Abstract
BackgroundWorld Health Organization (WHO) has created an essential list of in-vitro diagnostics. Supply chain management (SCM) is said to be the vehicle that ensures that developed point-of-care (POC) tests reach their targeted settings for use. We therefore, mapped evidence on SCM of and accessibility to POC testing (availability and use of POC tests) in low- and middle-income countries (LMICs).MethodsWe conducted a systematic scoping review using Arksey and O’Malley’s framework as a guide. We searched PubMed; CINAHL; MEDLINE; WEB of Science; Science Direct; and Google Scholar databases for studies that focused on POC diagnostic tests and SCM. The review included studies that were undertaken in 140 countries defined by the World Bank as LMICs published up to August 2017. Two reviewers independently screened the abstracts and full articles against the eligibility criteria. The study used the mixed methods appraisal tool version 2011 to assess the risk of bias for the included studies. NVivo version 11 was employed to extract themes from all included studies and results presented using a narrative approach.ResultsOf 292 studies identified in this review, only 15 published between 2009 and 2017 included evidence on POC diagnostics and SCM. Of the 15 studies, three were conducted in Zambia, one each in Mozambique, Uganda, Guatemala; South Africa, one in Burkina Faso, Zimbabwe, and one multi-country study (Tanzania, Uganda, China, Peru and Zambia and Brazil). Six studies were not country specific since they were not primary studies. Majority of the studies reported stock-outs of HIV, syphilis, and malaria POC tests. There was a moderate to substantial level of agreement between the reviewers’ responses at full article screening stage (Kappa statistic = 0.80, p < 0.01). Nine studies underwent methodological quality appraisal and all, scored between 90 and 100%.ConclusionsThe results demonstrated limited published research on SCM of and accessibility to POC testing in LMICs. Further studies aimed at investigating SCM of POC tests in resource-limited settings to identify the barriers/challenges and provide a context-specific evidence-based solutions for policy/decision makers, implementers, and POC developers, funders, and development partners would be essential.PROSPERO registration numberCRD42016043711.
Highlights
World Health Organization (WHO) has created an essential list of in-vitro diagnostics
Identifying the research question The main review question was: What is the evidence on supply chain management and accessibility to POC testing services in low- and middle-income countries (LMICs)?
Reasons for the exclusion after full article screening were: one study was not conducted in a LMIC [27], two studies reported no evidence of both supply chain management or the primary outcomes of this study [28,29,30]; four studies reported no information for POC diagnostics [31,32,33,34]; three studies had undefined study setting [35,36,37] and; five studies reported laboratory-based POC testing [38,39,40,41,42]
Summary
World Health Organization (WHO) has created an essential list of in-vitro diagnostics. Safe and appropriate point-of-care (POC) testing is vital for routine care, early diseases, and monitoring of diseases [1]. A POC diagnostic tests refer to medical device used for detection, diagnosis, and monitoring of diseases at the POC or near where healthcare service is provided [2,3,4,5,6]. Access to POC testing services reduces test result turnaround times and facilitates prompt disease diagnosis and treatment initiation [6]. World Health Organization (WHO) encourages countries to establish their own essential diagnostic list based on the country’s disease burden and epidemiology to improve access to healthcare services [7]. Access to POC testing services can improve health outcomes in resourcelimited settings
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