在加纳博诺地区没有实验室的卫生设施中提供即时诊断检测服务的可持续解决方案：一项定性研究。
Sustainable solutions to barriers of point-of-care diagnostic testing services in health facilities without laboratories in the bono region, Ghana: a qualitative study.
机构信息
Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001, South Africa.
The University Clinic, Sunyani Technical University, Sunyani, Ghana.
出版信息
BMC Prim Care. 2024 May 22;25(1):179. doi: 10.1186/s12875-024-02406-4.
BACKGROUND
A sustainable point-of-care (POC) diagnostic testing implementation in low-resourced facilities enhances quick diagnostic investigation and halts unnecessary referrals. This study identified the barriers impeding the implementation of POC diagnostic testing in health facilities without laboratories in the Bono Region of Ghana; as well as explored potential solutions that could enhance the accessibility and effectiveness of POC diagnostic testing, ultimately improving the quality of healthcare delivery.
METHODS
A total of twenty-eight participants were purposively selected from health facilities in low-resourced settings in the Bono Region for a descriptive qualitative study. Of the twenty-eight participants, seventeen including ten healthcare providers from CHPS facilities, six district health depot managers, and one regional depot manager were engaged in in-depth interviews. Additional eleven including nine healthcare providers and two district depot managers were also engaged in focus group discussions. NVivo version 12 software was employed for condensation, labelling, and grouping of themes. Data was analysed narratively.
RESULTS
Work overloads, limited POC testing services, stock-outs of POC tests at the facilities, and supply-related challenges of POC test kits were identified as major barriers to POC testing services. To solve these barriers, adequate funding, an effective delivery system, stakeholders' engagement and advocacy, and in-service and refresher training courses were suggested as potential solutions to POC diagnostic testing services implementation by the stakeholders.
CONCLUSIONS
This study's findings emphasize the need to address the barriers hindering the implementation of POC diagnostic testing in health facilities without laboratories in the Bono Region of Ghana. The suggested solutions provide a roadmap for improving the accessibility and effectiveness of POC testing, which has the potential to enhance the quality of healthcare delivery, reduce unnecessary referrals, and ultimately improve patient health outcomes in underserved settings.
背景
在资源匮乏的环境中，可持续的即时检测（POC）诊断测试实施可以促进快速诊断调查并阻止不必要的转诊。本研究旨在确定在加纳博诺地区无实验室的卫生设施中实施 POC 诊断测试所面临的障碍；并探讨潜在的解决方案，以增强 POC 诊断测试的可及性和有效性，最终提高医疗服务质量。
方法
采用描述性定性研究方法，从博诺地区资源匮乏环境下的卫生设施中，有目的地选择了 28 名参与者。在这 28 名参与者中，有 17 名参与者（包括 10 名来自 CHPS 设施的医疗保健提供者、6 名地区卫生仓库经理和 1 名区域仓库经理）参与了深入访谈。此外，还邀请了 11 名参与者（包括 9 名医疗保健提供者和 2 名地区仓库经理）参加了焦点小组讨论。使用 NVivo 版本 12 软件对主题进行浓缩、标记和分组。采用叙述性数据分析方法进行数据分析。
结果
工作负荷过重、POC 检测服务有限、设施内 POC 检测试剂缺货以及 POC 检测试剂盒的供应相关挑战被确定为 POC 检测服务的主要障碍。为了解决这些障碍，利益相关者提出了一些潜在的解决方案，如充足的资金、有效的交付系统、利益相关者的参与和倡导、在职培训和进修课程，以促进 POC 诊断检测服务的实施。
结论
本研究结果强调了需要解决加纳博诺地区无实验室的卫生设施中实施 POC 诊断测试所面临的障碍。所提出的解决方案为改善 POC 检测的可及性和有效性提供了路线图，这有可能提高医疗服务质量、减少不必要的转诊，并最终改善服务不足地区的患者健康结果。
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