Health and Technology

, Volume 8, Issue 4, pp 291–300 | Cite as

A sustainability evaluation of a biomedical technician training program in Honduras

  • Dane EmmerlingEmail author
  • Paige W. Sholar
  • Robert A. Malkin
Original Paper


Engineering World Health (EWH) developed and executed a unique model to train biomedical technicians (BMET) in Rwanda, Honduras, and Cambodia. This model significantly decreased out-of-service equipment, one to two years after the training’s initiation, when comparing hospitals with EWH trained BMETs to similar hospitals with BMETs without EWH training [1–4]. Despite this model’s past evidence of impact, no study has shown evidence for sustained impact and continued delivery of services after the termination of funding. Here, one year after external funding ended for the EWH Honduras program, the model’s sustainability was assessed using qualitative interviews guided by an established sustainability framework and quantitative measures of continued impact on out-of-service rates of medical equipment. Interviews found the program, institutionalized within a technical training college, was strongly sustainable in each domain of an established sustainability framework. Additionally, there was evidence of continuing production of benefits to the health system. Technicians whose training through EWH had ended two years earlier had 35.37% less out-of-service equipment compared to similarly sized control hospitals, demonstrating continued impact of training (p < .0001). Overall, the program in Honduras was found to be strongly sustainable, albeit with some threats to continued sustainability.


Training program Sustainability Biomedical engineering technicians Resource-poor setting 



The authors thank Rony Meza for translation services, extensive coordination with local entities, and guide to the Duke team.


This research was supported by a grant from the GE Foundation.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© IUPESM and Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Dane Emmerling
    • 1
    Email author
  • Paige W. Sholar
    • 1
  • Robert A. Malkin
    • 1
  1. 1.Department of Biomedical EngineeringDuke UniversityDurhamUSA

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