Equipment Incorporation: Selection, Procurement, and Donations – The Uganda Experience

Paper presented at the First Global Forum on Medical Devices

byEng. Sam S.B. Wanda

Assistant Commissioner Health Services (Infrastructure)

Ministry of Health, UGANDA.9th – 11th September 2010

Bangkok, THAILAND

Location of Uganda in Africa

� Uganda is a land locked country in East Africa bounded to the East by Kenya, to the North by Sudan, to the West by the Democratic Republic Congo and to the South by Tanzania & Rwanda.

� It straddles the Equator and lies between;

� 40 N and 1.50 S Latitude, and

� 280E and 350E Longitude

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Location of Uganda in East Africa

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Introduction

� Factors that influence Selection and Procurement of

Medical Devices are the :-

� a) National Health System and services offered by level of health care

� b) Relevant Policies, and

� c) Procurement Procedures

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The Uganda National Health System

Levels of Health Care

• Ministry of Health

� National Referral Hospitals

� Regional Referral Hospitals

• District Health Services

� General Hospitals

� Health Centre IV

� Health Centre III

� Health Centre II

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The Uganda National Health System – cont’d

� HC II offers only ambulatory services, except in strategic locations (e.g. poor access to HC III or HCIV) where as an interim strategy, maternity services are provided with an enrolled nurse as the key personnel.

� HC III offers continuous basic preventive, promotive and curative care and provides

support supervision of HC IIs facilities under its jurisdiction. There are provisions for laboratory services for diagnosis, maternity care and first referral cover for the sub-county.

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The Uganda National Health System – cont’d 2

� HC IV and General Hospitals offer basic preventive, curative and rehabilitative care in their immediate

catchments and provide a second level referral services for the Health Sub District (HSD) including life-saving medical, surgical and obstetrical emergency care such as blood transfusion, caesarean section, and other medical and surgical emergency interventions

� Regional Referral Hospitals in addition to the services offered at the general hospital, offer specialist services such as psychiatry; ear, nose and throat (ENT); radiology; pathology; ophthalmology; higher level surgical and medical services, including teaching and research.

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The Uganda National Health System – cont’d3

� National Referral Hospitals in addition to the services offered at the regional referral hospital, provide comprehensive specialist services and are involved in teaching and health research.

� The services described above by level of health care determine the selection of Medical Devices by specification and quantity as given in the Medical Equipment Policy (1991), as revised in April 2009.

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Procurement of Medical Devices

� First, determine the needs at each facility by carrying out a detailed Inventory

� Then, specify the required devices (list & specifications in Volume 2 of the Policy above)

� Prepare Tender Documents for the procurement following the Public Procurement and Disposal of Public Assets [PPDA] Act & Regulations thereto unless there is agreement to the contrary with another Country or International Organisation

� Finally, Install, Commission, Train Users & Maintenance Technicians and {in the recent past} provide at least 5 years maintenance by Supplier

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Guidelines on Donations of Medical Equipment

� In Uganda, a significant proportion of equipment is acquired through donations from various agencies.

� The following guidelines are to be followed by all those donating medical equipment and those responsible for accepting donated equipment:-

� All equipment to be donated should be based on stated needs of the country and should be relevant to the health services provided in Uganda

� Donations intended for use in the health sector should be shipped with the prior consent of the Ministry of Health and the intended recipients.

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Guidelines on Donations of Medical Equipment – cont’d

� All donated equipment should be obtained from reliable sources and comply with quality standards of both the donor country and Uganda with two years guarantee and be on the standard list for the particular health care level.

� For electrical equipment, the electrical needs of the equipment should be determined prior to shipping. Only equipment that use 240V/50Hz should be accepted.

� All donated equipment should have a useful life of at least two years.

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Guidelines on Donations of Medical Equipment – cont’d 2

� Donated equipment should be packed as per international shipping regulations and have a detailed packing list specifying the contents of each numbered carton by quantity, serial number, weight and any special storage conditions, and

� Cost of international and local transport, warehousing, port clearance, appropriate storage and handling [including inspection by NDA] should be paid for by the donor agency, unless specifically agreed otherwise with the Ministry of Health or the recipient in advance.

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Conclusion

� The selection of type, specification and quantum of Medical device is determined by the level of health care.

� ALL procurements are according to the PPDA Act, 2003.

� Donation guidelines are in place though a some equipment still slips through that does not meet the stated requirements.

� The National Drug Authority {NDA} as Regulatorof Medical Devices acquisition needs to develop capacity for the assignment.

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THANK YOU

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FOR GOD AND MY COUNTRY