Deciding what is needed: Consulting local stakeholders and essential equipment lists

In the previous step, we asked you to think of ways you might come up with ideas on what to donate.

Although there is no one universal method, there are certain important issues you will need to consider.

Identify a clinical need

Most importantly, equipment donations must always be in response to an identified need.

It’s easy to assume that in a low-resource setting, any equipment will be useful – but this is not the case. The clinical and training needs of the recipient, as well as their existing resources, must drive what is selected for donation. Without careful consideration, well-intentioned donations could become a burden instead of a help.

Consider the following two real-life quotes, from healthcare workers interviewed by THET as part of their ‘Making it work’ series:

“The anaesthesia machine we received is very good quality. But we don’t have an anaesthetist here at the hospital so we can’t use it properly”

Operating theatre nurse at Chama District Hospital in Zambia

“We received these two brand new ventilators from a donor. We want to use them in the ICU but we haven’t had any training on them and we don’t have any tracheostomy tubes.”

“Our director is trying to source the tubes but we can’t find any from the suppliers we have here in Somaliland.”

ICU in-charge at Hargeisa Group Hospital in Somaliland

Involve local stakeholders

In deciding what to donate, and planning the donation, you will want to involve local stakeholders:

• Clinical staff – e.g. Doctors and nurses. What do they think is needed?
• Non-clinical staff – many people work in a healthcare facility to support the clinical work e.g. lab technicians, cleaners, porters. Are they lacking equipment that would improve patient care?
• Senior administration at the hospital/healthcare facility – Note that many hospitals will already have performed their own needs assessments to prioritise new equipment needs – which may take into account existing equipment, facilities and services, and patient demand.
• Patients and their families – What do they think is needed?

Of course, your own insights from your experience if you have spent time at the recipient institution, will also be useful, but this cannot substitute for the experience of permanent local staff.

Essential equipment lists

If there is no local plan for what equipment is needed, or nothing on that list is suitable or within your budget, a useful resource would be the World Health Organisation (WHO), which has produced several lists of essential equipment for healthcare facilities, found on their website.

For example, a list of essential emergency equipment for resuscitation: – The WHO generic essential emergency equipment list

The WHO has also produced a list of essential medicines for any healthcare system. Later in the course we will cover the pros and cons of donating single-use medicines versus re-usable equipment.

Conduct your own research

Even if the health facility asks for a specific piece of equipment, you still need to conduct your own research into whether this is appropriate and will be effective.

For example (quoting Humatem’s guidelines on preliminary assessments for medical equipment support projects), before you give an ultrasound scanner to a health facility that asks for one, it is essential to ensure that there is:

• A clinical need for ultrasound images: i.e. lack of ultrasound images is affecting patient care.
• A specialist doctor who knows how to use the device and interpret the images.
• A budget available for regular purchases of scan gel and printing paper, but also money for spare parts and repairs.
• A biomedical technician and/or a service provider who can carry out the maintenance
• An air conditioned room with stable electrical voltage to store the device.