A Scoping Review Protocol for Supply Chain Management Systems for Point of Care Diagnostics Services: Optimising COVID-19 Testing Capacity in Resource-limited Settings

Abstract

BackgroundRapid and specific diagnostic tests are essential for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) testing to allow prompt isolation and early treatment initiation if necessary. Currently, reverse transcription polymerase chain reaction (RT-PCR) tests are the gold standard for SARS-CoV-2 testing but are difficult to implement in resource-limited settings with poor access to laboratory infrastructure. Point of care (POC) testing may be more feasible in resource-limited settings because POC testing is cost-effective, easy to perform, results are rapid, and they can be performed at all levels of healthcare by health professionals with minimal training. To ensure equitable access, it is important that SARS-CoV-2 testing is optimised through well-established supply chain management (SCM). Here we outline a protocol for a scoping review aimed at mapping literature on SCM for POC testing in resource limited settings to guide both future research and the implementation of SARS-CoV-2 POC diagnostics. MethodologyThis scoping review will be guided by an adapted version of the Arksey and O’Malley methodological framework. We will search the Medline Ovid, Medline EBSCO, Scopus, PubMed, PsychInfo, Web of Science and EBSCOHost databases. We will search gray literature in the form of dissertations/theses, conference proceedings, websites of international organisations such as the World Health Organisation and government reports. We will include articles reporting evidence published since inception. Language restrictions will not be applied. We will use a search summary table to test the effectiveness of the search strategy. Two reviewers will screen eligible studies using a tool developed for this scoping review. The quality of the included studies will be appraised using the mixed method appraisal tool (MMAT) version 2018. Discussion The proposed scoping review will gather relevant studies on SCM systems for POC diagnostics services globally. We anticipate that this review’s findings will guide future research on SCM systems for POC diagnostics services in resource-limited settings. The results will be published in a scientific journal, presented at relevant conferences and form part of workshops with key stakeholders involved in SCM systems for POC diagnostics services.

Facilitators and barriers to in vitro diagnostics implementation in resource-limited settings: A scoping review

“…3 In resourcelimited settings, POC technologies have become reliable and very important by providing healthcare providers with the easiest, most convenient and most accurate way of decision-making on diagnosis and treatment. 3,14,17,18,19,20,21,22,23 The quality of POC for limited-resource settings according to the WHO should be designed to meet the following benchmarks: affordable, sensitive, specific, user-friendly, rapid or robust, equipment-free, and delivered to those who need it (ASSURED). 8,24,25,26,27 Despite the benefits derived from POC testing, there are challenges with its implementation, which hinder accessibility for many patients in the LMICs.…”

“…Examples of these include low availability, low stock levels, procurement issues, poor supply chain management, funding, human resource capacity and many others. 21,24,27,31,32,33 Facilitators of POC testing are motivators or factors which contribute to POC testing implementation. For instance, effective regulations on quality and training enable the successful implementation of POC testing in healthcare facilities.…”