Equipping a district hospital: the equipment list department by department

Equipping a district hospital is an exercise in trade-offs. Needs always exceed the budget, and the temptation is to spread the envelope evenly across departments. That is the mistake to avoid: a hospital works through care chains, and an incomplete chain produces nothing. One fully equipped theatre beats a theatre and an imaging department that are both half operational.

The three infrastructures to settle before any equipment

These items appear in no catalogue and determine everything else:

• Electrical supply: a correctly sized generator with automatic changeover, and UPS units on critical equipment. A theatre without power continuity is not a theatre.
• Medical gases: oxygen production or supply, distribution network, medical air, vacuum. See the medical gases category.
• Water and waste: reliable running water, treated water for sterilisation and the laboratory, and a clinical waste stream.

Equipment bought before these three chains are in place is equipment that will wait in its crate.

Emergency and reception

• Equipped crash trolleys, defibrillator, suction unit
• Multiparameter monitors, pulse oximeters, blood pressure monitors
• Mobile and fixed oxygen supply, adult and paediatric resuscitation bags
• Beds and examination trolleys, examination couches, mobile examination lights
• Minor surgery and suture sets, immobilisation material
• Syringe drivers and infusion pumps

See emergency and monitoring.

Operating theatre

• Operating table, main and satellite surgical lights
• Anaesthesia workstation with vaporisers and integrated monitoring
• Anaesthesia monitor, surgical suction, electrosurgery unit
• Instrument sets: general, gynaecology, caesarean section, basic orthopaedics
• Furniture: instrument tables, Mayo stands, bowl stands, stools
• Recovery room: beds, monitors, oxygen, suction

See operating theatre and anaesthesia and intensive care.

Sterilisation

This is the department that determines surgical activity, and the one most often undersized:

• A class B autoclave, sized on the theatre's peak workload
• Ultrasonic bath, pouch sealer, wrapping consumables
• A physically separated dirty/clean circuit, baskets and containers
• Water treatment for the autoclave
• Traceability consumables: Bowie-Dick tests, helix tests, biological indicators

See our guide to choosing an autoclave and the sterilisation category.

Maternity and neonatal care

• Delivery beds, examination lights
• Fetal monitoring, portable fetal doppler
• Ultrasound machine with convex and endocavity probes
• Newborn resuscitation tables, incubators, phototherapy lamps
• Neonatal suction, paediatric bags and masks, baby scales
• Caesarean section sets and suture material

See obstetrics and gynaecology and paediatrics.

Laboratory

• Biochemistry and haematology analysers, sized on real volume
• Microscopes, centrifuges, water bath, mixers
• Refrigerators and freezers with controlled, logged temperature
• Blood gas analyser where intensive care activity justifies it
• Microbiological safety cabinet, incubator, laboratory autoclave
• Consumables, reagents, controls and calibrators — with an opening stock

See our guide to choosing a laboratory analyser and the laboratory category.

Imaging

• Fixed radiography unit, with room shielding
• Digitisation system or film processor, depending on the technology chosen
• General-purpose ultrasound machine
• Mobile radiography unit, for wards and theatre
• Radiation protection: aprons, thyroid shields, dosimeters

See medical imaging and our guide to choosing an ultrasound machine.

Wards and outpatient clinics

• Hospital beds, pressure-relieving mattresses, overbed tables, drip stands
• Treatment and distribution trolleys, screens
• Wheelchairs and mobility aids
• Examination couches, viewing boxes, basic diagnostic kit per room
• Storage furniture and linen logistics

See patient rooms and mobility aids.

Three trade-off rules that change the outcome

1. Complete one chain before opening another. An operational theatre with sterilisation and recovery beats three partially equipped departments.
2. Budget the first year's consumables at purchase. An analyser without reagents and an autoclave without test consumables are decorative. Allow at least twelve months of consumables in the initial investment.
3. Standardise references. One model of monitor, syringe driver and bed across the hospital massively reduces maintenance cost, parts stock and training time.

And maintenance?

Plan it into the project, not after delivery: inventory from reception, service contracts negotiated at purchase, a stock of critical parts, and at least one person identified as responsible for the estate. See our guide to preventive biomedical maintenance.

On MedicalExpo Africa you can build your list by category and send a single quotation request to several distributors in your country. For larger acquisitions you can also publish a tender and let suppliers come to you.