Sustainable procurement of medical devices in an international context - Part 2
Authors: Di Virgilio Valerio , Bouchard Saindon Alexia , Becerra Posada Francisco 
Published: December 2023

Background and Objectives: This article describes how sustainable procurement of medical devices (MDs) can be implemented in operational projects in developing countries. It also further details how sustainability principles and the needs assessment can be applied by the biomedical/clinical engineer lead (BCEL) responsible for the technical and quality aspects of the procurement process of MDs. It also emphasizes the importance of the BCEL considering the country’s or region’s specific healthcare context when working on MD procurement projects in developing countries.Material and Methods: This article describes how sustainable procurement of medical devices (MDs) can be implemented in operational projects in developing countries. It also further details how sustainability principles and the needs assessment can be applied by the biomedical/clinical engineer lead (BCEL) responsible for the technical and quality aspects of the procurement process of MDs. It also emphasizes the importance of the BCEL considering the country’s or region’s specific healthcare context when working on MD procurement projects in developing countries.Results: The BCEL has a key role in the sustainable procurement of MDs as an integrator able to understand clinical needs and translate them into requirements while being aware of the sustainability and safety risks linked to technology implemented in the fragile environment of a developing country with limited resources. This context also creates additional challenges that can be managed if the BCEL is conscious of the country’s health expenditure, geopolitical, healthcare, model of care, regulatory, infrastructure, and logistical conditions in which the MDs will be installed. Many equipment may remain unused if the technology implementation is not in line with the needs of the beneficiaries. Therefore, a thorough needs assessment performed by the BCEL to obtain the detailed list of MDs, their technological level and estimated budget is of utmost importance to increase the project’s sustainability and mitigate the risk of unused MDs.Conclusion: Besides traditional disciplines in biomedical and clinical engineering, the BCEL shall also learn at least basic principles in public health, healthcare planning, project management, health infrastructure, and development aid to facilitate the dialogue with stakeholders based on knowledge, flexibility, and capacity to anticipate and solve practical issues on the ground. To this extent, it is advisable for a BCEL new to the environment of developing countries to have progressive exposure to more complex projects and to extensively use the peer review mechanism to assure sustainability and quality during project implementation. A theoretical background based on sustainable procurement principles, analysis of the local and national health context and regulations, and knowledge of lessons learned from past projects should guide the BCEL’s approach to performing the needs assessment while implementing a new project.