Evidence map›Paper›PMID 42802921›Full record

ArticleGlobal health action2026

Task shifting of point-of-care testing to lay health workers in rural primary health facilities in Nsanje, Malawi.

Zibusiso Ndlovu, Rosie Burton, Mieke Steenssens, Kingsley Makwale, Simeon Maleka, Greywilly Madaliso, Gilbert Chapweteka, Fingani Mphande-Nyasulu, Emmanuel Kabwe, Johnny Falconer and 4 more

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Article in Global health action, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Zibusiso NdlovuMédecins Sans Frontières, Nsanje, Malawi.ORCID 0000-0003-0386-8641
Rosie BurtonSouthern African Medical Unit, Médecins Sans Frontières, Cape Town, South Africa.
Mieke SteenssensMédecins Sans Frontières, Nsanje, Malawi.
Kingsley MakwaleMédecins Sans Frontières, Nsanje, Malawi.
Simeon MalekaMinistry of Health, Nsanje District Hospital, Nsanje, Malawi.
Greywilly MadalisoMinistry of Health, Nsanje District Hospital, Nsanje, Malawi.
Gilbert ChapwetekaMinistry of Health, Nsanje District Hospital, Nsanje, Malawi.
Fingani Mphande-NyasuluFaculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand.
Emmanuel KabweInstitute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia.
Johnny FalconerSouthern African Medical Unit, Médecins Sans Frontières, Cape Town, South Africa.
Sarah Jane SteeleSouthern African Medical Unit, Médecins Sans Frontières, Cape Town, South Africa.
Tom EllmanSouthern African Medical Unit, Médecins Sans Frontières, Cape Town, South Africa.
Esther C CasasSouthern African Medical Unit, Médecins Sans Frontières, Cape Town, South Africa.
Geoffrey FattiDivision of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPoint-of-care testing (POCT) can reduce diagnostic gaps, but because it frequently falls to overstretched frontline healthcare workers (HCW), its real-world effectiveness is diminished. Despite World Health Organization recommendations for task sharing (TS) with lay health workers (LHW), it remains underutilized.

objectiveTo explore whether task-shifted POCT by LHWs can improve uptake compared to standard HCW-led care.

methodsA retrospective study at 5 PHC facilities in Nsanje, Malawi, compared a pre-intervention (model 1) period where HCW conducted POCT (for rapid HIV, AHD, syphilis, hepatitis B and malaria), and post-intervention (model 2) where POCT was shifted to trained LHW. The primary outcome was the total number of POCT performed. The two-sample proportion test was used to assess differences in testing uptake in model 1 and 2.

resultsA total of 3,428 POC tests were conducted by LHWs in model 2 compared to 1,738 in model 1 (a near-2-fold increase). In both models, rapid HIV (38.9%), malaria (21.9%) and CD4 cell count (20.0%) tests were most common. The CD4 cell count testing had the highest incremental change in testing volume of 338% between models (from 192 to 840 tests;

conclusionsTS for POCT with LHW was feasible in rural PHC facilities and contributed to increased POCT volumes across multiple diseases, particularly for CD4 testing. As the range of POC tests expands, TS can improve uptake of diagnostics in these settings, but it must be accompanied by appropriate training and supportive oversight.

Indexed as

Community Health WorkersPoint-of-Care TestingPrimary Health CareRural Health ServicesTask ShiftingFemaleHIV InfectionsHumansMalawiMaleRapid Diagnostic TestsRetrospective Studiesadvanced HIV diseaseLay cadresmulti-disease testingpoint-of-care testingtask sharing

Identifiers

PMID42802921
PMCPMC13629764

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.