40-70% of medical devices and equipment in low- and middle-income countries (LMICs) are broken, unused or unfit for purpose: ad-hoc, undiscerning and inefficient procurement methods and processes contribute towards this problem. This thesis presents the findings of four original studies on medical device and equipment procurement within LMICs. Chapter I reports findings of a systematic literature review on procurement and prioritization methods; recommendations from reviewed literature are synthesised. Chapter II describes fieldwork conducted in The Gambia and Romania to explore the processes and dynamics behind medical device procurement in contrasting settings. Findings suggest procurement processes are strongly influenced by political/cultural power dynamics; health technology assessment evidence is rarely considered. Chapter III discusses the feasibility of conducting medical device specific economic evaluations for informing procurement planning. A case study on the costeffectiveness of alternative treatment interventions for femur-shaft fracture fixation in Sub-Saharan Africa is presented. Chapter IV consists of a critical appraisal of the medical device specific elements of the One Health Tool for health system planning. The thesis concludes with a discussion contextualizing the findings and suggestions for further research.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:699126 |
| Date | January 2016 |
| Creators | Diaconu, Karin-Daniela |
| Publisher | University of Birmingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://etheses.bham.ac.uk//id/eprint/7063/ |
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