procurement of medical devices in countries: a protocol for a systematic review – pubrica
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Medical devices and equipment are important for providing high-quality health care. In low- and middle-income nations, reports and studies point to a shortage of basic medical devices and medical equipment that has fallen out of use. Continue Reading: https://bit.ly/3yKs2Uu For our services: https://pubrica.com/sevices/research-services/ Why Pubrica: When you order our services, We promise you the following – Plagiarism free | always on Time | 24*7 customer support | Written to international Standard | Unlimited Revisions support | Medical writing Expert | Publication Support | Biostatistical experts | High-quality Subject Matter Experts. Contact us: Web: https://pubrica.com/ Blog: https://pubrica.com/academy/ Email: [email protected] WhatsApp : +91 9884350006 United Kingdom: +44-1618186353TRANSCRIPT
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Copyright © 2021 pubrica. All rights reserved 1
Procurement Of Medical Devices In Low-
And Middle-Income Countries: A Protocol
For A Systematic Review
Dr. Nancy Agnes, Head, Technical Operations, Pubrica, [email protected]
In brief
Low- and middle-income countries (LMICs)
medical device procurement processes are poorly
understood and researched. International public
health organisations and research agencies
publish a wide body of mostly grey literature,
including guidelines, manuals, and
recommendations, to aid LMIC policy
formulation in this area. This part of conducting
a systematic analysis to classify and investigate
the medical device procurement methodologies
proposed and other literature (1)
. The facilitators
and obstacles to procurement will be established,
and methodologies for prioritising medical devices
under resource constraints will be discussed.
I. INTRODUCTION
Medical devices and equipment are important for
providing high-quality health care. In low- and
middle-income nations, reports and studies point to
a shortage of basic medical devices and medical
equipment that has fallen out of use. It has a
significant impact on healthcare delivery and also
results in a loss of staff and funds. There are two
potential causes for this issue, according to the
WHO's Priority Medical Devices project. First,
medical device manufacturers seek out economies
in high-income countries because of the higher
profit margins. As a result, medical device supply
and equipment design are limited to products and
requirements appropriate for implementation in
environments with specialised facilities and
technologically skilled human resources. Second,
low- and middle-income countries face judicious
medical device procurement (LMICs) (2)
.
Table: 1 Procurement of medical devices at
national level concerning country income
classification
Country
classification
Does procurement of medical
devices occur at the national level?
Yes NO
Low income 25 8
Low-middle
income 31 7
Upper-middle
income 30 17
High income 17 27
Total 103 59
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II. SEARCH STRATEGY
Early scoping searches on medical device
procurement strategies for LMICs turned up much
grey literature from foreign public health agencies,
think tanks, and other organisations, but few
journal articles or research studies. As a result, it
was critical to creating search and selection
strategies that were as broad and inclusive as
possible, with no time or language limitations.
However, the collection of data documents to be
included will be limited to publicly accessible
digitised content, partly due to resource limitations
and partly because we believe this best reflects the
different materials that LMICs will have access to.
A filled list of sources to be searched is provided in
the Table.
III. DATA COLLECTION
One reviewer (KD or MB) extracted data from all
included documents based on a pre-determined list
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Copyright © 2021 pubrica. All rights reserved 3
of questions. Normative or descriptive accounts of
MDE procurement and technology management
processes; the relevance of health technology
assessment exercises and health needs assessments
in procurement; the input of health care
professionals or specialist staff (e.g. biomedical
engineers, economists) in procurement decisions;
device installation, maintenance, and
decommissioning procedures. Now looked for clear
accounts of MDE prioritisation processes in the
documentation and extracted quotes or process
details for qualitative review (3)
.
IV. ANALYSIS
To summarise and analyse the data collected, two
methods of analysis were used. For issues related to
the research questions raised, narrative synthesis
provided a summative and descriptive report of all
included documents. For a subset of documents
detailing concrete prioritisation methods/processes,
a qualitative meta-summary was used to investigate
MDE prioritisation.
V. PROCUREMENT AND RELEVANT
STAKEHOLDERS
Individual health facilities also participate in the
direct acquisition. Not all medical device
procurement decisions are taken at the regional,
country, or supra-national level. The authors of the
documents reviewed caution that such procedures
are not uniform across LMICs: hospitals also lack
dedicated resources for MDE procurement and rely
on donations, reuse, and recycling to meet technical
needs.
The literature search help is largely vague on how
stakeholder views are aggregated or divergent
opinions treated, with only three documents
containing examples of such accounts. The value of
multi-criteria decision-making approaches for
aggregating and integrating individual decision-
makers perspectives. Decision-makers involved in
the procurement of MDEs and clinical or financial
administration personnel use this approach to rate
technologies based on a specific and well-defined
set of parameters, such as patient population
benefit. After that, the highest-scoring inventions
are purchased (4)
. However, such mechanisms can
be inherently biased: decision-makers experiences
may not represent the best available evidence
globally.
VI. LIMITATIONS
Distinguish that the current project has several
limitations. To begin, recognise the challenge of
conducting a first-line analysis on a subject with
methodologically diverse literature. Second, we do
not attempt to find or include national policy
documents on medical devices in this review.
VII. FUTURE SCOPE
Furthermore, the scope of the analysis may be
restricted, as it is not intended to define and include
prioritisation methodologies for whole intervention
packages rather than individual devices or
equipment. To ensure that relevant methodologies
are not overlooked, reviewers will consult
international health experts to recognise any
relevant methodologies and discuss the current
review's results in light of them (5)
.
VIII. CONCLUSION
It's unclear how LMICs go about procuring and
prioritising medical devices. Internationally
proposed guidelines, recommendations, or reports
are regularly provided to advise LMICs on this
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subject, whether produced by public health
agencies or clinical research organisations. They
may affect their national policy formulation. This
systematic review aims to describe these
methodologies, investigate the factors that have
been identified to influence procurement practises
in LMICs, and develop a preliminary framework
for how medical device prioritisation and
procurement can be planned and conceived in
resource-constrained settings. The results of this
systematic review help will formulate initial
hypotheses about what factors and stakeholders
influence these processes and a quality assurance
structure capable of providing LMIC decision-
makers with a well-rounded understanding of the
topic(6)
.
REFERENCES
1. Anderson, Darcy M., et al. "Safe healthcare
facilities: a systematic review on the costs of
establishing and maintaining environmental
health in facilities in low-and middle-income
countries." International Journal of
Environmental Research and Public
Health 18.2 (2021): 817.
2. Torloni, Maria Regina, et al. "Quality of
medicines for life-threatening pregnancy
complications in low-and middle-income
countries: A systematic review." PloS one 15.7
(2020): e0236060.
3. Singh, Neha S., et al. "A realist review to
assess for whom, under what conditions and
how pay for performance programmes work in
low-and middle-income countries." Social
Science & Medicine (2020): 113624.
4. Roberson, Jeffrey L., et al. "Lessons Learned
From Implementation and Management of Skin
Allograft Banking Programs in Low-and
Middle-Income Countries: A Systematic
Review." Journal of Burn Care &
Research 41.6 (2020): 1271-1278.
5. Gravitt, Patti E., et al. "Achieving equity in
cervical cancer screening in low-and middle-
income countries (LMICs): Strengthening
health systems using a systems thinking
approach." Preventive medicine 144 (2021):
106322.
6. Ryan, Nessa, et al. "Implementation outcomes
of policy and programme innovations to
prevent obstetric haemorrhage in low-and
middle-income countries: a systematic
review." Health Policy and Planning 35.9
(2020): 1208-1227.