Selection of Biomedical Equipment for public hospitals in Sri Lanka: A stakeholder perspective

Background: Health technology is an important component in delivering healthcare services. Healthcare technology can be expensive and often does not align with the unique needs of under-resourced areas. Out of the variety of health technologies, biomedical equipment is one of the major assets for any healthcare institution, and it plays an important role in healthcare delivery.
Unlike developed countries, Sri Lanka lacks a system for choosing effective biomedical equipment for hospitals. This study explored current practices to improve the biomedical equipment selection process.
Purpose: The study aims to assess stakeholders’ perceptions of the decision-making process for selecting biomedical equipment in selected line ministry hospitals in the Western Province of Sri Lanka.
Methodology: This cross-sectional study was conducted in four (4) line ministry hospitals, with each facility representing a specific level identified within the line ministry. A survey using a self-administered Questionnaire (SAQ) and a desk review using a checklist were conducted to assess the stakeholders' perceptions of the decision-making process in selecting biomedical equipment.
Results: The stakeholders' survey revealed low awareness of the unavailability of an HTA policy, institutional guidelines, and essential biomedical equipment list. Equipment requests were mainly paper-based, finalized by a committee, and took over two days to process. Respondents found the decision-making process inconvenient and dissatisfying.
The finalized requests assessed through the checklist revealed that they were incomplete, lacking crucial information, such as the Requesting Officer and infrastructure details, and not accounting for financial, environmental, and equipment demand factors.
Conclusions: The decision-making system practiced was revealed to be inefficient, inconsistent, and noncomprehensive. It was also found to be made without due consideration of factors related to equipment, finance, infrastructure, human resources, and services. Therefore, establishing a proper need assessment and prioritization method with criteria is recommended.