Methods for medical device and equipment procurement in low and middle-income countries
General Material Designation
[Thesis]
First Statement of Responsibility
Diaconu, Karin-Daniela
.PUBLICATION, DISTRIBUTION, ETC
Name of Publisher, Distributor, etc.
University of Birmingham
Date of Publication, Distribution, etc.
2016
DISSERTATION (THESIS) NOTE
Dissertation or thesis details and type of degree
Ph.D.
Body granting the degree
University of Birmingham
Text preceding or following the note
2016
SUMMARY OR ABSTRACT
Text of Note
40-70% of medical devices and equipment in low- and middle-income countries (LMICs) are broken, unused or unfit for purpose: ad-hoc, undiscerning and inefficient procurement methods and processes contribute towards this problem. This thesis presents the findings of four original studies on medical device and equipment procurement within LMICs. Chapter I reports findings of a systematic literature review on procurement and prioritization methods; recommendations from reviewed literature are synthesised. Chapter II describes fieldwork conducted in The Gambia and Romania to explore the processes and dynamics behind medical device procurement in contrasting settings. Findings suggest procurement processes are strongly influenced by political/cultural power dynamics; health technology assessment evidence is rarely considered. Chapter III discusses the feasibility of conducting medical device specific economic evaluations for informing procurement planning. A case study on the costeffectiveness of alternative treatment interventions for femur-shaft fracture fixation in Sub-Saharan Africa is presented. Chapter IV consists of a critical appraisal of the medical device specific elements of the One Health Tool for health system planning. The thesis concludes with a discussion contextualizing the findings and suggestions for further research.
TOPICAL NAME USED AS SUBJECT
HD28 Management. Industrial Management
RA0421 Public health. Hygiene. Preventive Medicine