Background: The lack of adequate information about fever in low-resource settings, its unreliable self-assessment, and poor diagnostic practices may result in delayed care and under-or-overdiagnosis of diseases such as malaria. The mismatches of existing fever thermometers in the context of use imply that the diagnostic tools and connected services need to be studied further to address the challenges of fever-related illnesses and their diagnostics.
Objective: This study aims to inform a product-service system approach to design a reliable and accessible fever thermometer and connected services, as well as contribute to the identification of innovative opportunities to improve health care in low-resource settings.
Methods: To determine what factors impede febrile people seeking health care to access adequate fever diagnostics, a literature search was conducted in Google Scholar and PubMed with relevant keywords. Next, these factors were combined with a patient journey model to design a new product-service system for fever diagnostics in low-resource settings.
Results: In total, 37 articles were reviewed. The five As framework was used to categorize the identified barriers. The results indicate that there is a poor distribution of reliable fever diagnostic practices among remote communities. This paper speaks to the global public health and design communities. Three complementary considerations are discussed that support the idea of a more holistic approach to the design of fever diagnostics: (1) understanding of the fever diagnostics patient journey, (2) identifying user groups of the thermometers in a specific health care system, and (3) assessing different needs and interests of the different users.
Conclusions: Access to basic, primary health care may be enhanced with better information and technology design made through the involvement of system users.@en

Faced with large-scale wicked problems that include global warming, resource depletion, poverty and humanitarian emergencies, society needs new and more appropriate reasoning models. In particular, these problems pose unfamiliar challenges in contexts with poor financial and infrastructural resources. Systems-oriented design (SOD) is widely recognised as one promising approach that can support design engineers in addressing these complex societal problems. This paper explores the application of SOD in the development of product- service system (PSS) concepts by student teams in a multidisciplinary master course. The resulting twelve concepts were analysed using a case study approach and protocol analysis, describing the advantages and context- and process-related challenges of using SOD. From an educational perspective, the results demonstrate that while SOD provides students with a broad knowledge base and skills for addressing problems in complex societal contexts, there remains a need to introduce appropriate scope and depth to the design engineering curricula, making the transition from traditional product design a challenging one.@en

Purpose

– The purpose of this paper is to collect information about barriers and enablers experienced by international experts when transferring medical equipment to countries affected by humanitarian emergencies and to discuss the suitability of the principles of “openness”, “interconnections” and “non-linearity” of systems to understand the nature of the barriers and enablers as described by the international experts.

Design/methodology/approach

– In this study, six semi-structured interviews were conducted with experts from humanitarian organizations. The interviews were based on a simplified model of the transfer of medical equipment adapted from supply chain literature. The model ensured that all the process steps undertaken by humanitarian organizations were considered. Afterwards, the interviews were transcribed and structurally analysed to derive barriers and enablers. Finally, the results were described in light of three theoretical principles of systems thinking.


Findings

– In total, 14 types of barriers and 12 types of enablers were uncovered that illustrate the complexity of transferring medical equipment in humanitarian emergencies. The paper concludes with a proposal for future research to investigate if, and how, an approach guided by systems thinking could help to create a designated space for the formulation of original, synergetic solutions that address the identified barriers.


Originality/value

– This study is the first to explore the specific logistic challenges implicit in the transfer of medical equipment in humanitarian emergencies with a lifecycle perspective. Furthermore, the concept of systems thinking is rather novel in the field of transfer of medical technology.@en

Safety challenges related to the use of medical equipment were investigated during the training of nurse anaesthetists in Haiti, using a systems approach to Human Factors and Ergonomics (HFE). The Observable Performance Obstacles tool, based on the Systems Engineering Initiative for Patient Safety (SEIPS) model, was used in combination with exploratory observations during 13 surgical procedures, to identify performance obstacles created by the systemic interrelationships of medical equipment. The identification of performance obstacles is an effective way to study the accumulation of latent factors and risk hazards, and understand its implications in practice and behaviour of healthcare practitioners. In total, 123 performance obstacles were identified, of which the majority was related to environmental and organizational aspects. These findings show how the performance of nurse anaesthetists and their relation to medical equipment is continuously affected by more than user-related aspects. The contribution of systemic performance obstacles and coping strategies to enrich system design interventions and improve healthcare system is highlighted. In addition, methodological challenges of HFE research in low-resource settings related to professional culture and habits, and the potential of community ergonomics as a problem-managing approach are described.@en

This study focuses on the role of Systems Design in addressing the challenges of healthcare provision by international emergency relief organizations in developing countries. More specifically the challenges related to the safety and performance of medical equipment that is transferred in the aftermath of a humanitarian crisis. The aim of this paper is to describe the transfer of medical equipment and its associated challenges from a systems perspective and to reflect on the value of Systems Design as an approach to humanitarian innovation, addressing the identified systemic challenges. The concepts of Human Factors and Ergonomics, and Product-Service Systems will be presented as valuable contributions to support designers in handling a larger degree of complexity throughout the design process and to support them to make informed choices regarding this particular context.@en