Table 1 Summary of benefits and challenges of implementing Xpert®HIV-1 Qual at the hospital setting

Access

• Specific PMTCT clinic day for HIV-infected mothers

• Shorter turnaround time (same-day results in some study sites)

• Early receipt of results by patients

• Time constraint with PMTCT clinic opening hours in the afternoon

• Communication among multi-level healthcare staff required in the process of testing and result return

• Logistical constraint (purchase of Xpert®HIV-1 Qual cartridges)

Efficiency

• Short testing time

• Early receipt of results by healthcare workers led to early initiation of ART

• A system for communicating EID testing and results to patients by healthcare staff and among healthcare staff

• Low throughput of POC test (two samples can be run at a time although instruments with higher capacity such as four-module device are available

• The distributor does not provide technical assistance in some locations

Operability

• Workforce of medico-social workers was advantageous for adherence counselling and patient follow-up

• Simple procedures of POC test

• Accessible refresher training and technical assistance

• Staff shortages and competing workloads

• Infrequent running of POC test

• Basic computer literacy

Infrastructure

• Minimal requirement for a system for sample and result transport

• Cramped space for staff and patients

• Irregular electricity supply