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Effective Health Care Technology Management: making health systems
sustainable
The International Summit on Health Care Technology: Vision 2020 with
the theme “Effective Health Care Technology Management: Making Health
Systems Sustainable” was held at the Harare International Conference
Centre, Zimbabwe from 6-8 April 1998. The Summit was organised by the African
Federation for Technology in Health Care (AFTH) in collaboration with the World
Health Organization (WHO), the German Technical Assistance Agency (GTZ) and the
International Federation for Medical and Biological Engineering (IFMBE), and
hosted by the Zimbabwe National Society for Hospital and Medical Engineering
(ZNSHME). The Summit was attended by representatives of 20 African nations and
several international and bilateral agencies, non-governmental organisations and
other institutions from Africa, America, Asia and Europe. It comprised a number
of events targeted at decision-makers and healthcare technology planners and
practitioners in the African Region. Events included the Third AFTH Health Care
Technology Conference, the Second General Assembly of the AFTH, workshops on
Healthcare Equipment Management, Medical Device Procurement and Essential
Equipment Lists, and a commercial exhibition.
The opening plenary was addressed, amongst others, by the Regional Director
of the WHO, Dr I. Samba, and the Zimbabwe Minister of Health and Child Welfare,
Dr. T.J. Stamps. At the closing plenary participants adopted the Harare
Declaration on Health Care Technology in Africa: Vision 2020 (see below).
This is expected to serve as a guiding vision for Regional activities relating
to healthcare technology into the next century. Other outputs from the Summit
include Recommendations from the above-mentioned topical workshops.
As part of the follow-up to the Summit, and following previous Resolutions
by the WHO Regional Committee for Africa (specifically AFRO/RC44/R15 on
Selection and Development of Health Technologies at District Level adopted in
1994 and AFRO/RC45/R3 on Strategies for Improving the Quality of Care in Health
Care Institutions in the African Region adopted in 1995) the WHO Regional Office
for Africa convened a meeting of a Heath Technology Task Force in Harare at the
end of June 1998. The terms of reference of this Task Force include the
provision of technical support to the Regional Office. In addition, a
comprehensive framework for the development of national healthcare technology
policy will be presented at the next meeting of the Regional Committee in
September 1998. This meeting is attended by Ministers of Health from the African
Region.
Harare Declaration on Healthcare Technology in Africa: Vision 2020
8 April 1998, Harare, Zimbabwe
- The proposed new global health policy for the 21st century reaffirms
the continuing importance of the vision of 'Health for All' as a fundamental
human right. All African countries share a major common concern, namely to
ensure that their healthcare system and its services meet the needs of their
populations.
- The potential for technology to improve health status throughout the
continent, and indeed throughout the world, has never been greater. The
application of health care technology to promotion, prevention, care and
rehabilitation has led to advances leap-frogging over past routes of
development. Prospects for the future are even brighter.
- Although healthcare technology encompasses many important elements, this
declaration reflects mainly on health care equipment and other physical assets.
- In Africa, there are still a number of urgent concerns. Despite certain
progress achieved in recent years, the inadequate management of healthcare
technology throughout its lifecycle - including provision, acquisition,
utilisation and maintenance - has led to unsustainable health systems,
inequitable access to health services, wastage of resources and decreased
quality of care.
- Advocacy activities are needed to improve awareness among policy and
decision-makers of the role and importance of technology in improving health
outcomes.
- Rapid improvements in health and information technology require that
governments develop a comprehensive healthcare technology policy and related
guidelines and procedures to ensure a match between technology investments and
overall health priorities.
- It is important to promote evidence-based decision-making conducive to
healthcare technology policy, consistent with overall health policy.
- Policy implementation must also address adequate allocation of human,
financial and technical resources.
- There is a need to take into account technology available in the private
sector, as well as to determine an appropriate public/private sector mix in
technology management within each specific country context.
- Research and development is necessary to stimulate local production of
selected technologies and ensure their sustainability.
- It is important to promote the methodology for definition of essential
healthcare technology packages. This should be based on scientific and technical
criteria, including technology assessment, for selecting technologies
appropriate to national health priorities and resources.
- Methods for evaluating the health impact of new technologies should be
developed and implemented.
- It is necessary to further emphasize healthcare technology and related
issues in the education of health managers, physicians, nurses and other
professionals.
- To strengthen national capacity for healthcare technology management,
relevant training programmes should be established, supported and fully
utilised.
The way forward should include the following actions:
- To accelerate progress towards the attainment of health for all -
through more rational use of technology - the participants endorse the formation
of a continent-wide health technology promotion alliance. The goal of this
alliance is to advance the priorities for action set out in this declaration.
- The World Health Organization should take the lead in building such a
healthcare technology promotion alliance and in enabling African countries to
implement the recommendations of the Summit.
- An important part of this role is for the AFTH and WHO to undertake
advocacy activities to promote a partnership between governments and
non-governmental organisations, financial institutions, bilateral and
multilateral agencies, user groups, the community and the private sector.
Mladen Poluta
IFMBE Regional Liaison to the AFTH
Email: poluta@anat.uct.ac.za
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