Performance of health care equipments in the public sector hospitals in the eye of good governance, a case study based on the Sri Lankan public sector hospitals

Abstract

Today all healthcare delivery systems are very much technology dependent and virtually no medical intervention can take place without recourse to technology or precisely medical equipment and devices. An existence of a good governance framework is a pre-requisite to determine introduction, utilization and management of health care equipment and devices for better performance of any healthcare delivery system. High cost of medical equipment and devices is often cited as the prime driver behind rising cost of health care business. However, health care administrators world over are compelled to deploy the latest technology so that standards of health care will not be compromised. With limited financial resources on one hand and increased expectations of the public for a better health care service on the other hand, developing countries have many challenges to face in making the right medical equipment available in proper working order at all times in hundreds of public hospitals in their countries. This underlines the need for good governance framework with right technology management policy, which is absent in health care systems in most of the developing countries. This has resulted in poor performance of health care equipment and wastage of resources by undermining the quality of the health care service. In this context, this research paper ascertain the problems and causes related to the failure of health care equipment in the Sri Lankan public sector hospitals with special emphasis on good governance aspects and furthermore, recommend policies and strategies to develop a procedure or mechanism for better management of healthcare equipment in transparent and accountable manner to upgrade health care delivery and to minimize wastage of scarce public resources. A structured questionnaire survey used to collect data from a sample of twelve public sector hospitals situated in different regions of Sri Lanka. This survey also included many discussions with medical professionals, health care administrators and Para medical staff (as users of equipment and devices), etc. This paper concludes that non-existence of national healthcare technology management policy as a part of good governance on selection, assessment, acquisition, usage, maintenance, disposal and replacement of medical equipment in Sri Lanka is the main responsible factor for poor management of health care equipment. Formation and implementation of new coherent health care equipment management policy as a part of good governance framework at national and regional level would improve health care delivery and resolve many of the management and governance problems related to health care equipment and devices in the public sector hospitals in Sri Lanka.