International Journal of Health Policy and Management

International Journal of Health Policy and Management

Ineffective Healthcare Technology Management in Benin’s Public Health Sector: The Perceptions of Key Actors and Their Ability to Address the Main Problems

Document Type : Original Article

Authors
P. Thierry Houngbo 1
Tjard De Cock Buning 2
Joske Bunders 2
Harry L. S. Coleman 2
Daton Medenou 3
Laurent Dakpanon 3
Marjolein Zweekhorst 2
1 Ministry of Health, Cotonou, Republic of Benin
2 Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands
3 Polytechnic School, University of Abomey-Calavi, Cotonou, Republic of Benin
10.15171/ijhpm.2017.17
Abstract
Background
Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and costeffectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems.
 
Methods
We conducted 2 surveys in 117 selected health facilities. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at health facilities. The Temple-Bird Healthcare Technology Package System (TBHTPS), tailored to the context of Benin’s health system, was used as a conceptual framework.
 
Results
The findings of the first survey show that 85% of key actors in Benin’s HTM sector characterized the system as failing in components of the TBHTPS framework. Biomedical, clinical, healthcare technology engineers and technicians perceived problems most severely, followed by users of equipment, managers and hospital directors, international organization officers, local and foreign suppliers, and finally policy-makers, planners and administrators at the Ministry of Health (MoH). The 5 most important challenges to be addressed are policy, strategic management and planning, and technology needs assessment and selection – categorized as major enabling inputs(MEI) in HTM by the TBHTPS framework – and installation and commissioning, training and skill development and procurement, which are import and use activities(IUA). The ability of each key actor to address these problems (the degree of political or administrative power they possess) was inversely proportional to their perception of the severity of the problems. Observational data gathered during site visits described a different set of challenges including maintenance and repair, distribution, installation and commissioning, use and training and personnel skill development.
 
Conclusion
The lack of experiential and technical knowledge in policy development processes could underpin many of the continuing problems in Benin’s HTM system. Before solutions can be devised to these problems, it is necessary to investigate their root causes, and which problems are most amenable to policy development.
Keywords
Stakeholders
Healthcare Technology Management (HTM)
Benin
Subjects
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International Journal of Health Policy and Management
Volume 6, Issue 10
2017
Pages 587-600

  • Received Date 08 July 2016
  • Revised Date 04 December 2016
  • Accepted Date 07 February 2017
  • First Published Date 01 October 2017
  • Published Date 01 October 2017