The silent epidemic: Equipment maintenance failures and patient outcomes in Ghana's healthcare system

Abstract

Broken tools indicate a broken system. This new study reveals how medical equipment failures destroy Ghana's public hospitals, turning life-saving technologies into silent murderers that disproportionately affect rural areas. Moving beyond technical diagnostics, we study the cascading systemic failures, chronic underfunding, critical staff shortages, and fragmented supply chains that leave 40% of vital equipment, such as ventilators, MRI scanners, and dialysis machines, inoperable at any given time. We quantify the devastating human toll through rigorous mixed-methods analysis of equipment downtime records across ten regional hospitals (2018-2023) and profound narratives from 50 frontline stakeholders, doctors forced to improvise without working incubators, nurses rationing oxygen from failing concentrators, and administrators rationing scarce maintenance funds. Our findings show that equipment breakdowns increase surgical wait times by 72% and maternal mortality by 18% in rural institutions, where geographic isolation intensifies each failure. Crucially, we show how these flaws spread beyond clinical outcomes: they demoralize healthcare staff, damage public trust, and cause families to incur catastrophic costs through emergency referrals. Nonetheless, this catastrophe contains actionable hope. We demonstrate how Ghana's thriving technological entrepreneurship, from drone delivery networks to battery-swapping innovations, can be leveraged for long-term solutions. This study issues an urgent, evidence-based appeal for a National Medical Equipment Maintenance Fund and expanded biomedical technician training, illustrating how deliberate investment in maintenance infrastructure can save broken tools and construct a robust healthcare system. The moment has come to change maintenance from an afterthought to a cornerstone of health justice.