Clinicians in low and middle-income countries (LMIC) face many challenges, including high patient-to-staff ratios, limited resources, and inconsistent access to electricity. This research aimed to improve health outcomes in LMIC through an enlightened understanding of challenges associated with healthcare technology. To understand LMIC barriers to acquiring, maintaining, and repairing medical equipment, a community-based participatory study was conducted at three clinical settings in southern Malawi. Thirty-six clinical staff participated in surveys and focus groups to provide information on medical device challenges. Results from the study emphasize the importance of community-based participatory innovation to improve global health. Many clinical staff expressed frustration regarding inability to prevent patient mortality attributed to equipment failure. Data from the community-based participatory study of medical technology conducted in Malawi revealed key insights for designing for low and middle income countries, and more specifically, for communities in southern Malawi. Specifically, partner communities identified mechanical suction machines as a top priority for design innovation. Working with technical and clinical staff in Malawian communities, a prototype mechanical suction machine was designed and constructed. This work suggests that engineers working in low and middle income countries face a unique sundry of design requirements that require an intimate understanding of the local community, including community leaders, community beliefs and values, and locally available resources. Technology innovation for global health should incorporate community expertise and assets, and health and technical education efforts should be developed to increase working knowledge of medical devices. / Master of Science / Clinicians in low and middle-income countries (LMIC) face many challenges, including high patient-to-staff ratios, limited resources, and inconsistent access to electricity. This research aimed to improve health outcomes in LMIC through an enlightened understanding of challenges associated with healthcare technology. To understand LMIC barriers to acquiring, maintaining, and repairing medical equipment, a community-based participatory study was conducted at three clinical settings in southern Malawi. Thirty-six clinical staff participated in surveys and focus groups to provide information on medical device challenges. Results from the study emphasize the importance of community-based participatory innovation to improve global health. Many clinical staff expressed frustration regarding inability to prevent patient mortality attributed to equipment failure. Data from the community-based participatory study of medical technology conducted in Malawi revealed key insights for designing for low and middle income countries, and more specifically, for communities in southern Malawi. Specifically, partner communities identified mechanical suction machines as a top priority for design innovation. Working with technical and clinical staff in Malawian communities, a prototype mechanical suction machine was designed and constructed. This work suggests that engineers working in low and middle income countries face a unique sundry of design requirements that require an intimate understanding of the local community, including community leaders, community beliefs and values, and locally available resources. Technology innovation for global health should incorporate community expertise and assets, and health and technical education efforts should be developed to increase working knowledge of medical devices.