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Narrative literature review of facilitators and barriers to implementing computerized maintenance management systems in low-middle-income countries

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Abstract

Purpose

Effective health technology management (HTM) is critical to healthcare delivery worldwide. The absence of proper HTM in low-resource settings leads to a lack of medical equipment that is operational or safe for use. Previous solutions including medical equipment donation have proven ineffective as The World Health Organization estimates that 50–80% of equipment is non-functional. This paper examines the facilitators and barriers to implementing Computerized Maintenance Management Systems (CMMS) as a means of improving HTM in Low-Middle-Income Countries (LMIC).

Methods

Five electronic databases were searched. Original research, literature reviews, and systematic reviews in English were included. Abstracts from all eligible articles were reviewed and, if indicated, the full text was screened. Furthermore, the reference list of included articles was scanned for relevant studies. Articles were analyzed using a ‘constant comparative’ method.

Results

Themes identified include quality improvement, facilitators to CMMS implementation, and barriers to CMMS implementation. Hospitals in resource-limited settings report improvements in their maintenance practices and operational costs following the implementation of CMMS. A centralized internet-accessible server and standardization of training were found to be the main facilitators of CMMS implementation. Major barriers included difficulty retaining trained of trained engineers, the need for continued education, costs, the lack of consumables needed for equipment maintenance, and considerations of local context.

Conclusion

The importance of proper HTM in resource-limited hospital settings cannot be overlooked. The absence of proper HTM can be, in part, attributed to the shortage of skilled engineers. This emphasizes the need for access to continued biomedical engineering education to continue to advance and develop HTM in low resource settings. Although the implementation of CMMS in LMICs presents a multitude of challenges, our review found that it is by no means unfeasible, especially when adequate standardization and local context are taken into consideration.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Faculty of Medicine, University of British Columbia, Vancouver, Canada

    Danielle Cohen & Nikola Visnjic

  2. Department of Medicine, Upper West Regional Hospital, Wa, Ghana

    Dominic Akaateba

  3. Department of Family Practice, University of British Columbia, Vancouver, Canada

    Kelly Hadfield

Authors
  1. Danielle Cohen
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  2. Nikola Visnjic
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  3. Dominic Akaateba
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  4. Kelly Hadfield
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Danielle Cohen and Nikola Visnjic. The first draft of the manuscript was written by Danielle Cohen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Danielle Cohen.

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Cohen, D., Visnjic, N., Akaateba, D. et al. Narrative literature review of facilitators and barriers to implementing computerized maintenance management systems in low-middle-income countries. Health Technol. 13, 373–378 (2023). https://doi.org/10.1007/s12553-023-00743-5

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