Health care workers' perceptions of point-of care testing in a low-income country -A qualitative study in Southwestern Uganda
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Date
2017-07-27Author
Rasti, Reza
Nanjebe, Deborah
Karlstrom, Jonas
Muchunguzi, Charles
Amumpaire, Juliet Mwanga
Gantelius, Jesper
Mårtensson, Andreas
Rivas, Lourdes
Galban, Francesc
Reuterswa, Philippa
Svahn, Helene Andersson
Alvesson, Helle M.
Boum, Yap
Alfven, Tobias
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Background
Point-of-care (POC) tests have become increasingly available and more widely used in recent years. They have been of particular importance to low-income settings, enabling them with clinical capacities that had previously been limited. POC testing programs hold a great potential for significant improvement in low-income health systems. However, as most POC tests are developed in high-income countries, disengagement between developers and end-users inhibit their full potential. This study explores perceptions of POC test end-users in a low-income setting, aiming to support the development of novel POC tests for low-income countries.
Methods
A qualitative study was conducted in Mbarara District, Southwestern Uganda, in October 2014. Fifty health care workers were included in seven focus groups, comprising midwives, laboratory technicians, clinical and medical officers, junior and senior nurses, and medical doctors. Discussions were audio-recorded and transcribed verbatim. Transcripts were coded through a data-driven approach for qualitative content analysis.
Results
Nineteen different POC tests were identified as currently being in use. While participants displayed being widely accustomed to and appreciative of the use of POC tests, they also assessed the use and characteristics of current tests as imperfect. An ideal POC test was characterized as being adapted to local conditions, thoughtfully implemented in the specific
health system, and capable of improving the care of patients. Tests for specific medical conditions
were requested. Opinions differed with regard to the ideal distribution of POC tests in the local health system.
Conclusion
POC tests are commonly used and greatly appreciated in this study setting. However, there are dissatisfactions with current POC tests and their use. To maximize benefit, stakeholders need to include end-user perspectives in the development and implementation of POC tests. Insights from this study will influence our ongoing efforts to develop POC tests that will be particularly usable in low-income settings. characterized as being adapted to local conditions, thoughtfully implemented in the specific
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