Equipment Maintenance in Primary and Secondary Healthcare, Punjab

Healthcare systems and, more specifically, public sector healthcare systems are complex hierarchical entities. Delivering quality healthcare services is a challenging task facing several key hurdles. Equipment maintenance and availability is one of the key issues since the non-functionality of medical equipment degrades service provision in public sector hospitals. In this case, we discuss the situation of primary and secondary healthcare services in Punjab, Pakistan, focusing on the current condition of equipment functionality and maintenance across thirty-six districts of Punjab. The healthcare sector in Punjab is organized in a tiered manner, with primary health care facilities providing basic medical services to the masses and secondary healthcare facilities providing referral and specialized services to the patients. Providing medical services requires an efficient network of medical professionals, adequate medical equipment, physical infrastructure and sufficient supply of medicines at all levels of the healthcare system. This case identifies and discusses the issue of non-functionality and maintenance of medical equipment in Punjab. Demand for medical equipment is generated on a central and district level, followed by a combination of central- and facility-level procurement. Maintenance of equipment is done by the facility without any standard operating procedures. The purpose of this case is to observe the current maintenance options in practice and to assess the impact of a decentralized maintenance system on the functionality status of biomedical equipment across districts. The objective is also to highlight the need for an efficient maintenance regime in accordance with the nature of the equipment to ensure cost and downtime minimization.