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Please see this new qualitative study by Nora Engel and colleagues on strategies to make HIV testing work at point of care in South Africa.https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2353-6BestMadhu
I like this paper.It speaks directly to a number of issues and concerns raised by a several participants (including me) at the recent GHDx workshop regarding POC disruption. The paper rightly points out that a significant amount of attention is given to POC feasibility, acceptability and related factors - which is important, but much less detail is available about the pragmatic realities of POC implementation and sustainability. I should also point out that this type of disruption is not just the domain of LMIC in my experience and can also occur when the "rubber needs to hit the road" in other settings. It seems to me there is value in having an simple "Essential Diagnostics Implementation and Monitoring Check List" or toolkit (if one does not exist already). Perhaps this could accompany the anticipated "Essential Diagnostics List" to be identified by the SAGE IVD Advisory Group and act -in part at least - as a potential agent of change. This list would allow new services to carefully pre-assess there preparedness to offer POC testing and be in a better position to sustain it they can anticipate some of the common challenges/distruptions ahead. The checklist/toolkit could easily apply to both RDT and portable Molecular Point of Care (MCOP) platforms given implementation issues between the two are often similar and simply be adapted or added to where they differ (such as the need for mains, solar or battery back up power etc.).