Abstract:
Access to point-of-care (POC) diagnostics in resource-limited settings, where laboratorybased
diagnostics are limited, depends on efficient supply chain management (SCM).
This study evaluated the SCM for SARS-CoV-2 POC diagnostic services in resource-limited
settings to determine the effect of SCM on accessibility to SARS-CoV-2 POC tests
and to identify barriers and enablers of accessibility to SARS-CoV-2 diagnostic services in
Mopani District, Limpopo Province, South Africa. We purposively assessed 47 clinics providing
POC diagnostic services between June and September 2022. One participant per
clinic completed an audit tool developed by the authors with guidance from the World
Health Organization and the Management Sciences for Health guidelines. The audit tool
evaluated the following SCM parameters: selection, quantification, storage, procurement,
quality assurance, distribution, redistribution, inventory management, and human
resource capacity. Percentage rating scores between 90–100% indicated that the facility
was compliant with SCM guidelines, while rating scores < 90% indicated non-compliance.
The clinic audit scores were summarized and compared across clinics and sub-districts.
Clinics had compliance scores ranging from 60.5% to 89.2%. Compliance scores were
the highest for procurement, redistribution, and quality assurance (all 100%), followed by
storage (mean = 95.2%, 95% CI: 90.7–99.7), quantification (mean = 89.4%, 95% CI:
80.2–98.5), and selection (mean = 87.5%, 95% CI: 87.5%–87.5%). Compliance scores
were the lowest for inventory management (mean = 53.2%, 95% CI: 47.9%–58.5%), distribution
(mean = 48.6%, 95% CI: 44.6%–52.7%), and human resource capacity (mean =
50.6%, 95% CI: 43.3%–58.0%). A significant correlation was found between compliance
score and clinic headcount (r = 0.4, p = 0.008), and compliance score and ideal clinic
score (r = 0.4, p = 0.0003). Overall, the 47 clinics audited did not comply with international
SCM guidelines. Of the nine SCM parameters evaluated, only procurement, redistribution, and quality assurance did not need improvement. All parameters are key in ensuring full functionality of SCM systems and equitable access to SARS-CoV-2 POC diagnostics in
resource limited settings.
