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A recent publication on accessibility and availability of point of care diagnostics in rural PHC clinics in South Africa.

By Tivani Mashamba-Thompson | 31 May, 2018

Abstract
Background: The World Health Organization (WHO) called for new clinical diagnostic for settings with limited access to laboratory services. Access to diagnostic testing may not be uniform in rural settings, which may result in poor access to essential healthcare services. The aim of this study is to determine the availability, current usage, and need for point-of-care (POC) diagnostic tests among rural primary healthcare (PHC) clinics in South Africa’s KwaZulu-Natal (KZN) province.

Methods: We used the KZN’s Department of Health (DoH) clinic classification to identify the 232 rural PHC clinics in KZN, South Africa. We then randomly sampled 100 of 232 rural PHC clinics. Selected health clinics were surveyed between April to August 2015 to obtain clinic-level data for health-worker volume and to determine the accessibility, availability, usage and need for POC tests. Professional healthcare workers responsible for POC testing at each clinic were interviewed to assess the awareness of POC testing. Data were survey weighted and analysed using Stata 13.

Results: Among 100 rural clinics, the average number of patients seen per week was 2865 ± 2231 (range 374–11,731). The average number of POC tests available and in use was 6.3 (CI: 6.2–6.5) out of a potential of 51 tests. The following POC tests were universally available in all rural clinics: urine total protein, urine leukocytes, urine nitrate, urine pregnancy, HIV antibody and blood glucose test. The average number of desired POC diagnostic tests reported by the clinical staff was estimated at 15 (CI: 13–17) per clinic. The most requested POC tests reported were serum creatinine (37%), CD4
count (37%), cholesterol (32%), tuberculosis (31%), and HIV viral load (23%).

Conclusion: Several POC tests are widely available and in use at rural PHC clinics in South Africa’s KZN province. However, healthcare workers have requested additional POC tests to improve detection and management of priority
disease conditions.

Attached resource:

Replies

 

Kathleen England Replied at 1:22 PM, 31 May 2018

Thank you for sharing. This is exactly the kind of deep dive data mining needed to understand gaps and needs for regional and national programs. I think this type of assessment goes along with the "Essential Diagnostics List" that every country needs to develop. However, we also need to assess what tests are performed at the other levels of care as well. I hope this type of operational research continues in order for every country to truly assess diagnostic access, needs and gaps in the healthcare system.

Tivani Mashamba-Thompson Replied at 3:32 PM, 31 May 2018

Dear Kathleen,

Thank you for your response Kathleen and your suggestion for future research is acknowledged.
Kind regards,
Tivani

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