Iterative Development and Verification of 37 Design Heuristics for the Design of Medical Devices for Low-Resource Settings

Abstract

Medical devices in low-resource settings are scarce and often become nonoperational after a short time, thus restricting health facilities from providing essential healthcare to patients. One major reason is that most devices are not designed for use in low-resource settings. Financial, infrastructure, and human resource constraints are not considered in the design process either due to lack of awareness or lack of guidance. This article develops and verifies a hands-on design method to communicate key challenges beyond affordability and guide designers to develop more appropriate devices for low-resource settings. First, an initial list of design heuristics is created to address previously identified key challenges for the use and maintenance of medical devices in resource-constrained settings. Second, 15 participants in Switzerland and Bolivia are involved in iterative improvements of the design heuristics through brainstorming sessions and discussions to reduce bias by including diverse perspectives. Finally, the updated list of 37 design heuristics is verified through an online survey with 45 participants who have experience with medical devices in diverse low- and middle-income countries, including medical, technical, and administrative staff. The results show that 93.3% of the respondents agree that it is important to design specifically for low-resource settings and 86.7% find the design heuristics helpful to achieve this. A ranking further shows that lowering the initial price of the device is not considered the most important. Finally, the proposed 37 design heuristics can be directly applied to design and adapt medical devices for low-resource settings.