Groundwork Toolkit: Assessing point-of-care diagnostics for resource-limited settings

How can healthcare delivery organizations evaluate whether to invest in or use a point-of-care diagnostic?
An MIT team present a framework developed during their project in rural in India

Following the completion of their Global Health Delivery Lab (ghdLAB) projects in Africa and India, we asked our MIT student teams to reflect on their ghdLAB project experience and share what they learned – insights, a how-to guide, best practice tips  – in ways that can be used by others undertaking similar work or facing similar issues in global health. We share their thoughts under the ‘management for the world’ (mftw) collection in the hopes that others will build on it in keeping with the creative commons license.

By Gabrielle Tiven, Lisa Frist, Michael Chang, Yechiel Engelhard

Point-of-care diagnostics are medical tools or devices that can diagnose disease in a patient’s community, generally outside of a formal clinic setting. By shifting disease diagnosis to the community level, POC diagnostics can save patients money (as they no longer have to travel to clinics), allow earlier diagnosis and expand access to previously under-served populations.

We provide a framework for healthcare delivery organizations in resource-limited settings to assess whether to use a given POC diagnostic. We suggest three steps:

  • First, identify the major disease burdens in the community and the major gaps in existing diagnostics. Only choose a given POC diagnostic if it responds to the needs of the community directly and effectively.
  • Second, understand whether the diagnostic is suitable for a resource-limited setting by assessing the diagnostic’s robustness, ease of use, accuracy and cost. We present a schematic for judging diagnostics on these criteria. Only choose the diagnostic if it is an improvement over the current method of diagnosis.
  • Lastly, consider whether the organization has the medical, financial, human and technology resources to adequately support the diagnostic and any required follow-up medical and support interventions.

To close, we present sample assessments of diagnostics for malaria and typhoid, as well as relevant selected resources.

Download Assessing point-of-care diagnostics for resource limited settings (pdf).

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