Medical device landscape for communicable and noncommunicable diseases in low-income countries

Abstract Background This study characterized the landscape of commercially available medical devices specifically designed for use in low-income countries (LICs). Methods A state-of-the-art review of peer-reviewed publications, patents, global health databases, and online resources was performed. The criteria established for a health technology’s inclusion in the study were: it met the definition of a medical device; it was designed and developed to address one of the top ten causes of death in LICs, Millennium Development Goal (MDG) 4, or MDG 5; and there was evidence of its commercialization. Results Analysis identified 134 commercialized devices exclusively designed for use in LICs. More than 85% of devices were designed to address infectious diseases or child or maternal health (MDG 4 or 5, respectively). None of the identified devices addressed prevention of noncommunicable diseases (NCDs). Only 8% of devices were designed for use in primary health facilities by non-physician health providers. Conclusion There is a significant mismatch between the projected global burden of disease due to NCDs and the relevant number of commercialized medical devices designed specifically for use in LICs. A limited number of commercialized devices were designed for use by non-physician health providers. These findings suggest the need for medical devices targeting NCDs in LICs and design processes that consider the broader context of design and engage stakeholders throughout all phases of design.https://deepblue.lib.umich.edu/bitstream/2027.42/144540/1/12992_2018_Article_355.pd

Development of culturally appropriate pictorial cards to facilitate maternal health histories in rural Ghana

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135249/1/ijgo244.pd

Obstetrics‐based clinical immersion of a multinational team of biomedical engineering students in Ghana

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135577/1/ijgo218.pd

Designing Task Shifting Medical Devices for Low-Resource Settings.

The availability and acceptability of medical devices designed for use in low-resource settings is affected by factors including unreliable energy supply, limited infrastructure, high product costs, and lack of spare parts. Further, the limited availability of highly trained health providers is another obstacle to providing care in low-resource settings. These pose a design challenge on how to develop task shifting medical devices that are simple to use by lay health providers to perform some of the tasks previously undertaken by highly trained health providers. This dissertation investigated the perceptions of task shifting. Also, existing qualitative and quantitative methods for eliciting user requirements were analyzed. Finally, a systematic design ethnography approach was used to develop an understanding of traditional male circumcision (TMC) in sub-Saharan Africa and inform user requirements for a device aimed at improving the safety of the procedure. Ease of use was identified as the most important characteristic that defines a task shifting medical device. This research also evaluated the effectiveness of open-ended, clustering, and discrete choice methods to elicit user requirements, and used individual difference scaling analysis to further extend the analysis to further analyze the data from the clustering method. Design ethnography techniques were systematically applied to inform the design process of a device to mitigate the adverse events of TMC in Uganda. The device’s cultural acceptance and fit were measured through preference analysis and a clinical trial. This dissertation made four contributions to the interdisciplinary field of design engineering. First, it provided an understanding about diverse stakeholders’ perceptions of task shifting medical devices. Second, it offered a set of methods by which requirements needed to develop a task shifting medical device can be elicited and identified the design requirements essential for designing mechanical task shifting medical devices. Third, it evaluated qualitative and quantitative requirements elicitation and prioritization methods, and presented a methodology that indirectly identified the highest priority user requirement categories. Fourth, it developed a culturally acceptable and appropriate device, based on design ethnography approaches, to make TMC safer. This work concludes with presenting a set of steps for requirements elicitation based on design ethnography principals.PhDDesign ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111571/1/asabet_1.pd

Defining and characterizing task-shifting medical devices

Abstract Background Task shifting could help address limited human resources available for the delivery of quality health care services in low-resource settings. However, the role of medical devices in supporting task shifting is not fully understood. This study aimed to 1) define “task-shifting medical devices” and 2) identify product characteristics to guide the design and development of task-shifting medical devices. A three-part survey questionnaire comprising open-ended, rank-ordering, and multiple-choice questions was disseminated to healthcare professionals worldwide. The survey included questions to capture stakeholders’ general understanding of and preferences for task shifting in medicine and public health, and questions to define task-shifting medical devices and identify desirable product characteristics of task-shifting medical devices. Results Task-shifting medical devices were defined by respondents as “devices that can be used by a less specialized health worker”. Aside from safe and effective, both essential characteristics for medical devices, easy to use was the most cited product characteristic for a task-shifting medical device. Responses also emphasized the importance of task-shifting medical devices to enable local agency, such as peer-to-peer training and local maintenance. Several additional frequently mentioned attributes included low cost, contextually appropriate, maintainable, capable of using an alternative power source, easy to understand, easy to learn, reusable, and easy to manage throughout its use cycle. Conclusion This study defines and characterizes task-shifting medical devices based on healthcare professionals’ responses. Ease of use was identified as the most important characteristic that defines a task-shifting medical device, alongside safe and effective, and was strongly associated with enabling peer-to-peer training and maintainability. The findings from this study can be used to inform technology product profiles for medical devices used by lower-level cadres of healthcare workers in low-resource settings.http://deepblue.lib.umich.edu/bitstream/2027.42/173689/1/12992_2021_Article_684.pd

Traditional male circumcision in Uganda: a qualitative focus group discussion analysis.

BACKGROUND: The growing body of evidence attesting to the effectiveness of clinical male circumcision in the prevention of HIV/AIDS transmission is prompting the majority of sub-Saharan African governments to move towards the adoption of voluntary medical male circumcision (VMMC). Even though it is recommended to consider collaboration with traditional male circumcision (TMC) providers when planning for VMMC, there is limited knowledge available about the TMC landscape and traditional beliefs. METHODOLOGY AND MAIN FINDINGS: During 2010-11 over 25 focus group discussions (FGDs) were held with clan leaders, traditional cutters, and their assistants to understand the practice of TMC in four ethnic groups in Uganda. Cultural significance and cost were among the primary reasons cited for preferring TMC over VMMC. Ethnic groups in western Uganda circumcised boys at younger ages and encountered lower rates of TMC related adverse events compared to ethnic groups in eastern Uganda. Cutting styles and post-cut care also differed among the four groups. The use of a single razor blade per candidate instead of the traditional knife was identified as an important and recent change. Participants in the focus groups expressed interest in learning about methods to reduce adverse events. CONCLUSION: This work reaffirmed the strong cultural significance of TMC within Ugandan ethnic groups. Outcomes suggest that there is an opportunity to evaluate the involvement of local communities that still perform TMC in the national VMMC roll-out plan by devising safer, more effective procedures through innovative approaches

Data-Driven Ranking and Visualization of Products by Competitiveness

Competitive analysis is a critical part of any business. Product managers, sellers, and marketers spend time and resources scouring through a huge volume of online and offline content, aiming to discover what their competitors are doing in the marketplace and to understand what type of threat they pose to their business' financial well-being. Currently, this process is slow, costly and labor-intensive. We demonstrate Clarity, a data-driven unsupervised system for assessment of products, which is currently in deployment at IBM. Clarity has been running for more than a year and is used by over 1,500 people to perform over 160 competitive analyses involving over 800 products. The system considers multiple factors from a collection of online content: numeric ratings by users, sentiment towards key product drivers, content volume, and recency of content. The results and explanations of factors leading to the results are visualized in an interactive dashboard that allows users to track the performance of their products as well as understand the main contributing factors. main contributing factors

Clarity: Data-Driven Automatic Assessment of Product Competitiveness

Competitive analysis is a critical part of any business. Product managers, sellers, and marketers spend time and resources scouring through an immense amount of online and offline content, aiming to discover what their competitors are doing in the marketplace to understand what type of threat they pose to their business' financial well-being. Currently, this process is time and labor-intensive, slow and costly. This paper presents Clarity, a data-driven unsupervised system for assessment of products, which is currently in deployment in the large IT company, IBM. Clarity has been running for more than a year and is used by over 1,500 people to perform over 160 competitive analyses involving over 800 products. The system considers multiple factors from a collection of online content: numeric ratings by online users, sentiments of reviews for key product performance dimensions, content volume, and recency of content. The results and explanations of factors leading to the results are visualized in an interactive dashboard that allows users to track their product's performance as well as understand main contributing factors. Its efficacy has been tested in a series of cases across IBM's portfolio which spans software, hardware, and services