Empirical Framework for Point-of-Care Diagnostics Supply Chain Management for Accessibility and Sustainability of Diagnostic Services in Ghana's Primary Health Care Clinics

Abstract Achievement of universal health coverage may be a mirage if supply chain management challenges of point-of-care (POC) diagnostics are not addressed to ensure accessibility and sustainability of POC diagnostic services in rural primary health care (PHC) clinics. Many patients accessing health care services in rural PHC clinics are likely to be undiagnosed and treated only based on syndromic management, due to stock-outs of POC tests. This potentially may result in complications such as wrong treatment, drug resistant to some infections, increased morbidities and mortalities, and many others. Public health activities for priority diseases such as tuberculosis, malaria, and human immunodeficiency virus, as well as maternal health services, may be affected. We have proposed an empirical model framework for POC diagnostics supply chain management to ensure accessibility and sustainability of POC diagnostic service in PHC clinics in Ghana based on evidence generated from our primary studies nested in a broader doctoral study entitled “Assessing the Accessibility of Antenatal Clinic Point-of-Care Diagnostic Services in Rural Ghana.” Prior to the development of this model framework, we conducted a literature review to identify the barriers and challenges of POC diagnostic services in low- and middle-income countries. We also conducted a cross-sectional survey to assess the accessibility of pregnancy-related POC diagnostic tests for maternal health care in the Upper East Region, Ghana. Finally, we conducted a formalized audit of the supply chain management of POC diagnostic tests also in the Upper East Region to investigate causes of deficiencies.