Contexts for developing of national essential diagnostics list. Lessons from a mixed-methods study of existing documents, stakeholders and decision making on tier-specific essential in-vitro diagnostics in African countries

Author:

Koster WinnyORCID,Mutegi Elishebah MarutaORCID,Ocen FrancisORCID,Odhiambo Collins OtienoORCID,Waweru Maina Michael,Ndione Albert Gautier,Yerra Sri Lakshmi Priyanka,Grunwald Jenny L.ORCID,Mack Delores,Kao KekeletsoORCID,Perrone Lucy A.ORCID,Ondoa Pascale

Abstract

Since 2019, the WHO recommends the development and implementation of National Essential Diagnostics List (NEDL) to facilitate availability of In-Vitro Diagnostics (IVDs) across the various tiers of the healthcare pyramid, facilities with or without a laboratory on-site. To be effective, the development of NEDL should take into consideration the challenges and opportunities associated with current modalities for organization of tier specific testing services in-country. We conducted a mixed-methods analysis set out to explore available national policies, guidelines and decision-making processes that affect accessibility of diagnostics in African countries; 307 documents from 48 African countries were reviewed and 28 in-depth (group) interviews with 43 key-informants in seven countries were conducted between June and July 2022. Of the 48 countries, Nigeria was the only one with formal NEDL. Twenty-five countries had national test menus (63% outdated, from 2015 or earlier) all specifying tests by laboratory tier (5 including the “community tier”), with additional details on equipment (20), consumables (12), and personnel requirements (11). The most popular criteria to select essential IVDs in the quantitative analysis relate to specificities of the tests, whereas in the qualitative study most mentioned were health care and laboratory contextual factors. Quality assurance and waste management for tests at “community tier” were highlighted as concerns by all the respondents. Additional barriers to implementation included the low decision-making power of Laboratory Directorates within the Ministry of Health, as well as the chronic budgetary gaps for clinical laboratory services and policy and strategic plan development outside of vertical programmes. Four countries out of seven would rather revise their test menus by updating them and add ‘‘community tier”, than developing a separate NEDL, the former being considered more operational. This study provides a unique set of practical recommendations to the process of development and effective implementation on NEDL in Africa.

Funder

FIND Australian Government award

Publisher

Public Library of Science (PLoS)

Reference23 articles.

1. The Lancet Commission on diagnostics: transforming access to diagnostics;KA Fleming;Lancet,2021

2. Yadav P. Supply chain issues in diagnostics. ASLM Special Session 2, Bringing the Diagnostics That Count into Routine Testing Services, ASLM, 10th Anniversary. 2021. https://aslm.org/wp-content/uploads/2022/06/ConferenceReport2021-SinglePage-2022-06-13-WebQuality.pdf?x58863

3. Availability of essential diagnostics in ten low-income and middle-income countries: results from national health facility surveys;H Yadav;The Lancet Global Health,2021

4. National laboratory policies and plans in sub-Saharan African countries: gaps and opportunities;P Ondoa;Afr. J. Lab. Med,2017

5. Boosting quality diagnostics could give Africa better health;L Greenslade;The Lancet,2019

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3