Implementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study

Simple item page
dc.contributor.authorde Vos, Lindsey
dc.contributor.authorDaniels, Joseph
dc.contributor.authorGebengu, Avuyonke
dc.contributor.authorMazzola, Laura
dc.contributor.authorGleeson, Birgitta
dc.contributor.authorBlümel, Benjamin
dc.contributor.authorPiton, Jérémie
dc.contributor.authorMdingi, Mandisa
dc.contributor.authorGigi, Ranjana M.
dc.contributor.authorFerreyra, Cecilia
dc.contributor.authorKlausner, Jeffrey D.
dc.contributor.authorPeters, Remco P.
dc.date.accessioned2024-01-23T12:45:47Z
dc.date.available2024-01-23T12:45:47Z
dc.date.issued2024-01-09
dc.date.updated2024-01-14T04:11:24Z
dc.description.abstractBackground South Africa maintains an integrated health system where syndromic management of sexually transmitted infections (STI) is the standard of care. An estimated 2 million cases of Neisseria gonorrhoeae (N. gonorrhoeae) occur in South Africa every year. Point-of-care diagnostic tests (POCT) may address existing STI control limitations such as overtreatment and missed cases. Subsequently, a rapid lateral flow assay with fluorescence-based detection (NG-LFA) with a prototype reader was developed for N. gonorrhoeae detection showing excellent performance and high usability; however, a better understanding is needed for device implementation and integration into clinics. Methods A qualitative, time-series assessment using 66 in-depth interviews was conducted among 25 trained healthcare workers involved in the implementation of the NG-LFA. Findings were informed by the Normalization Process Theory (NPT) as per relevant contextual (strategic intentions, adaptive execution, and negotiation capacity) and procedural constructs (coherence, cognitive participation, collective action, reflexive monitoring) to examine device implementation within primary healthcare levels. Interviews were audio-recorded, transcribed, and then analyzed using a thematic approach guided by NPT to interpret results. Results Overall, healthcare workers agreed that STI POCT could guide better STI clinical decision-making, with consideration for clinic integration such as space constraints, patient flow, and workload. Perceived NG-LFA benefits included enhanced patient receptivity and STI knowledge. Further, healthcare workers reflected on the suitability of the NG-LFA given current limitations with integrated primary care. Recommendations included sufficient STI education, and appropriate departments for first points of entry for STI screening. Conclusions The collective action and participation by healthcare workers in the implementation of the NG-LFA revealed adaptive execution within the current facility environment including team compositions, facility-staff receptivity, and STI management experiences. User experiences support future clinic service integration, highlighting the importance of further assessing patient-provider communication for STI care, organizational readiness, and identification of relevant departments for STI screening.
dc.identifier.apacitationde Vos, L., Daniels, J., Gebengu, A., Mazzola, L., Gleeson, B., Blümel, B., ... Peters, Remco P. (2024). Implementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study. <i>BMC Health Services Research</i>, 12. http://hdl.handle.net/11427/39133en_ZA
dc.identifier.chicagocitationde Vos, Lindsey, Joseph Daniels, Avuyonke Gebengu, Laura Mazzola, Birgitta Gleeson, Benjamin Blümel, Jérémie Piton, et al "Implementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study." <i>BMC Health Services Research</i> (2024): 12. http://hdl.handle.net/11427/39133en_ZA
dc.identifier.citationde Vos, L., Daniels, J., Gebengu, A., Mazzola, L., Gleeson, B., Blümel, B., Piton, J. & Mdingi, M. et al. 2024. Implementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study. <i>BMC Health Services Research.</i>:12. http://hdl.handle.net/11427/39133en_ZA
dc.identifier.ris TY - Journal Article AU - de Vos, Lindsey AU - Daniels, Joseph AU - Gebengu, Avuyonke AU - Mazzola, Laura AU - Gleeson, Birgitta AU - Blümel, Benjamin AU - Piton, Jérémie AU - Mdingi, Mandisa AU - Gigi, Ranjana M. AU - Ferreyra, Cecilia AU - Klausner, Jeffrey D. AU - Peters, Remco P. AB - Background South Africa maintains an integrated health system where syndromic management of sexually transmitted infections (STI) is the standard of care. An estimated 2 million cases of Neisseria gonorrhoeae (N. gonorrhoeae) occur in South Africa every year. Point-of-care diagnostic tests (POCT) may address existing STI control limitations such as overtreatment and missed cases. Subsequently, a rapid lateral flow assay with fluorescence-based detection (NG-LFA) with a prototype reader was developed for N. gonorrhoeae detection showing excellent performance and high usability; however, a better understanding is needed for device implementation and integration into clinics. Methods A qualitative, time-series assessment using 66 in-depth interviews was conducted among 25 trained healthcare workers involved in the implementation of the NG-LFA. Findings were informed by the Normalization Process Theory (NPT) as per relevant contextual (strategic intentions, adaptive execution, and negotiation capacity) and procedural constructs (coherence, cognitive participation, collective action, reflexive monitoring) to examine device implementation within primary healthcare levels. Interviews were audio-recorded, transcribed, and then analyzed using a thematic approach guided by NPT to interpret results. Results Overall, healthcare workers agreed that STI POCT could guide better STI clinical decision-making, with consideration for clinic integration such as space constraints, patient flow, and workload. Perceived NG-LFA benefits included enhanced patient receptivity and STI knowledge. Further, healthcare workers reflected on the suitability of the NG-LFA given current limitations with integrated primary care. Recommendations included sufficient STI education, and appropriate departments for first points of entry for STI screening. Conclusions The collective action and participation by healthcare workers in the implementation of the NG-LFA revealed adaptive execution within the current facility environment including team compositions, facility-staff receptivity, and STI management experiences. User experiences support future clinic service integration, highlighting the importance of further assessing patient-provider communication for STI care, organizational readiness, and identification of relevant departments for STI screening. DA - 2024-01-09 DB - OpenUCT DP - University of Cape Town J1 - BMC Health Services Research KW - Neisseria gonorrhoeae KW - Sexually transmitted infections KW - Point of care test KW - Implementation KW - Qualitative KW - Normalization process theory KW - South Africa LK - https://open.uct.ac.za PY - 2024 T1 - Implementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study TI - Implementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study UR - http://hdl.handle.net/11427/39133 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12913-023-10478-8
dc.identifier.urihttp://hdl.handle.net/11427/39133
dc.identifier.vancouvercitationde Vos L, Daniels J, Gebengu A, Mazzola L, Gleeson B, Blümel B, et al. Implementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study. BMC Health Services Research. 2024;:12. http://hdl.handle.net/11427/39133.en_ZA
dc.language.rfc3066en
dc.publisherBioMed Central Ltd
dc.publisher.departmentDivision of Medical Microbiology
dc.publisher.facultyFaculty of Health Sciences
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceBMC Health Services Research
dc.source.pagination12
dc.source.urihttps://bmchealthservres.biomedcentral.com/
dc.subjectNeisseria gonorrhoeae
dc.subjectSexually transmitted infections
dc.subjectPoint of care test
dc.subjectImplementation
dc.subjectQualitative
dc.subjectNormalization process theory
dc.subjectSouth Africa
dc.titleImplementation considerations for a point-of-care Neisseria gonorrhoeae rapid diagnostic test at primary healthcare level in South Africa: a qualitative study
dc.typeJournal Article
publicationissue.issueNumber1
publicationvolume.volumeNumber24
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
12913_2023_Article_10478.pdf
Size:
1.7 MB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.72 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Journal Articles