ArticlePLOS global public health2023
Contexts for developing of national essential diagnostics lists. Lessons from a mixed-methods study of existing documents, stakeholders and decision making on tier-specific essential in-vitro diagnostics in African countries.
Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation determinants of rapid diagnostic tests for fever management in sub-Saharan Africa: a mixed-studies systematic review.Nature communications · 2026Pooled it
- Task shifting of point-of-care testing to lay health workers in rural primary health facilities in Nsanje, Malawi.Global health action · 2026Article
- Article
- Identifying pathways to achieve diverse objectives of the National Essential Diagnostics List: developing an assessment framework based on field studies in Cambodia, Indonesia, Lao PDR, and the Philippines.Tropical medicine and health · 2025Article
- Assessing laboratory specimen losses for the city of Johannesburg, South Africa.African journal of primary health care & family medicine · 2025Article
- Task sharing for point-of-care testing: Review of national health policies and implementation landscape in 19 African countries.PLOS global public health · 2025Article
- Point-of-care biochemistry for primary healthcare in low-middle income countries: a qualitative inquiry.BMC primary care · 2024Article
- Development and evaluation of a simple treatment eligibility score (HEPSANET) to decentralise hepatitis B care in Africa: a cross-sectional study.The lancet. Gastroenterology & hepatology · 2024Article
- Delays in Blood Work and Disease Burden: A Cross-Sectional Analysis of Unmet Blood Work Need and Seven Key Health Conditions Across 21 Countries.International journal of public health · 2024Article
- Correction: Contexts for developing of national essential diagnostics lists. Lessons from a mixed-methods study of existing documents, stakeholders and decision making on tier-specific essential in-vitro diagnostics in African countries.PLOS global public health · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Since 2019, the WHO recommends the development and implementation of National Essential Diagnostics List (NEDL) to facilitate availability of In-Vitro Diagnostics (IVDs) across the various tiers of the healthcare pyramid, facilities with or without a laboratory on-site. To be effective, the development of NEDL should take into consideration the challenges and opportunities associated with current modalities for organization of tier specific testing services in-country. We conducted a mixed-methods analysis set out to explore available national policies, guidelines and decision-making processes that affect accessibility of diagnostics in African countries; 307 documents from 48 African countries were reviewed and 28 in-depth (group) interviews with 43 key-informants in seven countries were conducted between June and July 2022. Of the 48 countries, Nigeria was the only one with formal NEDL. Twenty-five countries had national test menus (63% outdated, from 2015 or earlier) all specifying tests by laboratory tier (5 including the "community tier"), with additional details on equipment (20), consumables (12), and personnel requirements (11). The most popular criteria to select essential IVDs in the quantitative analysis relate to specificities of the tests, whereas in the qualitative study most mentioned were health care and laboratory contextual factors. Quality assurance and waste management for tests at "community tier" were highlighted as concerns by all the respondents. Additional barriers to implementation included the low decision-making power of Laboratory Directorates within the Ministry of Health, as well as the chronic budgetary gaps for clinical laboratory services and policy and strategic plan development outside of vertical programmes. Four countries out of seven would rather revise their test menus by updating them and add ''community tier", than developing a separate NEDL, the former being considered more operational. This study provides a unique set of practical recommendations to the process of development and effective implementation on NEDL in Africa.
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Registered trials
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