Assessment of the operational status of medical equipment in public hospitals in the Amhara region, Ethiopia: a sub-national study

The functionality of medical equipment is critical for effective clinical service delivery. Despite the growing use of advanced medical equipment, the majority of hospitals in the Amhara region face difficulties, such as inadequate maintenance workshops, a shortage of spare parts, improper equipment file documentation, and a lack of biomedical professionals with the necessary training. This study aimed to assess the operational status of medical equipment in public hospitals in the Amhara region, Ethiopia. A cross-sectional study design was conducted. A sixty four (n = 64) hospitals were randomly chosen from a total of one hundred two (N = 102) public hospitals, which included 8 CSHs, 19 general hospitals, and 75 primary hospitals. The data on functionality, installation status, the availability of user and service manuals and Biomedical Equipment Technician (BMET) training of medical equipment items were collected by trained biomedical technicians (Diploma) and technologists(BSc degree) using a standardized format between May and June 2024. Analysis was performed using SPSS version 27. Descriptive statistics and binary logistic regression were done to evaluate the effects of service manual and training on medical equipment functionality. A total of 6,946 (on average 107 per hospital) medical equipment items were assessed, of which 5,232 (75.3%) were functional, while 1,070 (15.4%) were non-functional, 611 (8.8%) were non-installed, and 33 (0.5%) had incomplete accessories. Absence of a service manual was associated with a 55% less likely to be functional equipment with adjusted odds ratio 0.45 (95% CI: 0.36 to 0.55) and P value < 0.001. Similarly, lack of clinical user training was associated with a 64% less likely to be functional equipment with an adjusted odds ratio 0.36 (95% CI: 0.32 to 0.41) and P value < 0.001. Additionally, the absence of biomedical medical equipment technician training was associated with a 48% more likely to be a non-functional equipment with an adjusted odds ratio 1.48 (95% CI: 1.29 to 1.70) and P value < 0.001. The overall functionality of medical equipment items in public hospitals is suboptimal. A service manual, clinical user training, and biomedical medical equipment technicians training were key determinant factors of functionality. The finding has direct implication for health care providers, biomedical technicians, patients, policy makers and stakeholders. Hence, health care providers may not provide definitive diagnosis and treatment, hospitals would experience service interruption, and patients may merely receive only clinical therapy. We recommended that users and biomedical professionals receive maintenance training and proper documentation of user and service manuals could improve medical equipment functionality.