Achieving appropriate design and widespread use of health care technologies in the developing world. Overcoming obstacles that impede the adaptation and diffusion of priority technologies for primary health care.

OBJECTIVES To identify and describe constraints facing the development and dissemination of technologies appropriate for public health care challenges and solutions in the developing world. METHODS Review of lessons learned in development and introduction of numerous health technologies as experienced by a non-profit organization working on technologies for 25 years. RESULTS Many obstacles prevent appropriate technologies from reaching widespread use and acceptance. These include low profit margins in developing world markets, regulatory constraints, and the need for systems changes. Strong public/private-sector partnerships and realistic approaches to working in these environments make a difference. CONCLUSIONS There is a growing awareness of the need for new technologies and experience with strategies that can make them happen. Some technologies with documented value for maternal care in developing world settings appear to be stuck short of widespread acceptance and use. Understanding the factors impeding their progress can enable the public sector and its collaborators to organize and facilitate their progress more effectively.