Strengthening diagnostic performance in primary health care
A diagnostic performance framework to help a global health funder see how diagnostics support primary health care and where investment would matter most.
- 1AvailabilityAre diagnostics available?
- 2FunctionalityAre they working and quality assured?
- 3UseAre they used in clinical decisions?
- 4Clinical actionAre results linked to treatment or referral?
- What
- Performance data across availability, functionality, use, and clinical action.
- Why
- Identify barriers and enablers.
- Output
- Actionable insights for system decisions.
- Prioritization and clinical guidance
- Financing and procurement
- Service delivery and integration
- Workforce and infrastructure
Requires routine data use and an understanding of system barriers.
Routine measurement across the pathway enables system learning and informs better decisions.
The diagnostic performance framework: four measurement points across the care pathway feed system learning, which informs prioritization and investment decisions.
The challenge
Improving access to diagnostics requires more than placing tests in health facilities. Decision-makers need to know where the system is breaking down, from whether tests are available and functioning to whether providers use them and patients receive appropriate care.
Role
We developed a practical framework that helps decision-makers examine four questions across that pathway: are diagnostics available, are they working, are they being used, and do the results lead to appropriate treatment or referral? Built for a global health funder to identify investment priorities, using Kenya as the initial application.
What we did
HIA synthesized global evidence and country-level insights, then developed a framework examining diagnostic performance across availability, functionality, use, and clinical action. The analysis connected these measures to Kenya’s primary care delivery structure, essential diagnostics, data systems, financing mechanisms, and decision-making needs.
What resulted
A working framework that clarified system gaps, decision points, and priorities for further validation, giving a structured basis for where diagnostic investment could be focused.