Universal health coverage is a beacon of equitable healthcare access because it ensures that individuals receive medical services without facing financial adversity. South Africa’s National Health Insurance (NHI) scheme, which is designed to realise universal health coverage, is instrumental in advancing the United Nations’ Sustainable Development Goal 3 (Good Health and Well-being).

Point-of-care (POC) diagnostics – near-patient testing that does away with the need to send a sample to a laboratory – is a fundamental part of universal health coverage and, by extension, NHI implementation in South Africa. Scaling up and strategically deploying new POC diagnostics are critical to improving the accessibility of healthcare services to those most in need. The expansion of POC services will play a role in enhancing access, improving care quality, driving cost-effectiveness and fostering decentralised healthcare.

Improved access to healthcare services

POC diagnostics serves as a transformative force, particularly in South Africa’s rural and underserved areas, where access to medical facilities and diagnostic services are scant. These communities grapple with formidable healthcare barriers, such as sparse medical infrastructure and having to travel long distances to access care. By deploying POC diagnostics, healthcare services can be decentralised, minimising the need for patients to embark on difficult journeys for testing services and consultations. This spatial proximity ensures that more individuals receive timely and precise diagnoses, which is pivotal for early detection, treatment and disease management.

Moreover, POC diagnostics enables immediate results, expediting clinical decision-making. This is a vital component in emergency and acute-care settings, where speedy intervention significantly influences patient outcomes. By enabling swift diagnosis and treatment, POC diagnostics mitigates complications and improves recovery rates.

Enhanced quality of care for all

The integration of POC diagnostics significantly elevates healthcare quality. Early disease detection, facilitated by rapid and accurate POC testing, is imperative for effective treatment, while prompt intervention can arrest disease progression, enhance patient outcomes and alleviate the long-term healthcare burden.

Notably, timely diagnosis and treatment of infectious diseases emerge as pivotal disease management strategies. The COVID-19 pandemic emphasised the indispensability of POC diagnostics such as rapid diagnostic tests and decentralised testing, particularly in underserved communities, where centralised laboratory testing encounters logistical hurdles. Rapid diagnostic tests deployed at the point of care enable fast results, which is vital for limiting antigen spread. They also play a role in antigen surveillance by quickly identifying infected individuals, thereby enabling swift intervention and containment measures. However, areas with limited access to diagnostics often face challenges in implementing effective surveillance strategies, leading to inadequate monitoring and control of the spread of the antigen.

Additionally, POC diagnostics facilitates continuity of care by enabling regular monitoring and management of chronic diseases like diabetes and hypertension. Patients do not have to make frequent visits to centralised laboratories, enhancing treatment plan adherence and overall health outcomes; this is critical in managing chronic conditions that require continuous monitoring and treatment strategy adjustments.

Digital-linked and molecular-based diagnostics holds significant promise for enhancing access to rare disease diagnostics at the point of care, especially in underserved populations. By delivering rapid, precise, easily accessible diagnostic solutions, these technologies can improve early detection and management of rare diseases, ultimately leading to better patient outcomes. POC diagnostics for neurodegenerative diseases is a ground-breaking development in healthcare. Conditions such as Alzheimer’s disease, Parkinson’s disease and amyotrophic lateral sclerosis present significant challenges due to their progressive nature and the lack of definitive diagnostic tests; advancements in POC diagnostics offer a ray of hope for patients grappling with these conditions.

Cost-effectiveness

POC diagnostics can enhance cost-effectiveness for both the healthcare system and patients. Early, accurate diagnosis limits the need for costly hospitalisations by managing conditions before they escalate. This not only reduces healthcare costs but also enhances patient life quality by halting unmanageable disease progression.

Furthermore, POC diagnostics optimises healthcare resource utilisation by mitigating the need for multiple visits and laboratory tests. This kind of streamlined healthcare delivery ensures resource efficacy, facilitating fund allocation to other healthcare domains that need it. For patients, reduced travel and waiting times translate into fewer out-of-pocket expenses and less time away from family and occupational responsibilities.

Support for NHI implementation

Scaling up the integration of POC diagnostics across various healthcare system tiers, from primary to tertiary care, is crucial for strengthening the NHI’s mission of providing comprehensive health services to all citizens, irrespective of location or socio-economic status.

Decentralised healthcare, which is a cornerstone of the NHI, endeavours to dispense equitable healthcare services countrywide. POC diagnostics facilitates this by empowering healthcare providers to administer diagnostic services at the point of care, diminishing reliance solely on centralised laboratories. This decentralisation ensures that the remotest and most underserved communities are able to access high-quality healthcare services.

By enhancing healthcare service access, elevating care quality, providing cost-effective solutions and increasing decentralised healthcare, POC diagnostics aligns with the core objectives of the NHI. Meaningful stakeholder engagement and involvement are imperative for investing in and expanding POC diagnostics, ensuring their sustainable implementation. Successful execution promises to propel South Africa’s healthcare system forward, affording citizens the opportunity to lead healthier and more productive lives.