The management of medical and laboratory supplies and equipment shares many similarities with the management of pharmaceuticals and is just as important in providing effective health services. Although the value of supplies and equipment may equal a substantial proportion of what governments spend on pharmaceuticals, such items are rarely given enough attention. Each country’s ministry of health is responsible for ensuring that commodity management standards are set and followed by instituting quality assurance mechanisms and monitoring evaluation and reporting systems.
Problems associated with supplies and equipment include lack of policies, absence of dedicated government budgets, and lack of standardization. Countries should develop a national list of medical and laboratory supplies and equipment, based on expected types of tests, treatments, and interventions to be delivered at different levels of health care. Such a national list is useful to -
- Define priority items and help ensure that the most essential items are available where needed
- Promote cost-effective use of scarce financial resources
- Reduce the number of items through standardization
- Serve as the basis for training staff and technicians
The four main criteria in selecting equipment are
- local possibilities for servicing and spare parts;
- local availability of essential supplies (such as chemicals and filters);
- a well-established brand name and a simple and sturdy design; and
- local possibilities for training staff in equipment use and maintenance.
Finding good data on the consumption and cost of medical supplies is a challenge, especially on individual items.
The number of different items and brands is much larger than the average number of essential medicines, and the specifications are much less standardized. Another problem comes from the records used to compile data: Are different sizes of X-ray films or all sizes of syringes regarded as one item? In some countries, medicines and other medical supplies and laboratory supplies come under different management structures or different budgets, which makes intercountry comparisons difficult.
Before procuring medical and laboratory supplies and equipment, specifications should be defined in close collaboration with technical staff. These specifications are needed for the procurement department and for claims in case of faulty products.
Donations of commodities and equipment to laboratories and health facilities must be handled carefully, including the assurance that donations are based on need expressed by the recipient country. When donors provide medical and laboratory supplies and equipment, problems related to the lack of standardization and to maintenance may arise.