Kimani, Faith W.Mwangi, Samuel M.Kwasa, Benjamin J.Kusow, Abdi M.Ngugi, Benjamin K.Chen, JiahaoLiu, XinyuCademartiri, RebeccaThuo, Martin M.2017-12-062017-12-062017Micromachines 2017, 8, 317; doi:10.3390/mi8110317http://ir-library.ku.ac.ke/handle/123456789/17904Research ArticleReducing 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.enLow costDiagnosticsTechnology adoptionValue-added designHealth careRapid diagnosticsArticle