Maintenance of medical devices Submitted by Name: Mary Ngugi and Philip Anyango Affiliation: Ministry of Health Location: Nairobi, Kenya E-mail address for contact: anyangopa@gmail.com, brngitu@yahoo.com

Country Estimates in Brief Population 44.38 Million Population Growth Rate 2.7% Life Expectancy at Birth 61.68 (2013), Men 59,68, Women 63.64 Infant Mortality Rate 39 per 1000 lives Number of Health Centers in Country National Teaching and Referral Hospitals-2 Regional Referral Hospitals-10 County Hospitals-139 Sub-County Hospitals- 139 Health Centres-1112. Total Expenditure on Health as % of GDP 4.7 Global CE / HTM Success Stories

Country's Health Technology Program Key Success Story Before 1990; There was no engineers and technicians and skilled in service and maintain medical equipment Less than 50% of equipment were in use No maintenance was in place Facilities relied on vendor technicians for repairs Frequent breakdown of equipment Longer response and down time No laid down procedure for acquisition No equipped workshops January 2016 Global CE / HTM Success Stories

Interventions & Results Medical Engineering Training Centers were started in the country To train technologists and technicians on management of Medical equipment. They were posted to the facilities after three year programs More than 4,000 Bmets has been trained since 1987 Every level four and above have a BMET Bmets participate in decision on equipment acquisition 80% of equipment in facilities are in use Reduced response and downtime Currentyly Managed Equipment service is being implimented January 2016 Global CE / HTM Success Stories

National in –house ophthalmic equipment maintenance programme Background Ophthalmic equipment maintenance program started in 2009 due; Poor state of ophthalmic equipment and instrument Lack of well trained medical engineering personnel on maintenance of ophthalmic equipment 66% of the equipment and instrument were not working optimally( baseline survey report 2010) Most equipment put aside due to very minor faults. Poor inventory of ophthalmic equipment January 2016 Global CE / HTM Success Stories

Situation before intervention Lack of ophthalmic services in most hospital Common occurrence of un-serviced ophthalmic equipment and instruments in hospitals Over Reliance on equipment supplier for maintenance and service of the equipment which is very expensive. Demoralized work force due to lack of tools of trade Un-utilized equipment especially donations due to lack of operation skills by clinicians More expenditure on procurement of new equipment January 2016 Global CE / HTM Success Stories

Intervention/What we did Two biomedical engineering technician taken for a specialized training on maintenance of ophthalmic equipment and instruments and training of trainers (TOT) The two technicians were deployed in the division of ophthalmic service to; Undertake preventive and corrective maintenance of the ophthalmic equipment and instrument across the country Build capacity of other medical engineering technicians on maintenance of ophthalmic equipment and instrument Build capacity of eye care service providers on proper use and care of ophthalmic equipment and instrument Maintain an inventory of all ophthalmic equipment and instrument for all the public eye care units Give technical support to hospitals January 2016 Global CE / HTM Success Stories

Global CE / HTM Success Stories Results Outcome Increased availability of ophthalmic equipment and instrument from 34%-90% facts: Ophthalmic equipment maintenance report 2010-2015 100% of Maintenance works on ophthalmic equipment done in-house. Increased capacity of medical Engineering personnel to 32 by end of 2015 Build capacity for at least one eye care service providers( ophthalmic nurse/surgeon) on proper use and care of ophthalmic equipment and instrument Reduced breakdown to an average of 20% Maintain an updated national inventory for ophthalmic equipment . January 2016 Global CE / HTM Success Stories

Global CE / HTM Success Stories Action plan Due to devolution; Ensure these medical Engineering personnel keep abreast with emerging technologies. Establish a similar program in each county. Establish a national spare part program for ophthalmic equipment January 2016 Global CE / HTM Success Stories

Conclusions and action plan There is need to build capacity in specialized equipment like renal, Imaging, ICU To set up center of excellence which will act as calibration centers and for mentorship The country require Healthcare Technology Management policy that will regulatory body and accreditation program. January 2016 Global CE / HTM Success Stories