Medical equipment donated to developing countries inappropriate for local conditions

July 31, 2012, Lancet

Wealthy countries that make donations of expensive medical equipment to low- and middle-income countries may be missing the mark, according to a new Imperial College London / Lancet Commission. The report examines how medical technology should best be used to improve health in low- and middle-income countries, and finds that in many cases, medical technology – almost exclusively developed in rich countries – is simply inappropriate for use in poorer nations.

"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," says Peter Howitt of Imperial College London, UK, one of the Commission's authors.

According to hospital inventories, an estimated 40% of healthcare equipment in developing countries is out of service, compared with less than 1% in high-income countries. The inappropriate deployment of medical technologies from wealthy countries plays a major part in this high failure rate.

Instead of relying on hand-me-down technologies from wealthier countries, which can be costly, inappropriate for local conditions and even dangerous, the authors urge a renewed effort towards developing what they call "frugal technologies" – cost-effective technologies that are developed specifically to cope in local conditions. Examples of frugal technologies which have been developed to meet local needs include:

  • The Jaipur foot – a rubber prosthetic for people who have lost their leg below the knee. Designed in the late sixties in India, it has a flexible design which allows users to walk on uneven surfaces and without a shoe, unlike traditional prosthetic feet developed in high-income countries. It's cheap to manufacture and can be made using local materials with minimal investment in factory equipment.
  • PATH's Uniject injection system, which allows once-only use of needles for injectable contraceptives, meaning that recipients are much less likely to get infected through needle re-use.
  • The eRanger, a durable rural ambulance, based around a motorbike and stretcher sidecar (which can be modified to carry one or two people). It can be easily fixed, is cheap to purchase and maintain, and copes well with poor road surfaces. Studies show that it has markedly improved health outcomes in Malawi.
Another innovative approach is to take advantage of existing information and communications technology for health purposes. The mobile telecommunications revolution has led to a situation where many people who do not have adequate sanitation do have a mobile telephone. Mobile phones can therefore be used to support healthcare efforts – from smoking cessation via text message, to surveillance of disease outbreaks. ICT can provide a virtual training environment for doctors – currently being tested by Imperial College London (UK) to assess the feasibility of training doctors from Malawi.

The report also advocates a wider understanding of what we mean by medical technologies, pointing out that technological improvements to sanitation and road condition could also have a far-reaching impact on public health in many low- and middle-income countries. Furthermore, the authors argue that advances in technology need to be accompanied by innovation in processes to have a significant effect on health – this includes the development of effective delivery mechanisms and novel approaches to financing.

Professor Lord Ara Darzi of Imperial College London, UK, another of the report's authors, concludes that: "Technology is making a substantial contribution to global health, yet it could do so much more. The benefits of health technology should be available to all, not only those in high-income . Access to life-saving health technology should not be restricted to those with the ability to pay. Tackling current market failures is therefore a task for all those with an interest in improvement of global health."*

Explore further: Canada should play a role in addressing the global cancer epidemic: researchers

More information: … (12)61127-1/abstract

Related Stories

Canada should play a role in addressing the global cancer epidemic: researchers

April 10, 2012
Cancer is a growing health concern in low- and middle-income countries, and there is an opportunity for Canada to make a significant contribution to help tackle the disease, states an analysis in CMAJ (Canadian Medical Association ...

Mental health of child refugees is global problem

August 11, 2011
(Medical Xpress) -- A recent two-part study, published online in the Lancet, highlights the urgent need for high-income countries and international agencies to contribute towards the funding of interventions to tackle the ...

Obesity linked to economic status in developing countries

July 18, 2012
(HealthDay) -- In low- and middle-income developing countries, socioeconomic status (SES) plays an important role in the development of obesity, particularly in women, according to research published online July 5 in Obesity ...

15 percent of American physician workforce trained in lower income countries

March 21, 2012
Fifteen percent of the American active physician workforce was trained in lower income countries, which is beneficial for the United States both clinically and economically but may have negative impacts on the countries of ...

New study identifies how information technology is used to solve global health challenges

May 1, 2012
In response to the considerable challenges in providing high-quality, affordable and universally accessible care in low- and middle-income countries, policy makers, donors and program implementers are increasingly looking ...

Recommended for you

Best of Last Year—The top Medical Xpress articles of 2017

December 20, 2017
It was a good year for medical research as a team at the German center for Neurodegenerative Diseases, Magdeburg, found that dancing can reverse the signs of aging in the brain. Any exercise helps, the team found, but dancing ...

Pickled in 'cognac', Chopin's heart gives up its secrets

November 26, 2017
The heart of Frederic Chopin, among the world's most cherished musical virtuosos, may finally have given up the cause of his untimely death.

Sugar industry withheld evidence of sucrose's health effects nearly 50 years ago

November 21, 2017
A U.S. sugar industry trade group appears to have pulled the plug on a study that was producing animal evidence linking sucrose to disease nearly 50 years ago, researchers argue in a paper publishing on November 21 in the ...

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.