This is a lay summary of the article published under the DOI: 10.1007/978-3-319-91068-0_7
Point-of-care (POC) refers to healthcare tests that are done in the same place where the patient receives care, rather than sending patient samples away to a laboratory for testing.
South Africa and India don’t deliver fast and efficient testing because of their poor POC systems and labs.
POC testing allows patients to have access to fast testing with quick results for the treatment and management of diseases. This can be done with relatively cheap and simple machines that can give test results quickly without having to take the samples to labs. But there are many challenges in POC that slow down patient care in South Africa and India.
The authors wanted to compare POC testing in South Africa and India so that they could identify problems.
They held interviews and group meetings with healthcare workers, patients and medical device companies from September, 2012, to June, 2013, in both countries. They asked about POC processes and problems.
In public healthcare, India uses multiple small labs and do basic tests, but their labs are not given enough money, so they don’t have enough materials to do the testing. Patients are often told to come back on another day or to go somewhere else, which causes problems for the patients.
The researchers also noticed that sometimes patients are tested but it takes long for the results to come back, and they find it hard to get in touch with their doctor afterwards.
The participants said that there should be more labs in hospitals, and that testing could be done at the same place where patients enter. They also said that follow-ups, treatments or counselling should also happen at the same place.
In South Africa, they found that in public healthcare, 1 company handles all the testing, so the samples go to this company. Some basic tests are done at the point of care, and the patients do get the results quickly.
HIV and TB tests take longer and so follow-ups or treatments are also delayed. Other delays are because of transport, incorrect spelling of patients’ names, mislabelling of samples, and the breakdown of computer systems.
For HIV testing, some labs used different methods of testing, and this gives unreliable results. They found that patients try to get HIV testing based on the distance to the site or the type of test, and because of this they sometimes use a different identity card, which causes problems when trying to get follow-up meetings.
The researchers suggested that healthcare workers must work together to share the workload. They said when new HIV testing kits come in, workers should be re-trained and that systems must be updated.
The authors compared the POC data from both countries and they suggested that authorities must look at POC properly before adding new products or devices. They also said more effort needs to be put into dealing with the workloads in the labs and understanding the role that a patient plays in their own healthcare.
The authors of this paper were from South Africa, India, Canada and the Netherlands.
Point of care (POC) testing in communities, home settings, and primary healthcare centers is believed to have tremendous potential in reducing delays in diagnosing and initiating treatment for diseases such as HIV, tuberculosis, syphilis, and malaria. Quick diagnosis and further management decisions completed in the same clinical encounter or at least the same day, while the patient waits, promise to overcome delays associated with conventional laboratory-based testing. However, the availability of cheap, simple, and rapid tests that can be conducted outside laboratories does not automatically ensure successful POC testing. In order to understand the new roles and challenges medical devices such as these encounter, we need to study how diagnostics are used at the POC and integrated into workflow and patient pathways. This chapter reviews selected results from a qualitative research project on barriers to POC testing in India and South Africa and discusses them comparatively. The project used semi-structured interviews and focus group discussions to examine diagnostic practices across major diseases and actors in homes, clinics, communities, hospitals, and laboratories in South Africa and India. In comparing selected results, it becomes clear that both countries have very different diagnostic eco-systems that provide very different conditions for POC testing. The chapter concludes by reflecting on how to take such insights into account when designing POC testing programs.
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