Task sharing for point-of-care testing: Review of national health policies and implementation landscape in 19 African countries

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. # 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](doi.org) ## 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.