Author:
Moturi Angela K,Robert Bibian N,Bahati Felix,Macharia Peter M,Okiro Emelda A
Abstract
Abstract
Background
Understanding the availability of rapid diagnostic tests (RDTs) is essential for attaining universal health care and reducing health inequalities. Although routine data helps measure RDT coverage and health access gaps, many healthcare facilities fail to report their monthly diagnostic test data to routine health systems, impacting routine data quality. This study sought to understand whether non-reporting by facilities is due to a lack of diagnostic and/or service provision capacity by triangulating routine and health service assessment survey data in Kenya.
Methods
Routine facility-level data on RDT administration were sourced from the Kenya health information system for the years 2018–2020. Data on diagnostic capacity (RDT availability) and service provision (screening, diagnosis, and treatment) were obtained from a national health facility assessment conducted in 2018. The two sources were linked and compared obtaining information on 10 RDTs from both sources. The study then assessed reporting in the routine system among facilities with (i) diagnostic capacity only, (ii) both confirmed diagnostic capacity and service provision and (iii) without diagnostic capacity. Analyses were conducted nationally, disaggregated by RDT, facility level and ownership.
Results
Twenty-one per cent (2821) of all facilities expected to report routine diagnostic data in Kenya were included in the triangulation. Most (86%) were primary-level facilities under public ownership (70%). Overall, survey response rates on diagnostic capacity were high (> 70%). Malaria and HIV had the highest response rate (> 96%) and the broadest coverage in diagnostic capacity across facilities (> 76%). Reporting among facilities with diagnostic capacity varied by test, with HIV and malaria having the lowest reporting rates, 58% and 52%, respectively, while the rest ranged between 69% and 85%. Among facilities with both service provision and diagnostic capacity, reporting ranged between 52% and 83% across tests. Public and secondary facilities had the highest reporting rates across all tests. A small proportion of health facilities without diagnostic capacity submitted testing reports in 2018, most of which were primary facilities.
Conclusion
Non-reporting in routine health systems is not always due to a lack of capacity. Further analyses are required to inform other drivers of non-reporting to ensure reliable routine health data.
Funder
Bill and Melinda Gates Foundation
Wellcome Trust
Wellcome Trust to the Kenya Major Overseas Programme
Wellcome Trust Intermediate Fellowship
Wellcome Trust Senior Fellowship
Royal Society Newton International Fellowship
Publisher
Springer Science and Business Media LLC
Reference51 articles.
1. Fleming KA, Horton S, Wilson ML, Atun R, DeStigter K, Flanigan J, Sayed S, Adam P, Aguilar B, Andronikou S. The Lancet Commission on diagnostics: transforming access to diagnostics. The Lancet. 2021;398(10315):1997–2050.
2. Catharina B, Madhukar P. Diagnostic Gaps in Global Health. https://www.thinkglobalhealth.org/article/diagnostic-gaps-global-health. Accessed August 2022.
3. Yadav H, Shah D, Sayed S, Horton S, Schroeder LF. Availability of essential diagnostics in ten low-income and middle-income countries: results from national health facility surveys. The Lancet Global Health. 2021;9(11):e1553–60.
4. Carter JY, Lema OE, Wangai MW, Munafu CG, Rees PH, Nyamongo JA. Laboratory testing improves diagnosis and treatment outcomes in primary health care facilities. Afr J Lab Med. 2012;1(1):1–6.
5. Wilson ML, Fleming KA, Kuti MA, Looi LM, Lago N, Ru K. Access to pathology and laboratory medicine services: a crucial gap. The Lancet. 2018;391(10133):1927–38.
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