Introducing a national essential diagnostics list in India

Vijay, Sonam; Gangakhedkar, Raman; Shekhar, Chander; Walia, Kāmini

doi:10.2471/blt.20.268037

Cited by 9 publications

(9 citation statements)

References 8 publications

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“…Unfortunately, despite the availability of many indigenously developed rapid tests for pathogen identification or AMST in the country, none were ready to be included in the Indian NEDL and FDI list. 22 Developers have done well at focusing on UTI and sepsis as both the syndromes warrant excessive antimicrobial use, in community and in hospitals/ICUs, respectively. Although the diagnostics developed addressed the important syndromes and pathogens relevant to India, 23 24 they also missed important country specific requirements.…”

Section: Discussionmentioning

confidence: 99%

Understanding complexities in the uptake of indigenously developed rapid point-of-care diagnostics for containment of antimicrobial resistance in India

et al. 2021

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A good point-of-care diagnostic test holds a promise to reduce inappropriate use of antibiotics by enabling early detection of the pathogen and facilitating rapid testing of antimicrobial susceptibility. India has taken many initiatives in the recent past to augment the development and deployment of diagnostics in Indian health care system. Funding opportunities to promote innovation in diagnostics development were started in early 2000s through various ministries and departments. India released National Essential Diagnostics List which enlists essential tests and there is now Free Diagnostics Service Initiative of Government of India under National Health Mission that mandates to provide all essential tests free of cost. We wanted to understand how these initiatives have impacted the diagnostics that could be of use in containment of antimicrobial resistance (AMR) and whether there is a smooth process for bringing indigenously developed products relevant to AMR into the healthcare system. We conducted a longitudinal survey (January 2019 and January 2021) to understand the availability of market ready indigenous rapid diagnostics for AMR in the country and their progress towards introduction in the private market or uptake in healthcare system. We found that many innovators and developers are working towards development of rapid tests that can be useful in the containment of AMR in India. While there are many promising diagnostics on the horizon, the pathway for uptake of indigenously developed diagnostics in healthcare system remains disjointed and needs to be harmonised for the investments made towards development to translate as tangible gains. Since most of these efforts are government funded, it is incumbent upon the government to also provide a seamless pathway to make these diagnostics available in health care system. In absence of this guidance, most of these diagnostics will sit with the innovators/developers and will never be used for the purpose they were intended to serve.

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Section: Discussionmentioning

confidence: 99%

Understanding complexities in the uptake of indigenously developed rapid point-of-care diagnostics for containment of antimicrobial resistance in India

et al. 2021

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“…Insufficient access to essential in-vitro diagnostics is a major global health challenge, and nearly half (47%) of the global population have little to no access to diagnostics 3 . The scale and scope of this challenge contribute to delay in diagnosis and initiation of appropriate treatment compromising health outcomes, especially in Africa [3][4][5][6][7][8][9][10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Implementing essential diagnostics-learning from essential medicines: A scoping review

Nyanchoka

Mulaku

Nyagol

et al. 2022

Preprint

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Background The World Health Organization (WHO) model list of Essential In vitro Diagnostic (EDL) introduced in 2018 complements the established Essential Medicines List (EML) and improves its impact on advancing universal health coverage and better health outcomes. We conducted a scoping review of the literature on the implementation of the WHO essential lists in Africa to inform the implementation of the recently introduced EDL. Methods We searched eight electronic databases for studies reporting on the implementation of the WHO EDL and EML in Africa. Two authors independently conducted study selection and data extraction, with disagreements resolved through discussion. We used the Supporting the Use of Research Evidence (SURE) framework to extract themes and synthesized findings using thematic content analysis. We used the Mixed Method Appraisal Tool (MMAT) version 2018 to assess the quality of included studies where applicable. Results We included 172 studies reporting on EDL and EML after screening 3,813 articles titles and abstracts and 1,545 full-text papers. Most (75%, n=129) included studies were purely quantitative in design comprising descriptive cross-sectional designs (60%, n=104), 15% (n=26) were purely qualitative, and 10% (n=17) had mixed-methods approaches. There were no qualitative or randomised experimental studies about the EDL. The main barrier facing the EML and EDL was poorly equipped health facilities - including unavailability or stock-outs of essential in vitro diagnostics and medicines and inadequate infrastructure to enable health service delivery. Financial and non-financial incentives to health facilities and workers were a key enabler to the implementation of the EML however, their impact differed from one context to another. Fifty-six (33%) of the included studies were of high quality. Conclusions The EDL implementation at the national level can learn from health system interventions to improve the availability and supply of essential medicines such as financial and non-financial incentives in different contexts.

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“…Insufficient access to essential in-vitro diagnostics is a major global health challenge, and nearly half (47%) of the global population have little to no access to diagnostics [3]. The scale and scope of this challenge contribute to delays in diagnosis and initiation of appropriate treatment compromising health outcomes, especially in Africa [3][4][5][6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Implementing essential diagnostics-learning from essential medicines: A scoping review

Nyanchoka

Mulaku²,

Nyagol³

et al. 2022

PLOS Glob Public Health

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The World Health Organization (WHO) model list of Essential In vitro Diagnostic (EDL) introduced in 2018 complements the established Essential Medicines List (EML) and improves its impact on advancing universal health coverage and better health outcomes. We conducted a scoping review of the literature on implementing the WHO essential lists in Africa to inform the implementation of the recently introduced EDL. We searched eight electronic databases for studies reporting on implementing the WHO EDL and EML in Africa. Two authors independently conducted study selection and data extraction, with disagreements resolved through discussion. We used the Supporting the Use of Research Evidence (SURE) framework to extract themes and synthesised findings using thematic content analysis. We used the Mixed Method Appraisal Tool (MMAT) version 2018 to assess the quality of included studies. We included 172 studies reporting on EDL and EML after screening 3,813 articles titles and abstracts and 1,545 full-text papers. Most (75%, n = 129) studies were purely quantitative in design, comprising descriptive cross-sectional designs (60%, n = 104), 15% (n = 26) were purely qualitative, and 10% (n = 17) had mixed-methods approaches. There were no qualitative or randomised experimental studies about EDL. The main barrier facing the EML and EDL was poorly equipped health facilities—including unavailability or stock-outs of essential in vitro diagnostics and medicines. Financial and non-financial incentives to health facilities and workers were key enablers in implementing the EML; however, their impact differed from one context to another. Only fifty-six (33%) of the included studies were of high quality. Poorly equipped and stocked health facilities remain an implementation barrier to essential diagnostics and medicines. Health system interventions such as financial and non-financial incentives to improve their availability can be applied in different contexts. More implementation study designs, such as experimental and qualitative studies, are required to evaluate the effectiveness of essential lists.

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Introducing a national essential diagnostics list in India

Cited by 9 publications

References 8 publications

Understanding complexities in the uptake of indigenously developed rapid point-of-care diagnostics for containment of antimicrobial resistance in India

Understanding complexities in the uptake of indigenously developed rapid point-of-care diagnostics for containment of antimicrobial resistance in India

Implementing essential diagnostics-learning from essential medicines: A scoping review

Implementing essential diagnostics-learning from essential medicines: A scoping review

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