2. for the neglect or non-use of medical

2. Introduction

2.1 This report aims at:

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1- Why medical
equipment matter.

2- Give an
overview of underused equipment in rural areas

3- Explain the
main reasons and factors for the neglect or non-use of medical equipment in
certain areas.

4- Give some ways to avoid problems of not using
medical equipment

2.2 Brief background

The quality of performance and continuous maintenance of medical
equipment is essential for everyone to have access to quality health care,
especially in these years because the reliance on modern equipment of high
quality is increasing (THET, 2017).

some of these medical equipment are useless because of lack of financial
resources in rural and low-income countries (THET, 2017).

2.3 health equipment

Medical devices are very important to achieve the best health
results by facilitating and improving access to good, safe and suitable
equipment for medical procedures (THET, 2017). It is very important to provide well trained professionals to
maintain and manage medical equipment and ensure the best value of equipment
available (THET, 2017).

2.4 underused medical equipment

Rural people face barriers to health care that limit their access
to the care they need (Ruralhealthinfo.org, 2017). Some rural residents also feel
unequal in the quality of medical care offered to them in exchange for urban
centers, and are concerned that provincial rural hospitals have no advanced
equipment to take advantage of the technological advances of diagnostic and
treatment equipment (Health.gov.bc.ca, 2017).

Health centers in rural and low-income countries often rely on
donations that provide appropriate diagnostic and therapeutic medical
equipment. However, sometimes donating does not recognize the need of the
recipient, and this leads to the inability to use these devices (Bosermann et
al., 2014).

Some rural health facilities have trained staff and doctors but
their lack of equipment has reduced their ability to provide medical care. In
the absence of government support, these medical centers relied on equipment
donated by foreign governments and others to provide or replace medical
equipment (Boserman et al., 2014).

At present, most donated equipment is old or unwanted, but received
by recipients in some rural or low-income areas to fill gaps and try to cover the
need in their health centers. On average 38% of medical equipment in rural and
developing areas is broken or useless (Bauserman et al., 2014).

Although donations are intended to help health centers in these
areas, donors are not aware of some shortcomings such as lack of clean water
and electricity. Many of the donated equipment are therefore non-practical and
unsuitable for the real needs of these areas (Bauserman et al., 2014).

2.5 reasons for the non-use of medical
equipment in certain areas

There are several reasons why medical devices are not used. The
main problem is when choosing or purchasing a medical device, whether it will
be used or not. Logically, for the use of medical devices, they must be usable
and must also be designed for the intended purpose of use (Medical
Devices: Managing the Mismatch, 2010). Factors that
prevent the use of medical devices:

1- Lack of information

When purchasing medical equipment, there must be a prior conception
of the desired benefit. Therefore, the choice of the medical device requires
sufficient information about the situation in the medical centers in the areas
where these devices are needed, in addition to sufficient information on how to
use this device (Medical Devices: Managing the Mismatch, 2010).

2- Lack of training

The operation of medical equipment requires some skills and
knowledge, and is obtained through training. Lack of adequate staff training
may be a major obstacle to the safe use of medical equipment. A large number of
errors in the use of equipment indicate lack of training. But lack of training
is not the only reason for repeated errors in the use of equipment, there are a
number of factors may cause these errors, such as equipment design and
inability to read equipment manuals (Medical Devices: Managing the Mismatch, 2010).

In many rural and low-income countries, there is no specialized
training for the maintenance of medical equipment. Although local mechanics and
electricians are working hard to maintain hospital equipment and devices, but
this remains a major challenge because most equipment malfunctions are due to
misuse (THET, 2017).

3- Donations

Medical donations often do not meet the needs of the recipients,
especially the complex devices, because the recipient rarely participates in
the selection process.

Developing countries and rural areas are often dependent on the
processing of their health centers on donor organs. In fact, the proportion of
use of donated devices is very small compared to the number of donated devices (Medical
Devices: Managing the Mismatch, 2010).

4- Management Limited

Many devices are purchased without a clear plan to manage these
medical devices and how to use and maintain them to ensure their job
performance, and this is also a reason enough to make medical devices or
equipment is useless (Medical Devices: Managing the Mismatch, 2010).

5- Maintenance problems

Insufficient maintenance is one of the major factors in the
accumulation of medical equipment in rural and developing countries. For
maintenance to be appropriate, there must be a budget, maintenance technicians
and a willingness to bring spare parts for these devices. Maintenance of
medical equipment requires trained personnel to supervise these devices and to
install spare parts and maintenance to maintain them for as long as possible
and with high efficiency (Medical Devices: Managing the Mismatch, 2010).

2.6 Overcoming barriers to using medical devices

In low-resource countries, the lack of public funds is a reason not
to use or misuse medical equipment. One possible solution to help reduce
barriers to the use of these devices is to assist countries in developing
medical technology policies and integrating them into their national health
system (Medical Devices: Managing the Mismatch, 2010).

1- Medical device design

There are many ways to ensure that the design of medical devices is
appropriate for the way they are used. One of these methods is the engineering
of human factors or the work environment. This method focuses on the user
interface of the device. This interface includes all components and accessories
for operating and maintaining devices, such as posters and instructions. This
is an opportunity to facilitate the use and operation of equipment,
particularly for low-resource countries with insufficient trained personnel (Medical
Devices: Managing the Mismatch, 2010).

2- Medical device management

Department of Medical Devices shall endeavor to:

device complies with regulatory requirements

device is properly installed and calibrated by trained personnel

environmental and human conditions

To be
monitored to ensure its safety and to report adverse events (Medical
Devices: Managing the Mismatch, 2010).

3- Training

The shortage of trained health workers can be minimized if
countries develop a human resources health plan. WHO has provided assistance to
all countries to develop a plan to address the training needs of health workers
as well as those who will deal with health technologies (Medical
Devices: Managing the Mismatch, 2010).

3. Methodology

In this report the information was collected through internet,
Governmental and educational sites, some articles and books. This report talked
about unused medical equipment in developing regions, rural areas and
low-income countries. It took about two weeks, three hours a day starting on
Friday, November 24, 2017 until Saturday, December 9, 2017. Headings used to
search for information:

equipment in rural area

medical devices in low income countries

medical equipment

donates medical equipment

medical equipment

4. Discussion

According to the report, 38% of donated medical equipment in rural
areas is useless or broken. This is a great waste of equipment because most
cases in these areas need these devices for treatment. This is an important
issue to be considered and resolved. I would like to point out that the
collection of information has been difficult because of the lack of reliable
sources and government web sites that have spoken and explained the problems of
the underused medical equipment in rural areas, as well as the lack of
statistics related to the problem.

4. Conclusion

The issue of medical equipment and its non-utilization in rural,
developing and low-income countries is important. Delivery of equipment to
these areas is necessary. If there are no specialized workers who know how to
maintain them or if there is not sufficient information on how to use them,
they will be disrupted within a short period of time. What is more important is
the need to provide good training for the use and maintenance of medical
devices (THET, 2017).

5. Recommendations

researching several sites about underused medical devices in rural areas and
developing countries, a number of points were suggested:

receiving donations, you must identify the required supplies and equipment,
verify that the donor has the capacity to meet the requests, also reject the
inappropriate equipment and explain the reason for the refusal (Kaur, Hall and
Attawell, 2001).

training courses for workers in rural health centers to learn about dealing
with medical devices and how to use them and maintain them.

purchasing medical equipment, there must be prior knowledge of the needs of the
rural areas of these devices, with full knowledge of how the devices work and
use (Medical Devices: Managing the Mismatch, 2010).


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