A sustainability evaluation of a biomedical technician training program in Honduras

Engineering World Health (EWH) developed and executed a unique model to train biomedical technicians (BMET) in Rwanda, Honduras, and Cambodia. This model significantly decreased out-of-service equipment, one to two years after the training’s initiation, when comparing hospitals with EWH trained BMETs to similar hospitals with BMETs without EWH training [1–4]. Despite this model’s past evidence of impact, no study has shown evidence for sustained impact and continued delivery of services after the termination of funding. Here, one year after external funding ended for the EWH Honduras program, the model’s sustainability was assessed using qualitative interviews guided by an established sustainability framework and quantitative measures of continued impact on out-of-service rates of medical equipment. Interviews found the program, institutionalized within a technical training college, was strongly sustainable in each domain of an established sustainability framework. Additionally, there was evidence of continuing production of benefits to the health system. Technicians whose training through EWH had ended two years earlier had 35.37% less out-of-service equipment compared to similarly sized control hospitals, demonstrating continued impact of training (p <.0001). Overall, the program in Honduras was found to be strongly sustainable, albeit with some threats to continued sustainability.