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District level Bio-Medical Equipment Repair Workshop, Himachal Pradesh
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Subject Area="Infrastructure and Equipment." Objective="Maintenance of equipment."
Details for Reform Option "District level Bio-Medical Equipment Repair Workshop, Himachal Pradesh"
Summary

Background: A study conducted by GTZ in 5 districts of Himachal Pradesh revealed that about 75% of the equipment inventory was lying unused because it was 'out of order'. The major cause of lack of repairs was non-availability of trained manpower. Action: Looking for a long-term solution, it was decided to motivate and train the operator and paramedical staff to undertake possible repairs to simple equipment. Three major categories were identified - (i) Equipment that can be repaired by using simple common sense and basic mechanical understanding. (ii) Electrical and electromechanical equipment that can be repaired by personnel trained on electrical appliances. (iii) Electronic and other equipment that required specialised skills. As a pilot study, a batch of 16 volunteer paramedics was trained in a specially-designed programme for simple equipment: stethoscope, sphygmomanometer, suction machines, weighing machine, autoclave and steriliser. After the course they were allowed to do flexible working at their parent hospital and their performance as a Biomedical Equipment Technician (BMET) was analysed. Results: In just one month, about 35% of the ‘out of order’ inventory of these items was made operational. The scheme was found to be quite satisfactory for simple and electromechanical equipment.

Cost Estimated cost: Training one person in “Basic Bio-Medical Equipment Repair” at Centre for Electronics Design and Technology of India (CEDTI), Mohali, Chandigarh, costs INR 3000. Cost of setting up a basic biomedical equipment repair workshop (including tools, furniture and fittings) costs not more than INR100,000.
Place Zonal Hospital, Dharamshala, and district hospitals at Chamba, Una and Bilaspur; since October/ November 2002.
Time Frame Training takes one week and setting up the workshop (fittings and working table, racks, etc.) takes one to two months.
Advantages

In-house: ensures quicker maintenance of basic, frequently-used equipment. Cost and time-effective: in terms of maintenance as well as decreasing the down time of machinery.

Challanges

High workload: In the absence of a dedicated full-time BMET, the workload is very high and the person responsible may not able to cope with the deadline. Increases expectations: of the local authorities and if unfulfilled (ie failure to repair in time) there can be an administrative backlash. Limited: the training only caters to basic and minor problems and there is no alternative to a trained engineer for major problems. Opposition: possible from the person responsible for the workshop if he/she is deployed full-time in maintenance work, as there is an increased workload.

Prerequisites

Budget for purchase of spare parts.

Who needs to be consulted

Chief Medical Officer of the district (for sanctioning budgets), Chief Pharmacist (for procurement), as well as state level authorities for overall sanction and support.

Risks

Sustainability

Is sustainable if finances for spare parts are provided for by district/ hospital authorities. Sustainability increases if the worker is given a monetary incentive to encourage him/her to find extra time for repairs.

Chances of Replication

Replicable in any health institution with a large volume of basic bio-medical equipment; a person who has interest and motivation to undertake repair job; finances available for spare parts and vendors for spare parts available nearby. In a similar initiative, at Aravind Eye Hospital, Madurai a department was created to do preventive maintenance of medical equipment and instruments of the hospital. This was done by training paramedical staff on preventive maintenance and providing them with the basic tools necessary. (For further information, see link to training of paramedics at Aravind Eye Hospital)

Comments

Totally dependent on the motivation and interest of staff involved in maintenance, support by his superiors in terms of periodically freeing him from regular duties and by providing some incentives.

Contact

Submitted By

Gautam Chakraborty, Health Economist, BHPHP. June 2004.

Status Active
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