Evaluating a computerized maintenance management system in a low resource setting.

This study documents the setup and roll-out of a Computerized Maintenance Management System (CMMS) in Burundi's resource constrained health care system between 1/04/2017 and 31/03/2020. First, in 2017 a biomedical assets ontology was created, tailored to the local health system and progressively mapped on international GMDN (Global Medical Devices Nomenclature) and ICMD (International Classification and Nomenclature of Medical Devices) classifications. This ontology was the cornerstone of a web-based CMMS, deployed in the Kirundo and Muramvya provinces (6 health districts, 4 hospitals and 73 health centers). During the study period, the total number of biomedical maintenance interventions increased from 4 to 350 per month, average corrective maintenance delays were reduced from 106 to 26 days and the proportion of functional medical assets grew from 88 to 91%. This study proves that a sustainable implementation of a CMMS is feasible and highly useful in low resource settings, if (i) the implementation is done in a conducive technical environment with correct workshops and maintenance equipment, (ii) the active cooperation of the administrative authorities is ensured, (iii) sufficient training efforts are made, (iv) necessary hardware and internet connectivity is available and (v) adequate local technical support can be provided.