How portable diagnostic devices are transforming healthcare delivery in resource-limited settings
Imagine a crowded emergency room in a Nigerian teaching hospital. A disoriented patient arrives, symptoms unclear. Is it a severe diabetic crisis? A dangerous electrolyte imbalance? A cardiac event? In critical medicine, every minute counts. Traditionally, doctors would draw blood and send it to a central laboratory, waiting hours for results while the patient's condition hangs in the balance. But what if the answers could be found right at the bedside?
This is the promise of point-of-care testing (POCT)—diagnostic tests performed at or near the patient, delivering results in minutes rather than hours. Across Nigeria, these portable devices are transforming clinical decision-making. Yet, as recent surveys reveal, their potential remains hampered by significant challenges.
This article explores what happens when advanced medical technology meets real-world healthcare constraints.
Point-of-care testing refers to medical diagnostic testing performed outside the conventional laboratory setting, closer to where patient care is delivered. Think of the common glucose meter used by diabetics—that's a POCT device. In hospital settings, this concept expands to include devices that can measure everything from blood electrolytes and kidney function to cardiac markers and blood gases, all within minutes.
Results in minutes instead of hours
Immediate treatment based on real-time data
Simplified processes for healthcare providers
The advantages are compelling: reduced turnaround time, faster clinical decision-making, streamlined workflows, and potentially improved patient outcomes. As one study noted, "The provision of a result may avert a life-threatening crisis and may also ensure that there is more rapid and effective change in patient management" 6 .
In Nigeria, where central laboratory services can be overwhelmed and transportation of samples causes delays, POCT offers a compelling alternative. But how widely is it understood and utilized by the doctors who stand to benefit most?
Multiple studies have surveyed Nigerian healthcare practitioners to assess their familiarity with point-of-care testing. The findings paint a picture of both promise and challenge.
A study of 174 doctors in government hospitals in Edo State found that only about half (50.6%) had good knowledge of POCT, while 32.2% demonstrated good utilization of these devices 4 6 . Knowledge significantly influenced practice—doctors who understood POCT were more likely to use it effectively.
| Test Type | Percentage of Doctors Who Had Used It | Primary Clinical Applications |
|---|---|---|
| Glucose Meters | 71.6% | Diabetes management, emergency medicine |
| Pregnancy Tests | 53.2% | Routine screening, emergency assessment |
| Urine Chemistry | 44% | Urinary tract infections, kidney function |
| Hemoglobin Meters | 43.1% | Anemia screening, surgical preparation |
| Blood Gas Analyzers | 16.5% | Critical care, respiratory distress |
Source: Survey of 109 doctors across Nigeria 7
Perhaps most tellingly, a study at the University of Calabar Teaching Hospital found that while 91.4% of operators used glucose meters, only about half (56%) understood the test reaction principles of their devices, and a mere 24.3% performed regular quality control practices 1 8 . This gap between usage and understanding highlights a critical challenge in Nigeria's POCT landscape.
In emergency and critical care settings, the speed of POCT becomes particularly valuable. A survey of 95 healthcare professionals (including laboratory scientists, doctors, and nurses) explored which tests they considered most essential for critical care 5 .
Source: Survey of 95 healthcare professionals 5
When asked what features they valued most in blood gas analyzers—one of the more sophisticated POCT devices—healthcare workers prioritized analyzer price as their primary concern, followed by analysis time and test range 5 . This practical focus on cost reflects the resource-conscious environment of Nigerian healthcare.
To understand the challenges with POCT implementation in Nigeria, let's examine a detailed study focused on glucometers—the most widely used POCT devices.
Healthcare practitioners surveyed across hospitals in Jigawa and Kogi States
Researchers conducted a cross-sectional study of 570 healthcare practitioners across hospitals in Jigawa and Kogi States in Northern Nigeria 2 . Using a total population sampling strategy, they distributed questionnaires to assess knowledge, competence, and experience with glucometers. The questionnaire covered three domains: basic knowledge about glucometers and calibrators, technical competence, and hands-on experience.
The results revealed significant gaps in operator competence. While most participants (66.5%) had heard about glucometer calibrators, 41.2% didn't understand their specific purpose 2 . Perhaps more concerningly, nearly half (49.8%) reported having no formal training prior to using glucometers for patient care.
Source: Glucometer competence study (n=570) 2
Source: Glucometer competence study (n=570) 2
The study also found that many operators lacked understanding of standard operating procedures for blood glucose testing and had limited practical experience with quality control practices 2 . This training gap is particularly important because, as the researchers noted, "operator errors and instrument errors could also be checked through adequate end-user competency assessment training programs" 6 .
| Aspect Assessed | Finding | Implication |
|---|---|---|
| Formal Training | 49.8% had no training before first use | Increases risk of operator error |
| Understanding of Calibrators | 41.2% didn't know their purpose | Compromises test accuracy |
| Knowledge of Standard Operating Procedures | Significant gaps identified | Leads to inconsistent practices |
| Quality Control Practices | Limited implementation | Undermines result reliability |
The research consistently points to several strategies that could enhance POCT implementation in Nigeria:
"Periodically validating and calibrating POCT devices within the hospital by the central laboratory will go a long way to ensure uniform testing and improve result quality" 1 . Regular, hands-on training must become standard practice.
"Promotion of POCT's utilization with regulation, training of doctors and establishment of regulatory framework/assessment teams will help improve healthcare services" 6 . Clear guidelines are needed at national and institutional levels.
Integration of quality control practices, including routine calibration and participation in external quality assurance programs, is essential for reliable results.
Choosing devices that balance cost, durability, and ease of use can increase sustainability in resource-limited settings.
Point-of-care testing represents a paradigm shift in healthcare delivery—from centralized laboratories to bedside diagnostics, from delayed results to immediate answers. For Nigeria, with its heavy disease burden and stretched healthcare system, the potential benefits are too significant to ignore.
The surveys and studies reveal both progress and pitfalls. Nigerian doctors recognize the value of POCT, but knowledge gaps, training deficiencies, and quality control issues currently limit its impact. As one researcher aptly noted, "POCT that is faster could be better" 6 —but only if implemented correctly.
With proper training, appropriate regulation, and strategic investment, point-of-care testing could transform patient care across Nigeria. The path forward requires collaboration between healthcare professionals, hospital administrators, policymakers, and device manufacturers. When these pieces fall into place, the race against time in emergency rooms across Nigeria will become significantly more winnable.
This article is based on a synthesis of research findings from multiple studies conducted in Nigeria between 2015 and 2025. The information has been simplified for general readership while maintaining scientific accuracy.