Designing methods and tools to improve the quality of medical equipment projects

A series of tools and methods based on the same quality reference framework

PRECIS: a quality reference framework for projects involving the provision of medical equipment to health institutions in developing countries

The PRECIS quality reference framework was specially developed for projects involving the provision of medical equipment. It is called PRECIS because it is made up of the first letters of the six quality criteria which apply to this type of project:

P for Pertinence
R for Rigour
E for Effectiveness
C for Capacities
I for Impacts
S for Synergy

This reference framework reflects the values that international aid organisations should be committed to throughout their projects. It was specially devised to provide organizations who run medical equipment projects with support at the initial assessment, implementation, monitoring and evaluation phases.

An initial assessment method

This method is aimed at providing practical support in carrying out an initial assessment before running a medical equipment project. It includes both methodological advice and practical files.

It has been devised for international aid organisations who want to get involved in Health sector projects which aim to improve the quality of healthcare in developing countries.

It provides ideas for carrying out a review of the context, resources and the needs of the local health structure which is to be supported, and it encourages the user to think about their own capacity to cooperate. It provides support in terms of the kind of information that should be collected, how this should be analysed and the decision of whether or not to carry out the project.

An evaluation method

The method is aimed at international aid organisations who have carried out medical equipment projects who have decided to carry out an evaluation.

It may also inspire those who have been commissioned to carry out external evaluations in this domain. It includes methodological points and practical files.

It provides advice for collecting and analysing the relevant quantitative and qualitative data in the field and in relation to the organisation which implemented the project, using predefined criteria. It will help the organisation to learn from its experience, consider how to follow up its partnership and improve its capacity to carry out new projects.

Why is there a need for such methods and tools?

The amount of non-functional medical material in health institutions in developing countries raises questions about the responsibility of countries from the North, particularly concerning the effectiveness of aid that they provide as part of medical equipment support projects.

According to figures from the World Health Organisaiton (WHO), only 10% to 30% of the medical supplies donated to developing countries are functional in their new context, while, in some of these countries, 80% of medical supplies come from donations. Indeed, a lot of medical equipment arrives incomplete, without documentation, unserviced, or even already out of order, while other equipment is sent without taking the real needs of the receiving health institutions, the opinions of the local authorities or the environment into account.

It seems that these problems are partly the result of a lack of methodology on the part of international aid organisations when they carry out medical equipment support projects, which are often complex.

The involvement of a large number of partners

This project was devised as part of a programme which is co-funded by the European Union (EuropeAid) and the following French local authorities : Rhône-Alpes Region, Haute-Savoie Department and the town of Houche.

It is also part of the worldwide initiative in favour of health technologies launched by the WHO following resolution WHA60.29 of May 2007 regarding healthcare technologies, and which aims to encourage the elaboration of policies and tools in this field. Lastly, it follows the recommendations concerning donations of medical equipment published by the WHO.

The work group on Medical equipment in international aid projects was involved in the elaboration of these methods and tools, ensuring that it was done in a collective and consensual manner. Coordinated by Humatem since 2003, this work group is made up of international aid organisations, development education bodies and health professionals.