Insufficient technical understanding, poor selection and poor planning result in procurement of X-ray equipments that breakdown quickly. Some guidelines are given in this article for planning and procuring x ray equipment for district level hospitals. First of all, it is essential to have an X-ray room and a dark room ready before ordering the equipment. Otherwise, the equipment would lie in the sun and moisture leading to early repairs. The X-ray room should be at least 16 feet 20 feet with a ceiling height of 10 16 feet. It should be painted with light shade of colour. Wooden panel shutters are advisable. Flourescent light is not recommended as it leaves an after glow. Dark room should be adjacent to X-ray room with light tight windows and an exhaust. Powerline also should be ready before equipment is ordered. It is extremely important to check the voltage drop and electrical requirements of the equipment before ordering. It is better to order a machine which can tolerate a higher voltage drop as it will function more reliably under poor line conditions than the one which tolerates only a low voltage drop.

This paper highlights some of the Technical, Economical and Operational problems encountered in 1955 60 when the National Tuberculosis Programme was being evolved wherein considerable importance was laid on diagnosis of patients using mass miniature radiography. Technological imperfections seen were: 1) High breakdown rates of X-ray units 2) Though power supply was available, the quality of powerline was such that X-ray could not work satisfactorily in 75% of them. Moreover, running cost of X-ray unit when using petrol generator was very high. This can be reduced by connecting the unit to power supply. Reduced sensitivity and specificity of the X-ray is another operational deficiency. The number of suspects diagnosed was 7 times the actual number of cases and probably 60% of cases were being missed also.

In order to solve these problems, the suggestions given were 1) X-ray equipment capable of working from low capacity powerlines without loss in standard of performance is desirable. 2) Flouroscopic image intensifiers using solid state panels which are easy to operate and maintain can probably improve the reliability of flouroscopic examinations without increasing the radiation dose. 3) Electronic contrast enhancement of films are possible and this could improve the diagnostic reliability. Research is needed to improve contrast perceptibility without increase in radiation.