Medical Imaging in the Global Public Health: Donation, Procurement, Installation, and Maintenance



Medical imaging equipment can have tremendous clinical value, and is in great need in the developing world. Like all equipment, the most basic X-ray imaging systems require complex considerations to maintain quality, most notably maintenance and repair. The costs of maintenance and repair generally exceed the costs of purchase; thus donating a piece of imaging equipment does not necessarily save the recipient hospital money. Due to this reality, in addition to failure in planning and regulating these processes, nearly 50 % of all donated X-ray equipment is out of service. Donating medical imaging equipment often leaves the recipient hospital with additional financial burdens but without additional clinical abilities. This article reviews considerations for improving the probability of a successful donation of medical equipment.


  1. 1.
    Ministry of Health (MOH) [Zambia], Central Statistical Office [Zambia], ORC Macro. Zambia, HIV/AIDS service provision assessment survey 2005. Calverton, MD: Ministry of Health, Central Statistical Office, and ORC Macro; 2006.Google Scholar
  2. 2.
    Ministry of Health (MOH) [Uganda], Macro International Inc. Uganda service provision assessment survey 2007. Kampala, Uganda: Ministry of Health and Macro International Inc.; 2008.Google Scholar
  3. 3.
    Perry L, Malkin R. Effectiveness of medical equipment donations to improve health systems: how much medical equipment is broken in the developing world? Med Biol Eng Comput. 2011;49:719–22.PubMedCrossRefGoogle Scholar
  4. 4.
    Palmer PES, Hanson GP, Honeyman-Buck J. Diagnostic imagine in the community: a manual for clinics and small hospitals. Rotary District 6440 and the Pan American Health Organization, Washington DC; 2011.Google Scholar
  5. 5.
    Adler D, Mgalula K, Price D. Opal Taylor introduction of a portable ultrasound unit into the health services of the Lugufu refugee camp, Kigoma district, Tanzania. Int J Emerg Med. 2008;1:261–6.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Malkin RA. Design of health care technologies for the developing world. Annu Rev Biomed Eng. 2007;9:567–87.PubMedCrossRefGoogle Scholar
  7. 7.
    Drost WT. Transitioning to digital radiography. J Vet Emerg Crit Care. 2011;21(2):137–43.CrossRefGoogle Scholar
  8. 8.
    WHO. Guidelines for health care equipment donations. Geneva: WHO; 2000.Google Scholar
  9. 9.
    WHO. Medical device donations: considerations for solicitation and provision. Geneva: WHO; 2011.Google Scholar
  10. 10.
    Catholic Health Association of the United States. CHA medical surplus donation study: how effective surplus donation can relieve human suffering. St. Louis, MO: Catholic Health Association of the United States; 2011.Google Scholar
  11. 11.
    American College of Clinical Engineers. Guidelines for medical equipment donation. Plymouth Meeting, PA: ACCE; 1995.Google Scholar
  12. 12.
    Guidelines for the donation of medical equipment to Pacific Island countries. Royal Australian College of Surgeons. East Melbourne, Australia; 2009.Google Scholar
  13. 13.
    Gregory S, David G. A new look at OEM service agreements. Radiol Manage. 1995;17:54–8.PubMedGoogle Scholar
  14. 14.
    Mirsberger B. The advantages of aftermarket parts. Biomed Instrum Technol. 2011;45(6):459–61.PubMedCrossRefGoogle Scholar
  15. 15.
    Hockel D, Hamilton T. Understanding total cost of ownership. Health Purchasing News; 2011.Google Scholar
  16. 16.
    GE Healthcare. X-ray quickstart installation guide. Fairfield, CT: GE Healthcare; 2012.Google Scholar
  17. 17.
    WHO. Medical device regulations: global overview and guiding principles. Geneva: WHO; 1999.Google Scholar
  18. 18.
    Malkin R, Keane A. Evidence-based approach to the maintenance of laboratory and medical equipment in resource-poor settings. Med Biol Eng Comput. 2010;48(7):721–6.PubMedCrossRefGoogle Scholar
  19. 19.
    McClelland IR. X-ray equipment maintenance and repairs workbook for radiographers and radiological technologists. Geneva: WHO; 2004.Google Scholar
  20. 20.
    Ministry of Health and Social Services (MoHSS) [Namibia], ICF Macro. Namibia Health Facility Census 2009. Windhoek, Namibia: MoHSS and ICF Macro; 2010.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Biomedical EngineeringDuke UniversityDurhamUSA

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