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MAINTENANCE OF THE HEALTH ESTATE


Conclusion Given the country’s complexity in terms of political instability, security and social issues, initial observations highlighted the need to put in place a solid health facility operations and maintenance framework to ensure the sustainability of the infrastructure and equipment and to improve the quality of services offered. It was also evident that thorough


commissioning of the new facility was necessary prior to handing over as was careful follow ups during the transfer and post-occupancy phase. In the case of the HCRs, the strategy was based on a holistic approach that considers the health technologies as being intrinsically connected with the infrastructure, the electromechanical systems and installations. Resistance to this change was encountered, due to the inherent cultural separation between infrastructure and the biomedical sector of healthcare facilities. The core strategy chosen by UNOPS


to match the needs of the local setting has two main themes – project management and quality management, referred to international guidelines on healthcare management and maintenance frameworks, both adapted and scaled to the real context. This was accomplished through proper interventions at different


levels, which included establishing and adapting preventive maintenance policies for installations and equipment to be carried out by the hospitals local maintenance team, together with service contracts for advanced or specific tasks on more complex systems. It was equally critical to provide


basic training on the proper and secure functioning of the equipment, to both the technicians and the users. Use of the CMMS software will be a


major breakthrough, as it is expected to help with the analysis and tracking of data regarding medical equipment in the hospital. If exploited properly, this tool has the potential to improve the general performance of the biomedical engineering unit and become a reference for other departments. The introduction of a novel approach,


centered around preventive maintenance, represents a potentially significant improvement in the healthcare system in Haiti. The positive and sustainable impact


of this project is based on the commitment of the local public institutions, mainly the MSPP, to be involved in the support and adoption of a new work methodology. This, in turn, will pave the way towards a stronger infrastructure and medical equipment


maintenance policy, which can then be transferred to the national level. After the initial difficulties, thanks to


better communication and interaction with the people involved, the project has been accepted and better understood at all levels, representing an opportunity to really improve the facility operations and speeding up the process of reaching full functionality. The project highlighted how critical


it is to be aware that new modern health facilities, even of middle technical complexity, in a multifaceted setting like Haiti, introduce a significant gap that cannot be immediately covered through local capacity. It needs to be supported and accompanied and this should become a fundamental component in the vision of future donors.


References 1 Disaster emergency committee. Haiti Earthquake Facts and Figures. http://www.dec.org.uk/articles/ haiti-earthquake-facts-and-figures2 Unite


s de sante report – 2013.


3 UNOPS. Project Initiation report. Maintenance and support project 77635-141107.


4 World Health Organization. (2001). Health care technology policy framework. Eastern Mediterranean. Series 24.


IFHE


IFHE DIGEST 2017


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