دانلود رایگان مقاله انگلیسی علل ریشه ای مدیریت تکنولوژی مراقبت بهداشتی ناکارآمد در بهداشت عمومی - الزویر 2017

Abstract

This study aims to identify the root causes and solutions of main problems facing Healthcare Technology Management in Benin’s public health sector. Conducted in Benin from 2008 to 2010, two surveys were used with key actors in Healthcare Technology Management. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at selected health facilities The findings of the two surveys show that the problems are based on both high- and low-level corruption, characterized by self-interest and unwillingness of the policy makers to solve healthcare care equipment and maintenance problems. Appropriate solutions include: (i) development of policy and management tools to guide distribution, (ii) the use of reference price lists for procuring equipment, (iii) development of policy and management tools to guide financial resource allocation on the life cycle cost of the equipment, (iv) creation of a healthcare equipment and maintenance directorate, (v) development of policy and management tools for obsolete equipment, and (iv) the development of a new healthcare technology management policy with a budgeted action plan. We suggest that much can be improved by the strict development and implementation of policy and management tools, as well as regulations at each level of the Healthcare Technology Management process. A key role has to be attributed to the technical specialists, and the end users of equipment in healthcare facilities. Furthermore, there is a need for capacity building in Healthcare Technology Management institutions.

5. Conclusion

This study addressed the root causes of problems facing healthcare technology management in Benin’s public health sector and the possible solutions to satisfy STEEEP criteria.

Root cause analysis was used to investigate the problems and ascertain the chain of causal relationships. From the analysis and discussion of the findings, it was found that the deepest root causes of problems related to culturally-embedded practices of high- and low-level corruption i.e. self-interest and the unwillingness of policy makers to solve maintenance, and related, problems. Feasible solutions for policy interventions looked at causes and problems at the intermediate level of the causal chain.

Appropriate solutions, in order of decreasing priority, are: (i) the development and implementation of policy and management tools to guide distribution, (ii) the use of reference price lists, (iii) the development amd implementation of policy and management tools to guide financial resource allocation for the life-cycle costs of equipment, (iv) the creation of a healthcare equipment and maintenance directorate at the Ministry of Health, (v) the implementation of the available maintenance policy, and (vi) policy and management tools for obsolete equipment. Many improvements can be made by ensuring the strict implementation of policy and management tools, as well as regulations, at each level of the healthcare technology management cycle. A key role has to be attributed to the technical specialists, e.g., the biomedical, clinical and healthcare technology engineers and technicians, and the end users of equipment in healthcare facilities. These changes, however, do not require vast financial resources to be successful, but only several coordinated slight redirections in the current behavior of the stakeholders towards an increased level of concern for the well-being of the country, supported by the proposed set of policy instruments that affect multiple levels. Furthermore, there is a need for strengthening capacity in healthcare technology management institutions. This change could be supported and facilitated by hospital managers and directors and international organization representatives, i.e. Benin’s health development partners.