The sustainability of Point-of-Care (POC) diagnostic services in low and middle income countries is dependent on a lean and agile quality management system, according to a study conducted by UKZN’s School of Nursing and Public Health student, Ms Nobuhle Dwayisa.
Titled: “Lean and Agile Point-of-Care Diagnostic Services Quality Systems Management for Low- and Middle-Income Countries”, Dwayisa’s research discusses quality indicators for diagnostic tests in relation to the defined quality-Assured criteria for POC diagnostics in resource-limited settings.
‘The study is an evaluation of the quality management system of POC testing in primary health care clinics,’ said Dwayisa.
The aims of the research were to conduct an audit of the most universally used POC diagnostic test in rural primary healthcare clinics in KZN - the HIV rapid test - and to determine if any deficiencies existed in the quality management systems for primary health care clinic-based HIV rapid testing services.
Revealed in the study was that although the majority of the primary healthcare institutions that were audited showed high levels of adherence to recommended World Health Organization (WHO) guidelines for quality management systems of POC diagnostics, there is still a lot of room for improvement in order to provide quality POC diagnostic services in such settings.
‘The main goal of clinical activities such as POC diagnostic services are to provide the highest quality service, given the resources available,’ said Dwayisa.
She believes contextualising the implementation of POC diagnostics is one of the key elements in ensuring the effectiveness and sustainability of these services.
‘The regulation of POC diagnostic testing using appropriate quality management systems is imperative to control and support all testing processes in order to ensure the reliability of results for users,’ said Dwayisa.
The World Health Organization stipulates a set of criteria for POC diagnostics in rural and resource-limited settings. These are known as quality-Assured criteria which involve affordability, sensitivity, specificity, user-friendly, rapid and robust, equipment, free and deliverable to those who need it.
‘These results could help improve the quality of POC diagnostic testing in primary healthcare clinics in rural areas and thus improve healthcare in those areas,’ she said. She believes her results could also bring awareness regarding any possible deficiencies in POC diagnostic testing that is conducted within primary health care clinics and as such help to improve the quality of POC testing in those institutions.
Dwayisa had to overcome a number of challenges as she had to study and work full time; ‘Working and studying full time in my final year was challenging. There were times I felt I couldn’t carry on but the Lord was with me and helped me pull through. I was also blessed with an amazing supervisor in Dr Tivani Mashamba-Thompson and the wonderful support of my husband I saw the hand of the Lord in my life and I am truly grateful,’ said Dwayisa.
She is keen to get more involved in public health based work. ‘I love working with people and helping to improve their lives. I may also consider lecturing in the future.’