Towards an Integrated Curriculum for Engineering in support of Universal Health-related Coverage.pdf

Breaking down silos in Clinical Engineering and Health Technology Management capacity building and practice in addressing 'glocal' health technology challenges

1. Towards an Integrated Curriculum for Engineering in
support of Universal Health-related Coverage
MLADEN POLUTA
Member, GCEA Founders’ Council
Affiliations: Universities of Cape Town Stellenbosch & Pretoria
Southern Right HTM Consulting
1

2. Towards an Integrated Curriculum for Engineering in
support of Universal Health-related Coverage
MLADEN POLUTA
Member, GCEA Founders’ Council
Affiliations: Universities of Cape Town Stellenbosch & Pretoria
Southern Right HTM Consulting
2

3. ESSENTIAL PRIMARY HEALTH CARE
ALMA ATA DECLARATION (ARTICLE VII)
PHC includes at least:
▪health promotion;
▪prevention and control of locally endemic disease;
▪promotion of food supply andadequate nutrition;
▪safe water andbasic sanitation;
▪maternal & child healthcare, incl. family planning;
▪immunisation;
▪appropriate treatment of common diseases & injuries, and
▪provision of essential drugs.
(WHO, UNICEF 1978)
“Upstream”
interventions

4. 4

5. HEALTH (WELLNESS) SYSTEM PERFORMANCE
•Coverage: probability of receiving an effective health-related
intervention when needed
•Effective coverage: ratio of actual health gain from health-related
interventions to maximum potential health gain achievable from
the same interventions.
Elements:
▪access (availability, accessibility, affordability and acceptability)
▪utilisation
▪effectiveness
WHR 2000 (WHO): Measuring
Health Systems Performance

7. Panerai & Mohr, 1989
Use/adapt HTA tools:
Sequential allocation of HTM-
related interventions P
I
C
O

8. Minimum package of health-related services in LMICs
Multisectoral package of interventions

9. World Bank
‘Upstream’
sectors &
factors

10. People's Health Environmental Health
Community Focus
Individual Focus
Protection
Clinical
Clinical
Procedures
Prevention
Promotion
Supporting
Pharmaceuticals
& Other Consumable
Products
Facilities,Plant, Hospital
Equipment, Emergency
Vehicles
Medical
Equipment/
Devices ICT
Organization &
Management
Systems
Sanitation,
Roads
Housing
Water, electricity,
education/schools
…towards Community Wellness
integratedAssessment, Innovation & Management of
Health-related Infrastructure and Technology i-AIM-HIT
eH, mH, Community-/
home-based care
Reductions in toxic waste dumping, other
forms of pollution
Sustaining
Nutrition/food,
behaviour ….
PUBLIC HEALTH
TECHNOLOGIES

11. 11
Time (years)
Asset Condition
Very
Good
Good
Fair
Poor
Very
Poor
5 15 20 25 30 35100 40
No Maintenance
Condition Based Maintenance

12. 12/09/2023 12
Engineering Asset Management
HTM / CE = Applied EAM!
BSI:PAS 55 Asset
Management
ISO 55000 Series on Asset Management
▪CE = Medical Equipment Management & Maintenance (widely held)
▪CE = HTM (AAMI, 2011)

13. Healthcare EngineeringHealth Professions
Biomedical Engineering
Research
Clinical Engineering
MEM&M
Medical Device Eng.
Innovation
Hospital Engineering
HFM&M
Health Care EngineeringNon-Medical Professions
HTM Structures & Processes
*
* Medical Physicists, Clinical Technologists/Technicians, Radiographers, etc.
A Clinical engineeris "a professional who supports and advances patient care by
applying engineering and managerial skills to healthcare technology”. [ ACCE ]
BESSA CEASA SAFHE

14. How does CE relate to BME?
12/09/2023 14
▪Part/subset of BME (academia, ILO, WHO, IFMBE, BMES)
▪Not part of BME (other academia)
▪CE and BME are interchangeable terms (many countries)
V Alagumalai P Kadambi A Appaji
Interdisciplinarity in New Product Development in an Indian
MedTech Perspective: Gap and the Solution. Health and
Technology https://doi.org/10.1007/s12553-019-00344-1
Published online 11 July 2019
▪CE = Medical Equipment Management & Maintenance (widely held)
▪CE = HTM (AAMI, 2011)

15. IFMBE-CED 2017 Worldwide
Clinical Engineering Survey

16. Lack of training especially in specific
skills needed (e.g., PSA plants)
Limited number of biomedical
engineers and technicians in health
facilities
High number of health sector drop-outs
by biomedical engineers and
technicians
Lack of mentorship and coaching for
biomedical engineers and technicians
Many more COVID-19-
funded medical devices and
equipment arriving in
health facilities adding to
the problem
Large number of idle,
broken and
underperforming medical
devices in heath facilities
Limited medical device maintenance
contracts, especially preventive

17. *Case study for Rwanda (very applicable to other contexts)
For more details, insights and collaboration,
Please contact us:
[email protected]

18. Persistent Challenges / ‘ unfinished business’ requiring
concerted global action
The Global Action Plan on Management, Maintenance and Repair of Health Care
Equipment, launched by the WHO in 1987, identified four major obstacles
confronting developing countries:
•Lack of Organisational Policy: At present inadequate awareness of the magnitude of the
problem and limited expertise prevent the necessary policy, planning, funding and
identification of all the necessary components that constitute the essential inputs of the
problem.
•Ineffective Health Care Technical Service: Its infrastructure, organisational capability,
expertise, incentives, training, funding and collaboration with other health sector services
are lacking to such a degree so as to render it ineffective and inefficient.
•‘Manpower’ Development and Training: Lack of career structures, staff development and
appropriate training within ministries of health inhibit human resources from fulfilling their
mission.
•Lack of Information Support: Insufficient technical information exchange within the health
sector and from external inputs concerning particularly equipment specifications, tenders,
spare parts, manufacturers, technical manuals and data sheets hinder the updating of
technical know how and implementation of appropriate action.

21. ‘Back to Basics’ (Engineering BoK/BoP)

22. Graduate Attribute Profiles
Engineers Engineering Technologists Engineering Technicians

23. Competency Pyramid
Values
Behaviour
Knowledge
Skills
Demonstrated
ABILITY
ASSESSED

24. What is CPD?
•“… intentional maintenance and development of knowledge and
skills needed to perform in a professional context.”
•“ … honing current skills, developing them to a new level, or
learning new ones that will allow an employee’s job role to
expand or prepare them for potential promotion.”
https://www.cpdstandards.com/what-is-cpd/
3 types:
•Informal learning: includes on-the-job training, mentoring &
coaching from colleagues, as well as attending conferences and
networking.
•Formal learning: takes place in a more structured environment such
as attending courses, online learning workshops or lectures.
•Non-formal learning: includes reflective learning such as reading
industry publications or participating in online discussion forums.

25. African Development Bank
EAC Centres of Excellence in Biomedical Sciences
1. TANZANIA: EAST AFRICA HEART INSTITUTE
2. UGANDA: EAST AFRICA CANCER INSTITUTE
3. RWANDA: CENTRE OF EXCELLENCE IN BIOMEDICAL ENGINEERING
4. KENYA: EAST AFRICA KIDNEY INSTITUTE
5. Burundi: Nutrition
7/24/2017 United for Knowledge and Prosperity
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26. .
Thank you
[email protected]