Marks Isobel H, Thomas Hannah, Bakhet Marize, Fitzgerald Edward
Primary Care and Public Health, Imperial College, London, UK.
Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK.
BMJ Glob Health. 2019 Sep 29;4(5):e001785. doi: 10.1136/bmjgh-2019-001785. eCollection 2019.
Medical equipment donation to low-resource settings is a frequently used strategy to address existing disparities, but there is a paucity of reported experience and evaluation. Challenges such as infrastructure gaps, lack of technological and maintenance capabilities, and non-prioritisation of essential supplies have previously been highlighted. This pragmatic review summarises existing guidelines and literature relevant to surgical and anaesthesia equipment, with recommendations for future initiatives and research.
Retrospective literature review including both academic and grey literature from 1980 to 2018. We conducted a narrative synthesis to identify key factors that were condensed thematically.
Thirty-three biomedical equipment donation guidelines were identified from governments, WHO, World Bank, academic colleges and non-governmental organisations, and 36 relevant studies in peer-reviewed literature. These highlighted the need to consider all stages of the donation process, including planning, sourcing, transporting, training, maintaining and evaluating equipment donation. Donors were advised to consult national guidelines to ensure equipment was appropriate, desirable and non-costly to both parties. User training and access to biomechanical engineers were suggested as necessary for long-term sustainability. Finally, equitable partnerships between donors and recipients were integral to reducing inappropriate donations and to improve follow-up and evaluation.
There is a paucity of evidence on the causes of success or failure in medical equipment donation, despite its domination of equipment sourcing across many low-resource settings. Equitable partnerships, consultation of policies and guidelines, and careful planning may improve equipment usability and life span. A concerted effort is required to increase awareness of guidelines among health professionals worldwide.
向资源匮乏地区捐赠医疗设备是解决现有差距的常用策略，但相关经验和评估报告较少。此前曾强调过一些挑战，如基础设施差距、缺乏技术和维护能力以及基本物资未被优先考虑等。本务实综述总结了与手术和麻醉设备相关的现有指南和文献，并对未来的举措和研究提出了建议。
回顾性文献综述，涵盖1980年至2018年的学术文献和灰色文献。我们进行了叙述性综合分析，以确定按主题归纳的关键因素。
从政府、世界卫生组织、世界银行、学术机构和非政府组织中确定了33份生物医学设备捐赠指南，以及同行评审文献中的36项相关研究。这些研究强调，需要考虑捐赠过程的各个阶段，包括规划、采购、运输、培训、维护和评估设备捐赠。建议捐赠者参考国家指南，以确保设备对双方来说都是合适、有用且成本不高的。为了实现长期可持续性，建议进行用户培训并提供生物力学工程师的支持。最后，捐赠者和受赠者之间的公平伙伴关系对于减少不当捐赠以及改善后续跟进和评估至关重要。
尽管在许多资源匮乏地区，医疗设备捐赠在设备采购方面占据主导地位，但关于其成败原因的证据却很少。公平的伙伴关系、政策和指南的咨询以及精心规划可能会提高设备的可用性和使用寿命。需要共同努力提高全球卫生专业人员对指南的认识。
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