Low-resourced communities in the developing world are faced with a wide array of difficulties which often adversely affect the health of the population as well as the surrounding environment. These communities lack the technical knowhow, funds, and governmental/in-country support to adequately alleviate the existing problems on their own. Therefore, outside individuals and organizations are needed to come in and offer support to these communities. Professionals such as engineers are great resources for assisting the developing world, as they are adept in problem solving and creating unique solutions.
Here, I would like to focus on the factors that need to be considered for medical device development in low-resourced clinical settings. Although we will be concentrating on medical applications, most of the steps and considerations for engineering solutions in the clinical setting carry over to how one should go about solving problems which lay in other realms of civil and environmental engineering. Keep in mind also that engineering projects abroad come about from a wide range of sources and how one goes about carrying out a project can vary depending on the situation.
The development of devices to be used in one’s own developed country is already a complex process, but when an engineering team is tasked with designing a device to be used in the developing world many more factors need to be considered in order to carry out the design and implementation effectively. In effect, the complexity of the overall project increases when designing for the developing world. Among the factors to be considered are cultural and societal constraints, difficulties in communication due to language barriers and geographical distance, and especially designing for low-cost and sustainability.
Before the actual design process begins, a foundation needs to be laid to help the design team understand the community’s culture and society. A holistic understanding of the community’s culture and social structure and norms is important, as it will impact practically every step in the design process. One means to achieve this understanding is through networking with other organizations working in the community or region of focus. These established organizations can provide insight on what problems they have experienced and can provide advice on how to most effectively go about working with the community.
Equally as important to the design team is developing rapport and fostering relationships with the community itself. A good starting point for this is to find a person, whether native or not, who already has an established relationship with the community and who can act as a coordinator or liaison to the design team. Establishing a good liaison will help to alleviate the difficulties arising from the geographical and language barriers which affect long distance communication.
A thorough on-site needs assessment is necessary to acquire as many details as possible with regard to the problem statement, and surrounding causes need to be noted. The more on-site time spent during the design process the better, so as to identify small details otherwise unforeseeable due to lack of understanding of and ability to communicate the needs and wants of the stakeholders.
One of the biggest issues in developing world health care is lack of funds to acquire medical equipment and the maintenance of equipment when it loses functionality. For these reasons, important design considerations are often:
1) Designing for low-cost
2) Ease of maintenance
3) Use in no or intermittent power situations
4) Avoiding the requirement for disposables that are not accessible in the location of use; all the while maintaining a satisfactory level of device efficacy.
Authored By: John Sanderson, Technical Associate Applied Technologies Incorporated