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Dear Malcolm and Calil,

Once upon a time… Yes, it is a story I am about to tell.

Some years ago, in an assignment in Sierra Leone, West Africa, we came out with the following as provisions for CE staff job descriptions and “executive-level” positions:

1. Job designations

Job designations were recommended with these main features:

i-                    The types of human resources (engineers, technicians, trades workers) are in conformity with ISCO-88 ( International Standard Classification of Occupations) designations and levels;

ii-                   New designations are provided for trades workers and technicians in the three fields of work (medical equipment, technical equipment, civil works);

iii-                 Designations are provided for technicians in the fields of technical equipment and civil works;

iv-                 All the engineers in the three fields of work shall be called “clinical engineers”;

v-                  Managerial positions (District Department Manager, Regional Department Manager, Director/Central Department Manager) and higher level officers (Senior Technologist, Chief Technologist, Chief Technology Manager) are proposed respectively at district, regional and central levels;

vi-                 Grades are provided for the managerial positions and higher level officers.

2. Schemes of Services (Job descriptions)

The existing Schemes of Service were reviewed and extended to provide a comprehensive Cadre for Clinical Engineering Staff in the MOHS. Each reviewed SoS is presented in the format of the former SoS i.e. with the following headings:

-          Post: the designation of the post

-           Salary Grade: attached to the post

-           Age: minimum age of entry or promotion to the post

-          Qualifications: by promotion from a lower grade or by direct entry

-           Duties: main duties, responsibilities and reporting

-          Prospects: for promotion to higher grades and posts.

3. Specific recommendations

The following specific recommendations were made:

i.                 The MOHS shall create a cadre for Clinical Engineering Staff

ii.                  This cadre should be taken into consideration in the MOHS Human Resources Policy and Plan

iii.                 Adoption of these reviewed job descriptions and Schemes of Service shall be formal.

NOTA: The definitions below were adopted for our work:

Clinical Engineering is defined as “the management, support, development and quality assurance of healthcare technology as part of safe, cost-effective and sustainable healthcare delivery”

- Task Group, Engineering Council, South Africa

A Clinical Engineer is a professional who supports and advances patient care by applying engineering and managerial skills to healthcare technology.

- American College of Clinical Engineering (ACCE)

This proposal (details are provided in relevant documents) could well help to design an International CE/HTM Body of Job Descriptions by a Group of experts committed to Human Resource Development for CE/HTM.

Best wishes,

Andre.

Andre MBOULE
Engineer Manager, BEng., MBA, DMc
Institutional, Business, and Individual Development Specialist
Senior International Consultant
P.O Box 25096 Yaounde
CAMEROON

Mobile: +237-9982 8671
Mobile: +237-7509 2009

Dear all,

The discussion about the importance of access to medical
technologies/services illustrates the necessary connections between Health
Technology Management (HTM) and Health Technology Assessment (HTA).

The bigger picture mentionned in the emails is the focus of HTA.

Reiner Banken

Dear Michael and Andrei

No one is suggesting that Access to medical devices is all that
matters, but it is a crucial step in achieving the benefits of medical
devices via healthcare interventions, and constitutes one element (the
other two being utilisation and effectiveness) of Effective Coverage,
defined as ˜the ratio of actual health gain from healthcare
interventions to maximum potential health gain achievable from the same
interventions” (WHO).

Access is understood as meeting the requirements of the 4A’s:
availability, accessibility, affordability and acceptability. These
certainly apply to medical devices in their own right and the 3 elements
of Effective Coverage combined, I would suggest, cover the issues that
you are alluding to. My own view therefore is that Access for medical
devices should not be seen or defined differently from that for drugs or
other health technologies, since there is much to be gained from a
common framework.

I would further submit that barriers to true benefits from
drugs/medicines ALSO lie beyond access, and they too have issues around
˜management capacities and recurrent budgets” that need to be
addressed (case in point: the possible cuts in PEPFAR and Global Fund
support for ARVs and the effects this could have in resource-poor
environments).

All that I was suggesting is that we need to leverage and tap into
significant initiatives related to health- and healthcare technologies
as a whole, in order to advance our own cause. That said, I accept that
many Infratechers (myself included) depend for their livelihood on the
fact that medical devices are different from drugs ; )

A luta continua !

Best regards

Mladen Poluta

Dear All,

Let us be cautious to equate the benefits of access to medicine with that of
access to medical devices. With medicine, the pill does the job; with
medical device, they rely on the user to effect outcome and to maintain
durable devices. Barriers to true benefits from medical devices lie beyond
access. Let us not forget about the management capacities, recurrent budget
.issues.

Michael Cheng