Lessons from the pandemic: new best practices in selecting molecular diagnostics for point-of-care testing of infectious diseases in sub-Saharan Africa.

INTRODUCTION: Point-of-care molecular diagnostics offer solutions to the limited diagnostic availability and accessibility in resource-limited settings. During the COVID-19 pandemic, molecular diagnostics became essential tools for accurate detection and monitoring of SARS-CoV-2. The unprecedented demand for molecular diagnostics presented challenges and catalyzed innovations which may provide lessons for the future selection of point-of-care molecular diagnostics. AREAS COVERED: We searched PubMed from January 2020 to August 2023 to identify lessons learned from the COVID-19 pandemic which may impact the selection of point-of-care molecular diagnostics for future use in sub-Saharan Africa. We evaluated this in the context of REASSURED criteria (Real-time connectivity; Ease of specimen collection; Affordable; Sensitive; Specific; User-friendly; Rapid and robust; Equipment free; and Deliverable to users at the point of need) for point-of-care diagnostics for resource-limited settings. EXPERT OPINION: The diagnostic challenges and successes during the COVID-19 pandemic affirmed the importance of the REASSURED criteria but demonstrated that these are not sufficient to ensure new diagnostics will be appropriate for public health emergencies. Capacity for rapid scale-up of diagnostic testing and transferability of assays, data, and technology are also important, resulting in updated REST-ASSURED criteria. Few diagnostics will meet all criteria, and trade-offs between criteria will need to be context-specific.

Perceptions of patent and proprietary medicine vendors and communities of the tiered accreditation programme for family planning services in Lagos and Kaduna states, Nigeria.

This study evaluated the perception of patent and proprietary medicine vendors (PPMVs) of the accreditation programme to improve their capacity to provide family planning (FP) services in Lagos and Kaduna, Nigeria. A cross-sectional mixed-method approach among 224 PPMVs was used to investigate their perception, willingness to pay for and adhere to the programme, its benefits, and the community women's perception of the value of PPMVs. Chi-square analysis and structural equation modelling (SEM) were used to analyse survey data, while focus group discussions (FGDs) were analysed using the grounded theory. PPMVs were enthusiastic because of the benefits, including increased clientele, revenue, and improved service provision capacity. Approximately 97% of PPMVs found the programme acceptable and were willing to pay, with 56% and 71% willing to pay between N5000-N14900 ($12-36) and N25000-N35000 ($60-87), respectively. A significant relationship between educational attainment, location, and willingness to pay was revealed. Among community women, the fear of side effects, lack of partners' support, myths and misconceptions, and lack of access to modern contraceptives were factors affecting contraceptive uptake. The capacity of PPMVs to improve FP uptake is promising and can be leveraged to improve health outcomes in communities while strengthening their businesses.