1. RADIATION PROTECTION IN HEALTH FACILITIES
2018-SARPA CONFERENCE/AGM
Misty Hills
S BAKHANE
Director: Health Technology Policy
National Department of Health
21 AUGUST 2018

2. VISION AND MISSION FOR HT
9/5/2019
Vision
Appropriate, safe and cost effective health technology available at the point of need.
Mission
To position HT as a key enabler of quality and affordable health service delivery by:
creating a national health technology system;
facilitating safe and appropriate utilization of health technology ;
promoting the optimal distribution of the limited HT resources to facilitate equity in access.

3. Quality Sustainability Efficiency Access & equity
Adverse event
monitoring
Licensing,
testing
Appropriateness
Affordability
Safety
Availability at a
point of need
Adequacy
Risk
Management
Performance
of HT
Sustainability
PPP
HTA
Appropriateness
Affordability
CMMS
Cost Of
ownership
Self
Sufficiency
Local
Industry
Strategic
Sourcing
Reduction
R&D
Efficiency
Maintenance
Reduce
Downtime
Improving HT
Extended
Lifetime
HTA
Efficient
Use HT
Availability
Gaps
Analysis HT
availability
Access
&
equity
audits
distribution
Essential
Equipment
Lists
Appropriate

4. CURRENT CHALLENGES
9/5/2019
The following challenges were identified as outlined in National HT Strategy:
A fragmented approach to planning and procurement of Medical Equipment and/or lack of systematic replacement strategy
Inconsistencies in prices between private and public sector and between provinces for health technology items
The rapid rate of technological influx and lack of a scientific mechanism to decide on appropriate technologies(HTA).
Mismatch between the need and available technologies
Poor maintenance practices /Quality Assurance with a high percentage of equipment that is not fully functional and high levels of maintenance backlogs coupled with low user training levels.
Also - lesser control and monitoring capability, not realizing benefits from leveraging on economies of scale, poor inventory management.

5. RADIOLOGICAL EQUIPMENT/TECHNOLOGIES
9/5/2019
The use of ionizing radiation in medicine is well established, and has resulted in tremendous benefit to humankind in diagnosing and treating diseases.
While the medical benefits are unquestionable, there has been growing evidence of unintended and unnecessary use of radiation in medicine, creating the need for radiation protection principles. Radiation Protection in Medicine Conference(IAEA) 2017.This was a follow up conference to “Bonn call for action”
The aims of the “Bonn Call for Action” conference of 2012 are:
(a) to strengthen the radiation protection of patients and health workers overall;
(b) to attain the highest benefit with the least possible risk to all patients by the appropriate use of ionizing radiation medicine;
(c) to aid the full integration of radiation protection into
health care systems;
(d) to help improve the benefit–risk dialogue with patients
and the public; and
(e) to enhance the safety of technical operations in medicine.

6. RADIOLOGICAL EQUIPMENT/TECHNOLOGIES...
9/5/2019
Radiological Equipment: One of the Key Priorities in the NHI White paper, the recently developed National Cancer Plan and Joint work with National Treasury(OCPO).
Radiology: X-rays, CT, Mammography, Dental
Biggest use within our Health care institutions
Quality assurance critical(SANAS Accredited service providers)
Infrastructure: Shielding critical,
Equipment: PPE, Dosimeters
Key professionals: Radiologists, Radiographers & medical Physicists
Interventional Radiology: Fluoroscopy, Cathlabs
Cardiologists, Radiologists, Nurses & other Medical specialists
Infrastructure& Equipment: Theatre, PPE, Dosimeter
Nuclear Medicine: PET/SPECT
NM Physician, NM radiographers, Medical Physicists, Radiation protection Specialist, Nursing

7. RADIOLOGICAL EQUIPMENT/TECHNOLOGIES...
9/5/2019
Combination Technologies: PET/ CT/MRI
Use within Regional/Private Health care institutions
Quality assurance critical(SANAS Accredited service providers)
Infrastructure: Shielding critical
NM Physicians, NM radiographers, Medical Physicists, Radiation protection Specialists, Nursing, Diagnostic Radiographers
External Beam Radiation Therapy: Linear accelerators, Cobalt Units
Quality assurance critical(Regulatory compliance)
Radiation Oncologists, Radiotherapists, Radiobiologists, Other Medical Specialists, Radiation protection Specialist, Nursing, Diagnostic Radiographers

8. RADIOLOGICAL EQUIPMENT/TECHNOLOGIES...
9/5/2019
Particle therapy: Neutron /Proton
Infrastructure,
Equipment: PPE, Dosimeters
Isotope Therapies: gamma/Beta source
NM Specialists, Radiation Oncologists, Urologist &other specialists, Medical Physicists, Radiobiologists
Infrastructure: Patient isolation Rooms,
Equipment: PPE , dosimeters

9. SUMMARY OF CHALLENGES RECOMMENDATIONS
9/5/2019
Critical shortage of RP staff at Medical Centers
Creation of RP posts at Institutions/Strategic Partnerships
Training Needs(Continuing Education etc)(Competency)
Academic Institution, PPP
Shortage of Appropriate Equipment
Need for standardized Specification(appropriateness, quality)
Lack of skill on Quality Assurance/Management
Train personnel on QA and improve budgets for service
Improve regulatory Enforcements
Obsolete equipment
Put in place proper replacement plan and improve budgets
Frequent confusion on Disposal of Radiological waste

10. 9/5/2019
THANK YOU