Providing adequate healthcare in low- and middle-income countries (LMICs) faces significant challenges due to the frequent failure of medical devices, including hospital beds. These failures arise from environmental stressors, resource limitations, and design mismatches that fail to address the specific needs of LMIC settings. This thesis examines these challenges and develops a robust and modular solution tailored to these contexts, focusing on designing an appropriate backrest movement mechanism as a foundational component of a Universal Modular Hospital Bed.

Hospital beds are essential medical devices that provide quality patient care, comfort, and safety. However, existing designs often need to be more suitable for the harsh environmental conditions and resource constraints of LMICs, leading to high failure rates, compromised patient safety, and increased operational costs. This research addressed these gaps by designing a backrest movement mechanism that prioritizes durability, affordability, and contextual adaptability while laying the groundwork for a Universal Modular Hospital Bed suitable for diverse healthcare environments.

The study employs a comprehensive methodology integrating a systematic literature review, fieldwork, and a structured design process. The literature review identified key causes of medical device failures in low- and middle-income countries (LMICs), including environmental challenges, maintenance issues, and inadequate design considerations, which also apply to hospital beds. Fieldwork in Nepal, Suriname, and the Netherlands assessed hospital bed performance in different contexts. Drawing from these insights, a structured design process was used to generate, evaluate, and refine several concepts for a backrest movement mechanism. The chosen concept was then validated through prototyping and testing to ensure it met performance criteria, including robustness, safety, and ease of maintenance.

The research revealed that hospital beds in LMICs frequently fail due to high humidity, fluctuating temperatures, and unreliable infrastructure, compounded by limited access to spare parts and maintenance expertise. These challenges necessitate a context-sensitive design approach. The designed solution for the backrest movement mechanism employs a counterweight-based system that is manually operated, minimizing dependency on electricity and ensuring usability in resource-constrained settings. The design's modularity allows for easy maintenance, scalability, and integration with more advanced features, making it suitable for LMICs and high-income countries (HICs).

The backrest movement mechanism developed in this study addresses the critical challenges of hospital bed performance in LMICs. Its modular design ensures adaptability and compatibility with various healthcare settings, while its robust construction enhances durability and reduces maintenance costs. By focusing on local manufacturing and cost-effective materials, the design promotes accessibility and sustainability.

Future research should focus on scaling the modular design to incorporate additional features such as height adjustment and lateral movement systems. Collaborations with local manufacturers and healthcare providers are recommended to facilitate adoption and implementation. Long-term field testing will further validate the design’s efficacy and provide insights for continuous improvement. This study contributes significantly to developing medical devices that are both contextually appropriate and globally adaptable, addressing a critical gap in healthcare infrastructure in LMICs.