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FYI, Most Medical Devices Are Not Designed For Most People

Written by: Elizabeth Johansen (from Spark Health Design) and Beth Loring (from Loring HF)


Health is an internationally-recognized, fundamental, human right. However, only 13% of the global population accounts for 76% of the global medical device use, illustrating inequitable healthcare access in favor of high-resource settings (Arasaratnam & Humphreys 2013). This means most medical devices are not designed for most people. As human factors professionals, it is heart-wrenching to realize the work we do benefits the few instead of the many.

In low- and middle-income countries (LMICs), medical devices go unused because they were not designed for the uses, users, and contexts for those settings. We believe human factors and usability engineering practitioners can play a critical role in delivering equitable access to medical technology worldwide.

In March of 2023, we gave a presentation at the 2023 HFES International Symposium on Human Factors and Ergonomics in Healthcare explaining how an international consortium used human-centered design and human factors engineering methods to develop an open-access report titled, “Design for Oxygen Concentrator Usability in Under-Resourced Settings: An evidence-based guide to designing oxygen concentrators, humidifier bottles, and flow splitters to address the oxygen gap in healthcare settings in low and middle-income countries.” You can download the report for free here.

Our presentation described how we created the consortium, collaborated to promote human factors capacity building in Nigeria and Kenya, and lessons learned from our partners Oxygen for Life Initiative and Center for Public Health and Development about the process and the value of conducting usability evaluations in LMICs.

We plan to continue this type of work and call on all HF/UE practitioners to join us. We’re hoping the oxygen concentrator model can be used to improve other medical devices used in LMICs. If you would like to get involved, reach out to us!

Image: most medical devices are not designed for most people
Slide from Elizabeth and Beth's presentation from the 2023 HFES Symposium


To learn more:

Johansen, E., Bakare, A.A., Sogbesan, A., Olojede, O., Bakare, D., Mate, M., Eleyinmi, J., Kendi, C., Njuguna, M., Onyango, E., Olatunde, O., Loring, B., Gheorghe, F., Ruddick, L., Subbaraman, K., Graham, H., Olayo, B., Falade, A.G. (2022). Design for Oxygen Concentrator Usability in Under-Resourced Healthcare Settings. Spark Health Design, Oxygen for Life Initiative, and Center for Public Health and Development.

PATH. (n.d.). COVID-19 Oxygen Needs Tracker. Retrieved September 19, 2022, from

Patnaik, P. (2021, Nov 05). COVID-19 Oxygen Needs in Low- and Middle-Income Countries Have Tripled in Just Three Months – Where are Solutions?. Health Policy Watch.

United Nations Children’s Fund and NEST 360. (2022, April). Target product profile: resilient oxygen concentrator (2nd Ed.). https://www.

World Health Organization and the United Nations Children’s Fund. (2019). WHO-UNICEF technical specifications and guidance for oxygen therapy devices (ISBN 978-92-4-151691-4).


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