Sustainable Procurement of Medical Devices in an International Context: Part 1 Part 1 - background and definitions
Main Article Content
Keywords
Medical device procurement, sustainable procurement, needs assessment, health services in developing countries, quality assurance, sustainability
Abstract
Background and Objectives
Sustainability is a working principle included in the United Nations (UN) procurement processes with the adoption of the Sustainable Development Goals (SDGs) in 2015. In the context of internationally funded projects in developing countries for procuring health-related goods during and following the COVID-19 pandemic, this article further investigates what sustainable procurement means when applied to purchasing medical devices (MDs), considering its impact on health services. It also proposes a reflection on the concepts of sustainability and quality assurance as guiding principles for technical teams during the process of MD procurement.
Material and Methods
This article aims to identify how sustainability can be implemented during the execution of a project based on the analysis of principles that guide procurement actions in the four UN agencies with the highest volume of MD procurement. The concept of sustainability is also explored from a macrosystemic point of view as the ratio between the impact of a procurement project on healthcare services and its investment. Its implications for population health and wealth is also discussed. Based on the experience of the authors in implementing purchasing processes of MDs, a framework for the specific technical activity is then proposed.
Results
In the UN system, sustainable procurement focuses on the social, economic, and environmental quality of the equipment and on the conditions of its production to guarantee that a sustainable good is procured. Not being enough, the focus should also be on the benefit of a procurement project, not as the possession of a new MD, but as the utility of the device: an instrument to provide healthcare services of the beneficiary country. Procuring sustainable goods should include planning their future use as an essential component for a sustainable positive impact on the health and wealth of the beneficiary population. Thus, the intended use of the procured devices should be defined, planned, and measured. In the proposed framework, sustainability is a ratio between an MD’s social, economic, and environmental costs and the benefits of its use. When neglecting the essential factor of sustainable use of MDs, the risk of purchasing equipment that will not be properly and efficiently used is relevant. To guarantee the sustainable use of a MD, it is essential to assess the needs, the local conditions, and the conditions for its lifelong use. Further evolution of the concept of sustainability is developed towards the possibility of modulating the project’s objective from procuring sustainable MDs to improving the sustainability of the health services by procuring MDs.
Conclusion
Sustainable procurement of MDs is a key factor in supporting the sustainable development of health services and health systems toward the SDGs. Post-pandemic investments to strengthen the resilience of health services in developing countries shall consider sustainable procurement, including the essential quality assurance process. This process, led by an expert clinical engineer, shall be centered on the future use of the equipment and not be limited to its quality as a material good.
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References
2. Rasanathan K, Diaz T. Research on health equity in the SDG era: the urgent need for greater focus on implementation. Int J Equity Health. 2016 Dec 9;15(1):202. Available at: https://pubmed.ncbi.nlm.nih.gov/27938374/.
3. DiPrete Brown L, Miller Franco L, Rafeh N et al. Quality Assurance of Health Care In Developing Countries. Quality Assurance Methodology Refinement Series.1-33. Available at: https://pdf.usaid.gov/pdf_docs/pnabq044.pdf.
4. Russell S, Ability to pay for health care: concepts and evidence, Health Policy and Planning 1996; 11(3); 219–237. Available at: https://doi.org/10.1093/heapol/11.3.219.
5. One Planet Network. Sustainable Health in Procurement Project Annual Report 2020 is here. Kumwenda R (Dr), Wilburn S.; 2021 May 18. Available at: https://www.oneplanetnetwork.org/news-and-events/news/sustainable-health-procurement-project-annual-report-2020-here.
6. UNDP. Sustainable procurement: United Nations Development Programme. UNDP. Retrieved April 8, 2023. Available at: https://www.undp.org/procurement/sustainable-procurement.
7. Peña Hernandez A, L, Rosenström E, Can addressing asymmetrical information gaps be an approach towards sustainable public procurement. Blekinge Institute of Technology. 2017. Available at: https://www.diva-portal.org/smash/get/diva2:1115465/FULLTEXT02.
8. Project management. The Triple Constraint in Project Management: Time, Scope & Cost. Jason Westland; 2022 Jan 17. Available at: https://www.projectmanager.com/blog/triple-constraint-project-management-time-scope-cost.
9. Bloom D E, Canning D,The Health and Wealth of Nations. Science 287. 2000. 1207-1209. Available at:https://www.science.org/doi/abs/10.1126/science.287.5456.1207.
10. United Nations. Goal 3 | Department of Economic and Social Affairs. United Nations. Retrieved April 8, 2023, Available at: https://sdgs.un.org/goals/goal3.
11. Mcintyre D, Meheus F, Røttingen JA. What level of domestic government health expenditure should we aspire to for universal health coverage? Health Econ Policy Law. 2017 Apr;12(2):125-137. Available at: https://doi.org/10.1017/S1744133116000414.
12. OECD. Boosting investment in health systems will be essential to deal with future shocks, says OECD. OECD; 2023 february 23. Available at: https://www.oecd.org/newsroom/boosting-investment-in-health-systems-will-be-essential-to-deal-with-future-shocks.htm.
13. OECD. OECD Health Statistics 2022. OECD. Available at: https://www.oecd.org/els/health-systems/health-data.htm.
14. Präg P, Mills M, Wittek R, Income and Income Inequality as Social Determinants of Health: Do Social Comparisons Play a Role?, European Sociological Review, Volume 30, Issue 2, April 2014, Pages 218–229, Available at: https://doi.org/10.1093/esr/jct035.
15. Sambo L G, Simões J, Do Rosario O. Martins M, Financing healthcare in low-income developing countries: A challenge for equity in health, Oxford Textbook of Medicine 2020; 6: 168-C2.16P62. Available at: https://doi.org/10.1093/med/9780198746690.003.0022.
16. United Nations. The 17 goals | sustainable development. United Nations. Retrieved April 8, 2023, Available at: https://sdgs.un.org/goals.
17. United Nations. Goal 3 | Department of Economic and Social Affairs. United Nations. Retrieved April 8, 2023, Available at: https://sdgs.un.org/goals/goal3.
18. United Nations Global Marketplace (UNGM). Procurement data by category. UNGM. Retrieved April 19, 2023. Available at: https://www.ungm.org/Shared/KnowledgeCenter/Pages/asr_data_category.
19. SPHS. Sustainable Procurement in the Health Sector. Who we are. Retrieved April 8, 2023, Available at: https://savinglivesustainably.org/who-we-are.
20. Lindstrom A, Coronado-Garcia L. Sustainable Health Procurement Guidance Note. UNDP. March 2020. 1-62. Available at: https://www.undp.org/publications/guidelines-sustainable-procurement-healthcare-commodities-and-services.
21. United Nations Global Marketplace (UNGM). Procurement data by category. UNGM. Retrieved April 19, 2023. Available at: https://www.ungm.org/Shared/KnowledgeCenter/Pages/asr_data_category.
22. WHO. Sustainable Procurement. WHO; April 2022. Available at: https://apps.who.int/gb/MSPI/pdf_files/2022/04/Item5_11-04.pdf.
23. UNICEF. UNICEF Implements Sustainable Procurement. UNICEF Supply Division; September 2018. Available at: https://www.unicef.org/supply/sites/unicef.org.supply/files/2019-06/sustainable-procurement-information-note.pdf.
24. Lindstrom A, Coronado-Garcia L. Sustainable Health Procurement Guidance Note. UNDP. March 2020. 1-62. Available at: https://www.undp.org/publications/guidelines-sustainable-procurement-healthcare-commodities-and-services
25. United Nations Office for Project Services Procurement Group. Sustainable Procurement Framework - Annex 1 to the Procurement Manual. UNOPS. 2021, July 1. Available at: https://content.unops.org/service-Line-Documents/Procurement/UNOPS-Procurement-Manual-Annex-1-2021_EN.pdf.
26. UNICEF. UNICEF Implements Sustainable Procurement. UNICEF Supply Division; September 2018. Available at: https://www.unicef.org/supply/sites/unicef.org.supply/files/2019-06/sustainable-procurement-information-note.pdf.
27. UNDP. Practitioner’s Guide to Sustainable Procurement. Available at: https://popp.undp.org/UNDP_POPP_DOCUMENT_LIBRARY/Public/PSU_Procurement%20Overview_Sustainable%20Procurement.docx#:~:text=Several%20of%20factors%20influence%20sustainable,line%20with%20good%20financial%20management.
28. Perry L, Malkin R. Effectiveness of medical equipment donations to improve health systems: How much medical equipment is broken in the developing world? Medical and Biological Engineering and Computing. 2011. 49(7):719-722. Available at: https://doi.org/10.1007/s11517-011-0786-3
29. Kaufman R, Guerra-López I. Needs Assessment for Organizational Success. Alexandria(VA): ASTD Press; Feb 2013.
30. DiPrete Brown L, Miller wordo L, Rafeh N et al. Quality Assurance of Health Care In Developing Countries. Quality Assurance Methodology Refinement Series.1-33. Available at: https://pdf.usaid.gov/pdf_docs/pnabq044.pdf.
31. Huang, E. (2021). A multi-platform information management system of total life cycle for medical equipment. Global Clinical Engineering Journal, 4(1), 5–13. https://doi.org/10.31354/globalce.v4i1.78.
32. David Y, Jahnke E. G. (2018). Planning Medical Technology Management in a Hospital. Global Clinical Engineering Journal, (1), 23–32. Available at: https://doi.org/10.31354/globalce.v0i1.23
33. Perry L, Malkin R. Effectiveness of medical equipment donations to improve health systems: How much medical equipment is broken in the developing world? Medical and Biological Engineering and Computing. 2011. 49(7):719-722. Available at: https://doi.org/10.1007/s11517-011-0786-3
34. Lindstrom A, Coronado-Garcia L. Sustainable Health Procurement Guidance Note. UNDP. March 2020. 1-62. Available at: https://www.undp.org/publications/guidelines-sustainable-procurement-healthcare-commodities-and-services
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Valerio Di Virgilio, Università degli studi La Sapienza - Roma
Valerio Di Virgilio is a biomedical engineer (Ph.D.) with 12 years of experience as University Professor and Director of Clinical Engineering Departments in 3 University Hospitals and additional 17 years of experience in implementing international MDs procurement projects in more than 40 developing countries. Has worked as the Regional Advisor of Medical Technology for UNOPS in Latin America and the Caribbean coordinating a network of 40+ Biomedical Engineers. Presently works as a researcher in the department of DIAG of the University “La Sapienza” in Rome.
Alexia Bouchard Saindon, United Nation Office for Project Services
Alexia Bouchard Saindon holds a bachelor’s degree (BEng) in biomedical engineering from Polytechnique Montreal and a master’s degree (M.Sc.A) in clinical engineering from the University of Montreal, Canada. Is also a certified project manager professional (PMP) and works as a biomedical engineer consultant for UNOPS.
Francisco Cesar Gerardo Becerra Posada, United Nation Office for Project Services
Francisco Becerra-Posada is a Medical Doctor (National University, Mexico, 1982) with an MPH (Johns Hopkins, 1984), and DrPH (National Public Health Institute, Mexico, 2013). Has over 40 years of experience in public health related work both in Mexico’s health system in various roles of responsibility, and internationally. He is a former Assistant Director of the Pan American Health Organization and is UNOPS Regional Health Advisor for Latin America and the Caribbean.
