HTM needs

HTM Needs

When assessing the needs related to health technology and maintenance in the Dodoma region, the follwing elements were taken into account:

  • Policies for health technology management
  • Structure and organisation of health technology management
  • Capacity to carry out effective maintenance (personnel resources, tools, spare parts)

 

National Context

At a national level, a Health Care Technology Policy Guideline exists. The policy outlines plans for a referral system for maintenance management, and anticipates local, regional and district workshops to oversee all maintenance activities. The guidelines have not been implemented, however.

New schemes for health care personnel were developed in 2011, including defined roles for technicians, artisans and engineers to work at health centres and hospitals. Qualified technical staff is in short supply in Tanzania, however, plans to train staff through a 3 year diploma course began at the Dar es Salaam Institute of Technology and Arusha Technical College in 2011 from which 6 graduated technicians have now been employed in Dodoma districts.

 

Dodoma Region - Infrastructure

  • HTM Needs 1
In practice, individual health facilities are responsible for their infrastructure maintenance. They usually lack qualified staff to provide comprehensive maintenance planning or implementation. Infrastructure maintenance is contracted out to local artisans, but the systematic planning, monitoring and supervision of this work is neglected.

The key infrastructure challenges that HPSS identified in the Dodoma region are

  • Maintenance requirements are insufficiently planned for at a facility and district level (including budgeting)
  • There is no systematic maintenance culture—no regular inspection of buildings, no medium and/or long term planning for infrastructure maintenance
  • Procedures for maintenance and for acquiring district support for maintenance are not clear
  • Too few qualified technical staff available at the district level to provide adequate support for health facilities and hospitals
  • Inadequate supervision of external suppliers

 

Dodoma Region - Equipment

Health facilities in the Dodoma region are mostly responsible for their own equipment maintenance (for some types of equipment, such as radiology and some laboratory equipment, they benefit from MoHSW support).

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The HPSS situation analysis found that there is no systematic approach to equipment maintenance—preventative maintenance does not routinely occur, and the administration does not adequately plan or budget for equipment maintenance.

Facilities try to deal with equipment failures as they occur, but competent equipment technicians are scarce to non-existent in the Dodoma region.

The key equipment challenges that HPSS identified in the Dodoma region are:

  • No comprehensive technical inventory; this means there is little information about where equipment is and whether it works
  • Limited resources for equipment maintenance, including manpower and knowledge, workshops and tools, and available spare parts
  • No systematic approach to maintenance management: preventative maintenance, individual repairs, supervision, quality control, procedures and documentation
  • Inadequate planning and budgeting for maintenance needs
  • Complex and inefficient procedures to obtain financial support from the district.