A procurement checklist for hospital equipment tenders in Kenya

A specification written too loosely — 'one ICU ventilator, adult use' — produces bids that cannot be compared. One bidder offers a transport ventilator, another a full ICU platform, and the evaluation committee is left comparing price against unstated capability. The cheapest compliant bid wins, and the unit is inadequate within a year.

A specification written too tightly, typically by copying a single manufacturer's datasheet, produces one compliant bidder. It may deliver the right machine, but it is difficult to defend on review and frequently costs more than an open specification would have.

The workable middle states clinical capability and performance ranges rather than model-specific features. 'Adult and paediatric ventilation with tidal volume adjustable from 15 mL' is a requirement several manufacturers can meet; 'tidal volume 15–300 mL in 1 mL increments, paediatric' describes one particular unit.

For a ventilator, the clinically meaningful requirements are patient range, ventilation modes, monitoring parameters, battery endurance and gas requirements. A current-generation ICU ventilator, for instance, covers adult tidal volume 100–2200 mL and paediatric 15–300 mL, offers eleven ventilation modes including PRVC and APRV, and provides high-flow oxygen therapy up to 210 L/min — a specification that can be expressed as minimum requirements without naming the model.

For an anaesthesia workstation, the equivalent requirements are patient range, minimum deliverable tidal volume, mode set and fresh gas control. A theatre listing paediatric cases needs low tidal volume capability stated explicitly — a current workstation may deliver from 5 mL in PCV mode — because a workstation that cannot ventilate an infant safely is unusable for that list regardless of its other capabilities.

Evaluating on purchase price alone reliably selects the wrong equipment for consumable-dependent categories. An analyser with a low capital cost and expensive proprietary reagents costs more over five years than a dearer instrument with reasonably priced consumables.

Require bidders to state the price of consumables and reagents per test, the cost of an annual maintenance contract, and the price of the parts most commonly replaced. Evaluated over a five-year horizon, the ranking often changes.

Ask bidders to state, and evidence, the number of engineers they employ locally who are trained on the specific equipment, the spare parts held in country, the guaranteed response time for a fault, and the number of that model already installed and supported nationally.

These are verifiable claims, and they discriminate between suppliers far more usefully than price does. A supplier with an installed base and a parts inventory can support the equipment; one importing against each order cannot promise the same response.

For public and donor-funded procurement, the compliance file usually needs a manufacturer authorisation letter naming the bidder for that tender, regulatory registration where applicable, an itemised quotation with unit prices and lead times, warranty terms in writing, and the installation and training scope stated as deliverables rather than assumed.

Requesting these at bid stage rather than at award prevents the delays that follow when a successful bidder cannot produce authorisation from the manufacturer.

Delivery is not commissioning, and commissioning is not training. Where these are not written into the contract as deliverables with acceptance criteria, they tend to be delivered thinly or not at all.

State that payment milestones depend on documented installation, acceptance testing against manufacturer criteria, and completion of operator training with an attendance record. This is standard practice and it protects both parties.