In the rare case where a developing world hospital does have access to skilled technicians for medical equipment repair, the issue of acquiring replacement parts still exists. The main benefit to having skilled technicians in developing world hospitals is having the ability to perform preventative maintenance which can dramatically reduce the prevalence of out-of-service medical equipment and need for replacement parts. Therefore, designing medical devices that are relatively easy to maintain and require minimal technical knowledge to repair/troubleshoot is important.
Electricity is a huge issue in the developing world. A firm understanding of the quality and presence of the electricity in the location of use is an influential consideration when designing a device. Electricity may not be present at all, it may be very intermittent, and/or power surges may be common. When designing for the developing world it is advantageous to assume all three of these electrical quality issues exist as the device may be used in a variety of geographical locations.
Developed world health care widely uses disposable parts and reagents, which has its advantages but increases costs as well as waste. When the use of these disposables is translated into the clinical setting of the developing world, a problem arises. The problem, of course, is that money and/or an accessible supplier is needed. Therefore, a large part of device design in the developing world is re-engineering a normally disposable item into a form that is reusable.
It is important to keep in mind that the design considerations which have been discussed do have the tendency to combat each other. For example, by formulating a way to incorporate less expensive parts and assembly methods into the design, device reliability may be compromised which in turn may reduce the longevity of the product and require more frequent maintenance and replacement of components. In addition, methods of reducing costs may reduce the efficacy of the device to the point where the device may not be suitable for use. Thus, all design considerations should be continuously in the forefront of the design process to ensure that the device is a viable asset to health care.
In conclusion, to incorporate designing for low-cost, ease of maintenance, use in non or intermittent power situations, avoiding the requirement for disposables that are not accessible in the location of use; and all the while maintaining a satisfactory level of device efficacy, one must be able to think creatively (i.e.: outside the box). Quality engineering and design already depends heavily on creative thinking, but additional creativity and situational knowledge is needed for solving problems in the developing world. Therefore, engineers and other creative minds that have a strong contextual grasp of the special needs of developing world are well positioned to provide innovative medical device solutions to the developing world.
Authored By: John Sanderson, Technical Associate Applied Technologies Incorporated