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导航监管格局:通过关键利益相关者视角对津巴布韦医疗器械和体外诊断医疗器械监管的定性探索。

Navigating regulatory landscape: A qualitative exploration of medical devices and in vitro diagnostic medical devices oversight in Zimbabwe through key stakeholder perspectives.

机构信息

Regulation and Prequalification Department, World Health Organization, Geneva, Switzerland.

Programs, African Society for Laboratory Medicine, Lusaka, Zambia.

出版信息

PLoS One. 2024 May 16;19(5):e0287415. doi: 10.1371/journal.pone.0287415. eCollection 2024.

Abstract

Medical devices and In Vitro Diagnostics (IVDs) are vital for public health and accessible healthcare. Still, there is an imbalance in high-quality products in Low and Middle-Income Countries (LMICs). Zimbabwe's regulatory framework for medical devices and IVDs is unclear, leading to ineffective compliance and surveillance. As a result, there are knowledge gaps regarding pre-market and post-market regulatory elements to ensure the safety, quality and performance of medical devices and IVDs used in Zimbabwe. Our study aimed to explore the current status of medical devices and IVD regulations in Zimbabwe. Semi-structured interviews were conducted with 12 regulators from the Medicines Control Authority of Zimbabwe (MCAZ) National Microbiology Reference Laboratory (NMRL), Medical Laboratory and Clinical Scientists Council (MLCScCZ) to understand the current status of medical devices and IVD regulations in Zimbabwe. Three participants completed a questionnaire to understand the regulatory landscape in Zimbabwe. Three key informant interviews were conducted with three regulators from the South African Health Products Regulatory Authority (SAHPRA), Tanzanian Medicines and Medical Devices Authority (TMDA), and World Health Organization Regulatory Systems Strengthening (WHO RSS) to learn best practices to create a roadmap for Zimbabwe. We analyzed qualitative data using a thematic analysis. The findings reveal significant deficiencies and gaps in the legal framework for regulating medical devices and IVDs, highlighting the need for a legal framework and the absence of more comprehensive regulations. Regulatory entities face capacity limitations, especially in regulating medical devices and IVDs. Conformity assessment processes, medical devices, IVD classification criteria, and post-market surveillance also represent challenges, highlighting the need for a well-defined framework and regulatory procedures. The Zimbabwean regulatory system pathway is reactive, prompting several regulatory initiatives to address needs. Despite facing challenges, there is recognition of the importance of collaboration among regulatory authorities, emphasizing a shared commitment to improving and strengthening medical devices and IVD regulations for improved patient safety. By advocating for a proactive, comprehensive, and legally sound approach, indicating the potential for collaboration and synergy, this study provides a foundation for well-informed policy recommendations to guide enhancements and build a framework for a resilient, efficient, and transparent regulatory environment in the Zimbabwe and African regions as a whole.

摘要

医疗器械和体外诊断试剂(IVD)对公共卫生和可及的医疗保健至关重要。然而,在中低收入国家(LMIC),高质量产品仍存在不平衡。津巴布韦医疗器械和 IVD 的监管框架不明确,导致合规和监测效果不佳。因此,在上市前和上市后监管要素方面存在知识差距,无法确保在津巴布韦使用的医疗器械和 IVD 的安全性、质量和性能。我们的研究旨在探讨津巴布韦医疗器械和 IVD 监管的现状。我们对津巴布韦药品管制管理局(MCAZ)国家微生物参考实验室(NMRL)、医学实验室和临床科学家理事会(MLCScCZ)的 12 名监管人员进行了半结构式访谈,以了解津巴布韦医疗器械和 IVD 监管的现状。三名参与者填写了一份问卷,以了解津巴布韦的监管格局。我们对来自南非保健产品监管局(SAHPRA)、坦桑尼亚药品和医疗器械管理局(TMDA)和世界卫生组织监管系统加强(WHO RSS)的三名监管人员进行了三次重点人员访谈,以了解制定津巴布韦路线图的最佳实践。我们使用主题分析对定性数据进行了分析。研究结果表明,津巴布韦医疗器械和 IVD 监管的法律框架存在重大缺陷和差距,突出了制定法律框架和更全面监管的必要性。监管实体面临能力限制,特别是在监管医疗器械和 IVD 方面。合格评定程序、医疗器械、IVD 分类标准和上市后监测也构成挑战,这表明需要有一个明确界定的框架和监管程序。津巴布韦的监管系统是被动的,需要采取若干监管措施来满足需求。尽管面临挑战,但人们认识到监管机构之间合作的重要性,强调了为改善和加强医疗器械和 IVD 监管以提高患者安全而共同努力的承诺。通过倡导积极主动、全面和有法律依据的方法,表明存在合作和协同增效的潜力,本研究为提供了有充分依据的政策建议,以指导加强和建立一个有弹性、高效和透明的监管环境,为津巴布韦和整个非洲地区提供了一个基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b600/11098438/b1c7b3e78977/pone.0287415.g001.jpg

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