DESIGN FOR DEVELOPMENT

The WHO (2010) identifies the correct selection and use of medical technologies as crucial to the

provision of good healthcare services, however it also argues that modern medical equipment is a

major contributor to rising costs.

These costs frequently result from unnecessary purchase and use of equipment in both high and

low-income countries.

The WHO also reports that one of the biggest contributors to the inefficiencies of medical

technologies in low-income countries is the existence of donations….

(WHO, 2010).

(Fig. 2. Society of St. Vincent de Paul Phoenix, 2006).(Fig. 1. Kortia, 2011). (Fig. 3. Design that matters, 2014).

In some Sub-Saharan African countries the WHO report that almost 80% of healthcare equipment is

donated and at least 50% of is either partly or totally unusable and 70% stands idle due to its

inability to be integrated into the existing environment. Resulting in equipment graveyards.(Hodges, 2007; Gatrad et al. 2007; Dyer et al. 2009; Malkin et al. 2011).

(Fig. 4. Miesen, 2008). (Fig. 5. Couilard, 2008). (Fig. 6. Miesen, 2008).

‘Most health technology is produced by companies from high-income countries for high-income

markets.

…Health technology is therefore mostly designed for an environment with high spending on health,

a reliable energy supply and large numbers of trained healthcare professionals.’ (Howitt. et al. 2012)

The Challenge

Currently ¾ of medical devices fail to be used outside their intended environment of use.

Lack of:

- needs assessment

- appropriate design

- robust infrastructure

- spare parts

- information for procurement

- ability to conduct/understanding of maintenance

The Mismatch

Global improvement of access, quality and use of medical devices. To ensure that solutions are not

just focused on the ‘upstream’ but also maintain a wider scope.

The Need

Availability

Accessibility

Appropriateness

Affordability (Diehl & Christiaans, 2007; WHO, 2010, Castillo et al. 2012)

Managing the Mismatch

How do we achieve this?

Developing countries are not best served by the direct transferal of technology from

developed to developing countries and the best technology isn’t necessarily the

biggest, most advanced or most expensive, but the technology that best suits the

environment of use. (Schumacher, 1973).

‘If you are going to help the developing world, you can’t just airlift in supplies we use in the rich

world. You need to deeply understand how the people there live. Then design things that make

sense for their specific conditions.’(Brown, 2013).

Acceptability

(Fig.7. Kandalf, 2011). (Fig.8. Miah, 2011).

Affordability

(Fig. 9. Lauren).

Appropriateness

(Fig. 10. PlayPumps, ) (Fig. 11. iDE)

Availability

(Fig. 12. The Dieline, 2013). (Fig. 13. The Dieline, 2013).

Jaipur foot Re motion Knee

(Fig. 14. Rajesh, 2013).(Fig. 15. D-Rev, 2015).

Litre of light project

(Fig. 16. Chang, 2012)

Thank you for listeningAny Questions?

ReferencesWHO, (2010a). ‘Health Systems financing: the path to universal coverage.' The World Health Report. Geneva: The World Health Organisation. WHO. (2010b). 'Medical devices: Managing the Mismatch. An outcome of the priority Medical Devices project.' Geneva: The World Health Organisation. WHO. (2010c). ‘Innovative technologies that address global health concerns. Outcome of the call global initiative on health technologies 2010.’ Geneva: the World Health Organization.Hodges, S.C., Mijumbi, C., Okello, M., McCormick B.A., Walker, I.A., & Wilson, I.H. (2007). ‘Anaesthesia services in developing countries: defining the problems.’ London: The World Federations of Anaesthetists of Great Britain and Ireland. 62(1): pp. 4-11.Gatrad, A.R., Gatrad, S. and Gatrad, A. (2007). ‘Equipment donation to developing countries.’ Anaesthesia 62(s1): pp. 90-95. Dyer R.A, Reed A.R. & James M.F. (2009). ‘Obstetric anaesthesia in low-resource settings.’ Best Practice & Research. Clinical Obstetrics & Gynaecology. 24(3): pp. 401-412. Malkin, R. & Perry, L. (2011). ‘Effectiveness of medical equipment donations to improve health systems: how much medical equipment is broken in the developing world?’ Medical & Biological Engineering & Computing. 49(7): pp.719-722Howitt, P. Darzi, D., Yang, G-Z., Ashrafian, H., Atun, R., & Barlow, J. et al. (2012). ‘Technologies for Global Health’. The Lancet. 380(9840): pp. 507-535. Diehl, J.C. & Christiaans, H.H.C.M. (2007). ‘The first learning experiences of Design for the BoP.’ In IASDR07 Proceedings: ‘Emerging trends in design research.’ Hong Kong: The Hong Kong Polytechnic University, pp. 1-12.Castillo, L.G., Diehl, J.C. & Brezet, J.C. (2012). 'Design Considerations for Base of the Pyramid (BoP) Projects.' Northern World Mandate Culumus Helsinki Conference, Cumulus. pp. 1-15.Schumacher, E.F. (1973). ‘Small is beautiful.’ London: Blond & Briggs Ltd.Brown, T. (2013). '7 Brilliant designs that save lives.' Wired. [Online]. [Accessed 08/02/2014]. Available from: http://www.wired.com/2013/11/design-for-the-developing-world/ Brown, T. & Wyatt, J. (2010). ‘Design Thinking for Social Innovation.’ Stanford Social Innovation Review. Volume 12(1): pp. 31-35.

Figures: Fig.1. Kotria, K. (2013). ‘Donating Medical Equipment I Wheelchairs of Hope.’ http://info.blockimaging.com/bid/41086/Donating-Used-Medical-Equipment-Wheelchairs-of-Hope Fig.2. Society of St. Vincent de Paul Phoenix. (2006). ‘Medical Equipment loan closet.’ http://www.stvincentdepaul.net/programs/medical-equipment-loan-closet Fig.3. Design that matters. (2014). ‘Essay #2: Considering Green in every Invention: Saving babies and the environment using human-centred design.’ http://www.designthatmatters.org/blog/2014/10/15/firefly-essay-2 Fig.4. Misen, M. (2013). ‘The Inadequacy of Donating Medical Devices to Africa.’ http://www.theatlantic.com/international/archive/2013/09/the-inadequacy-of-donating-medical-devices-to-africa/279855/ Fig.5. Couillard, F. (2012). ‘Medical equipment matters: the aid vs. development paradigm.’ http://www.strategies-direction.com/medical-equipment-matters-the-aid-vs-development-paradigm/ Fig. 6. Misen. M. (2015). ‘We Know How Cerebral Malaria Kills Children — But Do We Know How to Save Them?’ http://www.mikemiesen.com/tag/medical-devices/ Fig. 7. Kandaf. (2011). ‘Mosquito Nets save children in Mozambique.’ http://www.school-link.org.uk/mosquito-nets-save-children-in-mozambique/ Fig. 8. Miah, R. (2011). ‘Reducing the incidence of mosquito borne diseases (MDG 6).’ https://my-munofs-ii.wikispaces.com/file/view/Reducing+the+incidence+of+mosquito+borne+diseases+%28MDG+6%29.pdf Fig. 9. Lauren. (2014). ‘Lifestraw Review and Giveaway.’ http://hikebloglove.com/2014/08/01/lifestraw-review-and-giveaway/ Fig. 10. PlayPumps. (2015). ‘Roundabout water solutions.’ http://www.playpumps.co.za/ Fig. 11. iDE (2015). ‘Treadle Pumps.’ http://www.ideorg.org/OurTechnologies/TreadlePump.aspx Fig. 12 &13. the dieline. (2013). ‘Colalife:kit Yamoyo.’ http://www.thedieline.com/blog/2013/4/24/colalife-kit-yamoyo.html Fig. 14. Rajesh, S. (2013). ‘Jaipur foot.’ http://www.pinkcity.com/citizenblogger/jaipur-foot-2/ Fig. 15. D-Rev. (2015). ‘Remotion knee.’ https://d-rev.org/ Fig. 16. Chang, E. (2012). ‘1 liter of light project illuminates thousands of Filipino homes with recycled bottles.’ http://inhabitat.com/1-liter-of-light-project-illuminates-thousands-of-filipino-homes-with-recycled-bottles/