Enhancing healthcare equity by using open-source pediatric medical devices in low resource settings: An exploratory international survey of pediatric clinicians

Abstract

Children in low-resource settings suffer from a high burden of treatable diseases that could be addressed with contextually appropriate technologies. However, numerous barriers to providing such technology to children in these settings exist. We propose that using open-source medical devices, where any qualified operator can freely make, modify, or distribute a product, may be a viable strategy to increase access to medical therapies in low-resource settings. However, given the novelty of open-source models, we sought to conduct an exploratory global survey on the perspectives and opinions of medical providers on the feasibility of this approach. Among 101 surveys completed by providers representing 34 countries, we found that the majority (89%) of respondents lacked experience working with open-source devices in low-resource settings; many respondents felt comfortable with providing an open-source pediatric medical device in a low-resource setting; lack of funding was the most significant barrier to successfully deploying these technologies; locally identified need was the most important factor to consider when conducting such projects; and respondents from the USA found no ethical issues with implementing open-source devices in low-resource settings, but respondents from outside the USA did find ethical issues with the same work. Our survey shows that most respondents in relevant specialties did not have experience working in either pediatric global health or with open-source medical devices in low-resource settings. Our survey may have revealed a potential unexplored frontier in addressing inequities in health care by enhancing access to equipment and technologies in areas of the world with the highest burdens of treatable pediatric disease, while also identifying ethical and cultural obstacles that warrant consideration.