RP-Department of Sociology

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Rethinking the Design of Low-Cost Point-of-Care Diagnostic Devices
(MDPI, 2017) Kimani, Faith W.; Mwangi, Samuel M.; Kwasa, Benjamin J.; Kusow, Abdi M.; Ngugi, Benjamin K.; Chen, Jiahao; Liu, Xinyu; Cademartiri, Rebecca; Thuo, Martin M.
Reducing the global diseases burden requires effective diagnosis and treatment. In the developing world, accurate diagnosis can be the most expensive and time-consuming aspect of health care. Healthcare cost can, however, be reduced by use of affordable rapid diagnostic tests (RDTs). In the developed world, low-cost RDTs are being developed in many research laboratories; however, they are not being equally adopted in the developing countries. This disconnect points to a gap in the design philosophy, where parameterization of design variables ignores the most critical component of the system, the point-of-use stakeholders (e.g., doctors, nurses and patients). Herein, we demonstrated that a general focus on reducing cost (i.e., “low-cost”), rather than efficiency and reliability is misguided by the assumption that poverty reduces the value individuals place on their well-being. A case study of clinicians in Kenya showed that “zero-cost” is a low-weight parameter for point-of-use stakeholders, while reliability and standardization are crucial. We therefore argue that a user-driven, value-addition systems-engineering approach is needed for the design of RDTs to enhance adoption and translation into the field.