title: Availability and utilization of medical devices in Jimma zone hospitals, Southwest Ethiopia: a case study.
abstract: Health systems throughout the world, whether in developed or developing countries, are struggling with the challenge of how to manage health-care delivery in conditions of resource constraint. The availability and utilization of various health care equipments at all levels of the health care system has been emphasized for effective and efficient service delivery. In Ethiopia lack of proper management of medical equipment limited the capacity of health institutions to deliver adequate health care. The main objective of this study was to assess availability and utilization of medical devices and identify reported reasons that affect availability and utilization of medical devices among hospitals in Jimma Zone.
  
  
  
  A cross-sectional multiple case-study using mixed quantitative and qualitative methods was used. Three hospitals of Jimma Zone were included in the study. Adapted and pre-tested structured English version checklist for availability and utilization of medical equipment and document review as well as interview guide for in-depth interview were used for data collection. Data were collected by observation of availability of the devices, interviewing selected professionals and document review of health care services using devices in the study hospitals. Data were analyzed using SPSS 16.0 statistical software. Descriptive analysis was made to determine the availability and functional status of medical devices. For qualitative part responses were transcribed, categorized and thematically analyzed.
  
  
  
  Observation and interview using checklist showed that 299 medical devices were available in the three hospitals among which, 196 (65.6 %) of them were available in Jimma University Specialized Hospital whereas, 57 (19.0 %) and 46 (15.4 %) were available in Limu Genet hospital and Shenen Gibe hospital respectively. Among 196 available medical devices in JUSH, 127 (64.8 %) were functional and the rest; 63 (32.1 %) and 6 (3.1 %) were not functional and not in use respectively. Similarly, 28 (60.9 %) and 30 (52.6 %) of the devices in Shenen Gibe hospital and LGH respectively were functional.
  
  
  
  More than a third of medical devices in the three study hospitals were not functional. Purchasing devices with bids and preference for cheap price, lack of training on how to operate devices, less sense of accountability, power interruption, staff work overload and lack of maintenance experts, and inappropriate referral system were among the reported reasons for influencing availability and utilization of medical devices.
authors.affiliation: College of Health Sciences(CHS), Population and family Health Departement, Jimma University, Jimma, Ethiopia. beyenewondafrash@googlemail.com.
authors.forename: Beyene Wondafrash
authors.initials: BW
authors.lastname: Ademe
authors.affiliation: College of Health Sciences(CHS), Nursing Departement, Jimma University, Jimma, Ethiopia.
authors.forename: Bosena
authors.initials: B
authors.lastname: Tebeje
authors.affiliation: College of Medicine and health sciences, School of nursing, Bahirdar University, Bahirdar, Ethiopia.
authors.forename: Ashagre
authors.initials: A
authors.lastname: Molla
mesh_terms: D003430:Cross-Sectional Studies; D004864:Equipment and Supplies / Q000600:supply & distribution*; D005002:Ethiopia; D005260:Female; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D019982:Organizational Case Studies; D036301:Qualitative Research; D011795:Surveys and Questionnaires
keywords: Availability; Functionality; Medical devices; Southwest Ethiopia; Utilization