Facilitators and barriers to in vitro diagnostics implementation in resource-limited settings: A scoping review

Abstract

Low-and middle-income countries.Methods: This scoping review was guided by Arksey and O'Malley's methodological framework. A comprehensive keyword search for literature was conducted in Google Scholar, EBSCOhost, PubMed, Web of Science and ScienceDirect using the Boolean terms ('AND' and 'OR'), as well as Medical Subject Headings. The study considered published articles in the English language from 2016 to 2021 and was limited to qualitative, quantitative and mixed-method studies. Two reviewers independently screened the articles at the abstract and full-text screening phases guided by the eligibility criteria. Data were analysed qualitatively and quantitatively. Results:Of the 57 studies identified through literature searches, 16 met this study's eligibility criteria. Of the 16 studies, 7 reported on both facilitators and barriers; and the remainder reported on only barriers to POC test implementation such as inadequate funding, insufficient human resource, stigmatisation, et cetera. Conclusion:The study demonstrated a wide research gap in facilitators and barriers, especially in the general POC diagnostic test for use in health facilities without laboratories in the LMICs. Extensive research in POC testing service is recommended to improve service delivery.Contribution: This study's findings contribute to a few works of literature on existing evidence of POC testing.

Sustainable solutions to barriers of point-of-care diagnostic testing services in health facilities without laboratories in the Bono Region, Ghana: a qualitative study

“…Like Huddy et al’s study, this study found that POC testing provides rural practice with access to diagnostic investigations [ 20 ]. This study supported Martin et al’s study on facilitators and barriers to POC testing for sexually transmitted infections in LMICs, and Ansu-Mensah et al’s study on facilitators and barriers to in vitro diagnostics implementation in a resourced-limited setting which reported several barriers to POC testing implementation [ 16 , 17 ].…”

“…A qualitative study was employed following a quantitative study to explore the availability, stock levels, and usage of POC tests at the CHPS facilities in the rural areas of the Bono Region [5]. The region is one of the newly created regions in Ghana with few hospitals.…”

“…The significance of timely and accurate diagnostic testing cannot be overstated in the quest to provide effective healthcare services, particularly in resource-constrained settings. Point-of-care (POC) diagnostic testing promises to revolutionize healthcare delivery, particularly in regions where access to fully equipped laboratories is limited [1][2][3][4][5][6]. Ghana, like many other low-andmiddle-income countries, faces substantial challenges in providing accessible and efficient diagnostic services, particularly at the primary healthcare (PHC) level, often resulting in delayed diagnosis, mismanagement of diseases, and unnecessary referrals to higher-level healthcare facilities [7][8][9][10][11].…”

“…These POC diagnostics adhere to WHO quality-ASSURED (affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free, and deliverable) recommendations, and are essential for disease diagnosis and increasing access to healthcare in resource-limited settings [14,15]. Moreover, these POC diagnostics are essential and are one of the several vehicles of attaining the Universal Health Coverage (UHC) by 2030 [13,[16][17][18]. Despite this essential role of POC diagnostics in healthcare access, their effective implementation often faces barriers [19].…”

“…Whiles Kuupiel et [37,38]. However, our previous study that involved the Bono Region revealed poor availability and low stock level of POC diagnostic tests [5]. Recognising this research gap and the need to address the availability and accessibility of POC diagnostic services, we embarked on a comprehensive study aimed at identifying the barriers impeding the implementation of POC diagnostic testing in health facilities without laboratories within the Bono Region of Ghana.…”