Engr. ESAN, Bukola Emmanuel, BME-MSc [Surrey] MIHEEM MNSE Head, Health Technology (Medical Devices) Management Department of Hospital Services Federal Ministry of Health Abuja, Nigeria Colorado Convention Centre Denver, Colorado USA June 7, 2015

The HT(Medical Devices) Management: Nigeria Experience June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA PREAMBLE: It is pertinent to note that the role of medical devices in the contemporary healthcare system is increasing globally Equipment are often used for disease prevention, diagnosis, treatment and varieties of complex surgical procedures in operating departments within healthcare facilities to mention but few June 7, 2015 HTM Seminar, Denver, CO, USA

What is a Medical Device? ‘’This refers to an instrument, apparatus, appliance, material or other article, whether used alone or in combination together with any software necessary for its proper application, which is intended by the manufacturer to be used for the purposes of diagnosis, prevention, monitoring, treatment or alleviation of disease diagnosis, monitoring, treatment, alleviation of, or compensation for, an injury or physical impairment, investigation, replacement, or modification of the anatomy or of a physiological process, control of conception. June 7, 2015 HTM Seminar, Denver, CO, USA

What is a Medical Device?- (cont’d) A medical device does not achieve its principal intended action in or on the human body by pharmacological, immunological or metabolic means. This definition includes devices intended to administer a medicinal product, such as a syringe driver, or which incorporate a substance defined as medicinal product, such as a drug-eluting stent.’’- MHRA June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA KEY FACTS It has been estimated that between 50 and 80% of medical equipment is out of service in low –income countries the estimated economic loss of 15% of medical equipment in the developing world being out of service is $12.8 billion USD annually, or 22% of the total health spending in the who’s afro region it is estimated that up to 80% of medical equipment in sub- Saharan African countries are donations; the majority of which is out of use in study of medical equipment maintenance services in low-income countries, 85% of hospitals in African reported difficulty finding qualified medical engineers locally compared with 77% in Latin America and 60% in Asia it has also been found that appropriate selection and procurement of medical equipment could save up to 90% of the cost associated with the operation and maintenance of the equipment over its lifespan- WHO Report June 7, 2015 HTM Seminar, Denver, CO, USA

CURRENT MECHANISMS FOR EQUIPMENT MANAGEMENT: THE NIGERIA EXPERIENCE 1. Establishment of Public Procurement Act- PPA (2007) June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA PPA (2007) cont’d The Act provides for the establishment of two regulatory authorities i. The National Council on Public Procurement ii. Bureau of Public Procurement June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA PPA (2007) cont’d Responsibilities: -Monitoring and oversight of public procurement -Harmonisation of the existing government policies and practices June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA PPA (2007) cont’d -regulating and setting standards -developing the legal framework -building professional capacity for public procurement in Nigeria June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA PPA, 2007 cont’d MEMBERSHIP: The Membership of the National Council on Procurement includes: The Minister of Finance as Chairman; The Attorney-General and Minister of Justice of the Federation; The Secretary to the Government of the Federation; The Head of Civil Service of the Federation; The Economic Adviser to the President; June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA Membership cont’d: f. Six part-time members to represent; Nigeria Institute of Purchasing and Supply Management; Nigeria Bar Association; Nigeria Association of Chambers of Commerce, Industry, Mines and Agriculture; Nigeria Society of Engineers; Civil Society; The Media; June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA Membership cont’d: and g. The Director –General of the Bureau who shall be the Secretary of the Council. Notwithstanding, the provision of Section (2) of the Act, the Council may co-opt any person to attend its meeting but the person so co-opted shall not have a casting vote or be counted towards quorum The Chairman and other members of the Council shall be appointed by the President June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA in Brief Population (2006) 140,431,790 Million Population Growth Rate 3.2 percent per annum Life Expectancy at Birth Male/Female 52.6/53.8 Infant Mortality Rate 69 deaths per 1000 live births Number of Health Centers in Country Primary Health Facilities - 30,098 Secondary Health Facilities -3992 Tertiary Health Facilities - 83 Total Expenditure on Health as % of GDP 3.9 HTM Seminar, Denver, CO, USA

(HTM Seminar) Experience Date of HTM Seminar June 04- 08, 2015 Location of HTM Seminar Mineral F- G Room, Hyatt Regency Hotel, Denver, Colorado, USA Number of Attendees (if recorded or known) 26 Topics of Interest for HTM Seminar 2015 i. Health Technology Management: Return on Investment (ROI) Analysis, HT strategic Planning, Capital Planning ii. Service Delivery Management: iii. Risk Management/Safety iv. The Future of Clinical Engineering : HTM Seminar, Denver, CO, USA

Nigeria Health System Profile Nigeria health system is classified into 3- tiers & referral system Tier 1: [i.e. Primary healthcare service] Tier 2: [i.e. Secondary healthcare service] Tier 3: [i.e. Tertiary healthcare service] June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health System Profile (cont’d) Line of responsibilities: Local Government Areas [Rural Health Centres & Primary Healthcare Centres] ii. State Government [secondary health facilities] iii. Federal Government [tertiary health facilities] June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health Technology Program Key accomplishments Training at Country Level: a. Training Curricula developed for training of Biomedical Equipment Technician (BMETs) for the award of National Diploma [ND] and Higher National Diploma [HND] in Biomedical Engineering Technology b. Two (2) Nigerian Universities are currently offering training in Biomedical Engineering programme leading to the award of Bachelor of Technology (B.Tech.) & Bachelor of Engineering (B.Eng.) c. 1 monotechnic is currently running an accredited 2- year programme leading to the award of National Diploma (ND) certificate in biomedical engineering technology June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health Technology Program Key accomplishments (cont’d) Training at sub-regional level: Development of harmonised training curricula for BMETs and Biomedical Engineers in 15- Member States of ECOWAS region is ongoing courtesy of West African Health Organisation (WAHO) The 15 Member States are Benin Republic, Burkina Faso, Cape Verde, Ivory Coast, The Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Niger Republic, Nigeria, Senegal, Sierra Leone and Togo www.wahooas.org June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health Technology Program Key accomplishments (cont’d) National Health Policy: National Health Equipment Policy for Nigeria, Plan of Action (2004-2007) Guidelines on Medical Equipment Management in Nigeria (August 2005) Guidelines for Equipment Procurement, Supplies and Management in Nigeria (August 2005) June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health Technology Program Key accomplishments (cont’d) Basic Equipment List for Primary, Secondary and Tertiary Healthcare Institutions in Nigeria (August 2005) Draft National Health Equipment Policy for Nigeria, September 2005 June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health Technology Program Key accomplishments (cont’d) FMoH _WHO Collaboration: 12- 13 August, 2013; Review of Country kickoff document on improving access to medical devices through local production and technology transfer- LPTT project [Phase II] 14- 15 July, 2014;Capacity Building Workshop on Local Production and Technology Transfer (LPTT) Project for Medical Devices in Nigeria June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health Technology Program Key accomplishments (cont’d) FMoH_WHO Collaboration: iii. Meeting on review of Essential Equipment List to ensure Neonatal Medical Devices are captured (*UNCoLSC) is ongoing * United Nations Commission on Life Saving Commodities June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health Technology Program Needs for Improvement To step up awareness for PPM Activities in accordance to original equipment manufacturer [OEM] Managed Equipment Service [MES] Outsourcing Public Private Partnership [PPP] June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health Technology Program Needs for Improvement Capacity Building: training and retraining of technical personnel; training of trainers- ToT and staff exchange and so on]. Training for professional users June 7, 2015 HTM Seminar, Denver, CO, USA

Nigeria Health Technology Program Needs for Improvement Infrastructure & services(building, utilities etc.) for the training institutions Appropriate legislation to ensure enforcement Strengthening of institutional framework (HRH) Adequate and appropriately-trained technical healthcare personnel/workforce Develop proper technical documentations system Funding June 7, 2015 HTM Seminar, Denver, CO, USA

Conclusions and Action Plan Development Partners (i.e. WHO, UNICEF etc.) to support Nigeria in review existing documents on Health Technology Management Need to outline a systematic approach to equipment purchasing, deployment, maintenance, repair and disposal WHO to support reviewing of inventory/baseline survey of equipment at country level June 7, 2015 HTM Seminar, Denver, CO, USA

HTM Seminar, Denver, CO, USA I thank you all for listening June 7, 2015 HTM Seminar, Denver, CO, USA