Issues on Clinical Engineering in Developing Countries (Continued)

1
Issues on Clinical Engineering in Developing
Countries (Continued)

• Prof. M. Frize, P. Eng., O.C.
• ELG5123/94.526

2
A Model Morocco (1986-2000)

• 1986 UNDP funds a study and project on equipment
  maintenance in public hospitals
• 1990 A study of existing services and state of
  project progress (Cornillot/Frize)
• 1992 A re-design of the project (Cornillot/Frize)

3
A Model Morocco (1986-2000)

• 1994 Assessment of progress and fine-tuning of
  project design (Frize)
• 1996 and 1998 Assessment of progress (Frize)
• 2000 Final assessment and recommendations (Frize)

4
Model continued

• 1986 biomedical and technical infrastructure
  together few human resources or materials
• 1990/1992 Development of a regional service
  concept (with 7 major regions, based on countrys
  largest division scale) BME separate

5
Model continued

• 1994 Re-design into 16 regions (63 provinces)
  including 3 in the Sahara
  and 3 pilot regions (Fes, Marrakech,
  Agadir)
• 1996 Other pilot regions (Casablanca, Meknes)

6
Model continued

• 1998 Regions now offer peripheral services but
  no more separation of two service types
• 2000 There remain some problems of coordination,
  loss of several key engineers

7
Current status

• Morale still low for engineers and technicians
• Budgets now de-centralised to some extent, which
  will help
• Cars are shared and accessed on a reasonable
  basis
• More test equipment and spare parts
• More knowledge and training
• More staff (techs and engineers)

8
Results

• Idle equipment less than 30 percent (due mainly
  to old equipment still in inventory)
• Physicians and administrators fairly satisfied
  with service levels
• Engineers and technicians paid a little more and
  have slightly more recognition (appreciation)

9
Improvements needed

• Need more incentives (travel allowances, etc)
• Better salaries and especially career progression
• Need more and better communication between
  central team and regional teams and with each
  other
• Need more visible appreciation from physicians in
  charge

10
Conclusion

• Moroccan model would be of great benefit to many
  developing countries
• Developed countries need to rethink how they can
  help
• National policies are critical
• Incentives for career development and better
  salaries essential
• Must integrate local culture and needs with
  western expertise and help