DOI: 10.5061/dryad.4b8gthtsr
title: Task sharing for point-of-care testing: Review of national health policies and implementation landscape in 19 African countries

description: The World Health Organization recommends task sharing (TS) for
 point-of-care testing (POCT) with lay health workers (LHW) to improve
 access when professional capacity is limited. Despite the many benefits of
 POCT, TS remains underutilized. This study examined national policies and
 the implementation landscape for TS of POCT with LHW in 19 African
 countries. We conducted a mixed-methods study from November 2024
 to March 2025 using an online cross-sectional survey with stakeholders
 from national ministries of health, medical associations, private
 laboratories, implementation supporting partners, and LHWs. We also
 conducted a document review of national health strategic and policy
 documents, as well as key informant interviews (KII) with national
 laboratory directors. Participants were recruited via standardized emails,
 whilst documents were obtained through direct requests and online
 searches. Quantitative data were analysed descriptively, and framework
 analysis was used for the qualitative analysis of KII data. Of
 217 policy documents collected, 197 (91%) were deemed relevant. Over half
 of national health strategic plans (10/19; 53%) recognize LHWs as vital
 for expansion of primary healthcare services, but fewer (7/19; 37%)
 mention TS. While 58% (11/19) of national laboratory strategic plans aimed
 to expand POCT access and quality in facilities with or without
 laboratories, 84% did not mention LHW to support TS. Among national
 HIV/AIDS strategic plans, 53% (9/17) referenced TS for POCT, mainly for
 HIV diagnosis; with only one addressing POCT for advanced HIV disease.
 Outside HIV and malaria, LHW POCT was rarely emphasised in policies or
 other disease-specific strategic plans. Seventy-five stakeholders
 (67% male) from 19 countries completed the online survey, and six KII were
 conducted. All reported that LHWs conduct POCT in disease programs, mainly
 with donor support. HIV rapid testing was cited as having the most
 structured training program. National laboratory leaders
 acknowledged implementation challenges but saw opportunities to expand lay
 provider POCT. While many African countries have adopted TS for POCT to
 LHW, challenges remain. Shifting from fragmented, disease-specific
 approaches to an integrated, health system-wide TS model is crucial for
 sustainable and equitable POCT. Coherent policy and implementation
 reforms, including user-training, fair remuneration, as well as governance
 frameworks, are needed to institutionalize TS amid declining resources and
 rising testing demands. National laboratory leadership should drive the
 adoption of training and quality assurance for task-shared multi-disease
 POCT with LHW.
description: # Task sharing for point-of-care testing: Review of national health
 policies and implementation landscape in 19 African countries Dataset DOI:
 [10.5061/dryad.4b8gthtsr](https://doi.org/10.5061/dryad.4b8gthtsr) ##
 Description of the data and file structure An electronic questionnaire,
 ‘Assessment of Point-of-Care Task-sharing Environment’ (APoCTe), was
 developed and sent via email to potential respondents. The tool collected
 semi-quantitative and qualitative data across four domains: policies and
 governance of TS for POC tests; LHW training and deployment; monitoring
 and sustainability; and costs or impacts of TS models. The tool was
 adapted to the Kobo Toolbox platform. ### Files and variables #### File:
 TS_survey_2025_eng_11dec.csv #### **Description:**  ##### Variables * Is
 there a dedicated national policy and or strategy document/s that support
 TS POCT with LHW * Are there any laws that prohibit LHW from conducting
 POCT * Do you think that TS POCT with LHW has added value * Is there any
 TS POCT with LHW happening in your country * What is the job profile for
 the LHW testers  * Who pays their remuneration * Is there any formal
 training for LHW for POCT * Is there any scheme that monitors the quality
 of TS POCT with LHW ## Code/software Microsoft Excel CSV ## Human subjects
 data All data variable that could re-identify study participants were
 removed. We received consent from participants to publish the
 de-identified data.