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Implementing essential diagnostics-learning from essential medicines: A scoping review.

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Area of Science:

  • Public Health
  • Health Systems Research
  • Diagnostic Technologies

Background:

  • The World Health Organization (WHO) Essential Medicines List (EML) has been complemented by the Essential Diagnostics List (EDL) since 2018.
  • These lists aim to improve universal health coverage and health outcomes globally.
  • Implementation in Africa requires specific contextual understanding.

Purpose of the Study:

  • To conduct a scoping review of literature on the implementation of WHO essential lists (EDL and EML) in Africa.
  • To identify barriers and enablers for implementing the WHO Essential Diagnostics List.
  • To inform future strategies for EDL implementation in African health systems.

Main Methods:

  • Scoping review of eight electronic databases.
  • Screening of 3,813 articles; 172 studies included.
  • Thematic content analysis using the SURE framework and MMAT for quality appraisal.

Main Results:

  • Poorly equipped health facilities and stock-outs of diagnostics/medicines are major barriers.
  • Financial and non-financial incentives can enable implementation but vary by context.
  • Only 33% of included studies were high quality; no qualitative or experimental EDL studies were found.

Conclusions:

  • Addressing health facility infrastructure and supply chain issues is critical for EDL/EML implementation.
  • Context-specific health system interventions, including incentives, are necessary.
  • Further implementation research, especially qualitative and experimental designs, is needed to assess effectiveness.