Stakeholders' perspectives on integrating point-of-care diagnostics into forensic death investigations in South Africa

Unnatural and unexplained deaths present critical challenges to the criminal justice, medico-legal, and public health systems. This study explored forensic professionals' perspectives on the integration of point-of-care (POC) diagnostics into unnatural death investigations in South Africa. A Nominal Group Technique (NGT) was conducted with eight key forensic stakeholders to identify and prioritize the potential benefits, facilitators, and barriers associated with POC implementation. Stakeholders ranked guidance for investigation and autopsy, improved turnaround times, and resource efficiency as the most significant POC diagnostic benefits. Scientific validity, quality assurance, and alignment with legal and regulatory frameworks were identified as critical facilitators, whereas technical limitations, quality management gaps, and legal uncertainties emerged as key barriers. Participants emphasized that POC diagnostics could support timely decision-making during death scene investigations and autopsies, reduce laboratory backlogs, and improve family and community outcomes through faster case resolution. However, successful integration requires standardized protocols, validation, and appropriate training to ensure scientific and legal defensibility. These findings provide foundational evidence to inform the responsible integration of POC diagnostics into forensic death investigations, with potential benefits for justice delivery and community health in South Africa.