Combating POCTs accessibility/availability issues | In order to enable staff to rely on POCT, it is essential that supply of the tests is consistent as highlighted by previous studies [1]. Context specific supply chain analyses should be carried out to identify and resolve any bottlenecks. |
Education and training | Comprehensive training should be developed for healthcare providers who deliver POCT, including clarification of the relative advantages of POCT in comparison to symptom-based diagnosis. We identified needs for training in effective use of the tests to ensure optimal accuracy, strengths and limitations of POCT, as well as problems associated with symptom-based diagnosis of malaria and anaemia. |
Encouraging patient involvement | Interventions to increase patient awareness of POCTs and their benefits could potentially improve patient involvement. Our findings showed staff felt it may allow the women to become more involved and compliant with healthcare recommendations. |
Supporting the development of effective working relationships between key specialities | This study highlighted barriers to effective communication between laboratory and clinical staff, and an implicit hierarchical power structure. The use of multidisciplinary group effort, with strong leadership, may be a method in which to combat these barriers [18]. This, plus joint training sessions could ensure key messages can be passed between staff groups, through open and honest communication. |
Development of policy | Fundamental to these recommendations is the need for effective policy and practical guidance on the diagnosis and treatment of malaria and anaemia in these regions. Although local government recommendations mirrored the WHO guidelines, this was not translated into practice at the health facilities. Staff involvement in the development of local policy is essential to ensure standardisation and understanding of practice. |