History
There has been a gradual improvement in Health Care services in Cambodia over the last 15 years. In such important services, medical equipment needs to be safe and accurate to effectively diagnose the diseases and treat patients, which require human resources, especially qualified technicians to maintain and ensure the good conditions of the equipment in health care institutions. However, Cambodia still lacks enough educated biomedical engineering staff to bring the profession into the general practice of every hospital.
Kingdom of Cambodia, 2015
“.. while the Health Coverage Plan proposed the recruitment of biomedical technicians, a training programme is yet to be established and there is only limited capacity for medical equipment maintenance, which remains a key issue for the next Health Strategic Plan. The need for quality improvement has also been addressed through Sub-Decree 21, which defines quality standards for all health educational institutions (DFAT, 2011).”
Kingdom of Cambodia, 2017
Japan International Cooperation Agency (JICA)
Data Collection Survey on Human Resources for Health and Health Facility
“… a non-profit organization named Engineering World Health (EWH) started a Biomedical Engineer Technician (BMET) training program in partnership with the GE Foundation, a philanthropic organization of the US medical equipment manufacturer. Since around April 2014, Cambodia has been receiving assistance from EWH for capacity development and conducting training for technicians and engineers in charge of maintaining medical equipment. The above-mentioned young ME technicians have received the BMET training by EWH and are said to have acquired basic knowledge of medical equipment. Biannual medical equipment inspections and record keeping have been performed continuously and ME management reports prepared as required under the ME Management System adopted through the MEDEM Project.”
“When the ME Management System was introduced to certain Cambodian public health facilities, each facility established an ME Working Group and assigned at least one ME technician to the Group to perform preventive maintenance on medical equipment. However, most of the ME technicians in these hospitals are not engineers, but were previously clerical workers, drivers, nurses, plumbers, etc. appointed on the spot to fill the position without knowledge in mechanical or electrical engineering. The original intent was to set up the ME Management System first to build an organizational structure for preventive maintenance. To augment the system, full time ME maintenance personnel were later appointed and their capacities developed through technical training.”
“For Cambodia to realize its high-level policy goal of “thorough investment in medical equipment and medical facilities incorporating the latest technology,” maintenance for the equipment and facilities will be vital. However, out of 35 hospitals, 10 hospitals lacked an ME technician. Furthermore, the only hospitals with an engineer on site are Siem Reap PRH and Kampong Cham PRH, which each have one engineer. There are only about 10 people nationwide who possess specialized knowledge and skills necessary for conducting maintenance on medical equipment. Private companies have been starting businesses with individual provincial referral hospitals to introduce high-level medical devices (CT scanners, etc.). However, many of the medical equipment introduced were procured at low cost from poor-quality manufacturers. They break down soon after purchase and in some cases become a hindrance to daily examination work. Regarding medical equipment procurement, the MOH lacks personnel capable of checking medical equipment specifications with an expert eye, and establishment of laws covering this field has been delayed. Therefore, many companies are easily able to expand their business in this field, and some of them are predatory contractors which sell poor quality items while completely failing to provide a guarantee for post-sales maintenance. Due to the above, the MOH must swiftly train technicians who possess the knowledge and skills needed to accurately evaluate products handled by medical equipment procurement contractors. Furthermore, structuring a system and organization for this field which ensures that predatory contractors and poor quality manufacturers are removed, while import and procurement of high-quality products proceeds. In the future, Cambodia must also consider training experts who can independently develop medical equipment suited to Cambodian standards.”
Results and current state:
- – Lack of budget and personnel for medical equipment maintenance at the central and provincial levels
- – No training organization or certification system for medical equipment maintenance personnel
- – No institutions (universities or professional schools) which conduct education in the medical engineering field, and no certification system in that field
- – Lack of incentive to keep medical equipment well maintained
- – ME technicians at each health care facility were appointed on an impromptu basis, so their level of knowledge and ability relating to medical equipment is low, and they are not trusted by other personnel. Furthermore, their salaries are even lower than those of other personnel, so technicians’ motivation to maintain medical equipment is low