan para mejorar los sistemas de gestion de los productos sanitarios en la Republica Unida de Tanzania, que se implemento a traves de la cooperacion suizo-tanzana en el marco del Proyecto de Promocion de la Salud y Fortalecimiento del Sistema. Se aumento la disponibilidad de ingenieros biomedicos mediante nuevos cursos de formacion y la creacion de puestos permanentes en el gobierno. Ademas, se construyeron talleres de mantenimiento y reparacion adicionales de distrito y regionales, y se establecio un Centro Nacional de Calibracion y Formacion para garantizar el correcto funcionamiento de los productos sanitarios. La introduccion de un sistema electronico de gestion de productos sanitarios proporciono a los centros sanitarios y al Ministerio de Sanidad datos sobre el estado operativo de los productos sanitarios y la necesidad de reparaciones y piezas de repuesto. Se animo a todos los niveles de gobierno a asignar mas recursos humanos y financieros a la gestion de los productos sanitarios. Tras este esfuerzo de una decada, el porcentaje de equipos en funcionamiento aumento notablemente y los costes se redujeron al reparar los equipos en lugar de sustituirlos. El proyecto tambien demostro el valor de un enfoque integrado de refuerzo del sistema que tenia en cuenta el personal, las instalaciones de mantenimiento y reparacion, la documentacion y la gestion, y la politica y los presupuestos gubernamentales., Introduction Health-care technology includes medical devices, procedures and systems, as well as medicines and vaccines, and involves the application of organized knowledge and skills. (1-3) Such technology plays a crucial [...]

A physician decries the carelessness of US medical personnel and other doctors in needlessly wasting medical supplies and other resources daily. He notes that if these resources were added up, the total amount of daily wastage could be used to treat the rest of the world. Further, he believes that medical-industrial big business has brainwashed the public into believing more is better and that defensive medicine has forced doctors to perform many redundant procedures., Just another morning in the OR. I ask for a razor to shave my patient's belly. Do I get a razor? No, I get a package of them. "A few [...]

Background: Sepsis accounts for up to 15% of an estimated 3.3 million annual neonatal deaths globally. We used data collected from the control arms of three previously conducted cluster-randomised controlled trials in rural Bangladesh, India, and Nepal to examine the association between clean delivery kit use or clean delivery practices and neonatal mortality among home births. Methods and Findings: Hierarchical, logistic regression models were used to explore the association between neonatal mortality and clean delivery kit use or clean delivery practices in 19,754 home births, controlling for confounders common to all study sites. We tested the association between kit use and neonatal mortality using a pooled dataset from all three sites and separately for each site. We then examined the association between individual clean delivery practices addressed in the contents of the kit (boiled blade and thread, plastic sheet, gloves, hand washing, and appropriate cord care) and neonatal mortality. Finally, we examined the combined association between mortality and four specific clean delivery practices (boiled blade and thread, hand washing, and plastic sheet). Using the pooled dataset, we found that kit use was associated with a relative reduction in neonatal mortality (adjusted odds ratio 0.52, 95% CI 0.39-0.68). While use of a clean delivery kit was not always accompanied by clean delivery practices, using a plastic sheet during delivery, a boiled blade to cut the cord, a boiled thread to tie the cord, and antiseptic to clean the umbilicus were each significantly associated with relative reductions in mortality, independently of kit use. Each additional clean delivery practice used was associated with a 16% relative reduction in neonatal mortality (odds ratio 0.84, 95% CI 0.77-0.92). Conclusions: The appropriate use of a clean delivery kit or clean delivery practices is associated with relative reductions in neonatal mortality among home births in underserved, rural populations. Please see later in the article for the Editors' Summary., Introduction Every year, an estimated 3.3 million newborn infants worldwide die in the first month of life, 99% of them in low- and middle-income countries, and 35% of them in [...]

When I used to go to the gym, I would add up the calories I burned and 'spend' them on the way home. A perfect arrangement--300 calories on the rowing [...]

Q: Now that our founding partner has retired, the rest of us want to upgrade our medical equipment. How should we go about selling our somewhat outdated inventory? A: By [...]