What technologies for health care in developing countries?

Abstract

In order to decide whether a health technology is suitable for introduction into a developing country it is first necessary to assess both it and the infrastructural conditions in which it would have to function. The present article examines the rationale for establishing national health technology assessment programmes and outlines how they might be conducted.

PIP: The article examines the rationale for establishing national health technology assessment programs, offers a structure for such programs, discusses the phases of assessment, and outlines how they might be conducted. The transfer of health technologies from developed to developing countries has often been disappointing, mostly because of failure to recognize factors or other deficiencies in advance. In one country in the Americas it was discovered that 44% of the technological research institutions did not have a maintenance engineer or technician. In North America, Western Europe, and Japan, noncommunicable diseases are more prevalent than communicable diseases as causes of mortality, whereas in the developing world the reverse is true. In the developing world more emphasis on disease control is desirable and could prove economically beneficial in the long run. For many illnesses, life- saving treatment costs twice as much per patient as do individual preventive measures. In developing countries there are seldom adequate funds for the creation of a separate entity for health technology. However, by relying on personnel and material resources already present in government and private institutions, a national program for health technology can be established. The creation of a clearing-house is also essential for information on both the state of the national health system and the use of technology. The data collected by the technology planning group is compiled. A procedure is needed for obtaining information from care sites and research institutions. Information is shared with other governments through the setting up of a regional clearing-house. Once the structure and mechanism for health technology assessment are in place, and basic information on the status of the national health system has been gathered, individual health technologies can be assessed. The cost of operating and maintaining equipment is often much higher in developing countries than in the industrialized world.