The Lancet Commission on diagnostics: transforming access to diagnostics (2) Appropriate use of diagnostic tests

21 October, 2021

Neil, thank you for sharing this interesting study. [ ]

In our work in primary health care in Nigeria, using PACK Nigeria programme, we have noticed that access and availability of evidence based information can change attitude and practice. A few extracts of clinicians feedback from the PACK pilot we conducted in 2017, in three states in three different geopolitical zones in Nigeria, illustrate this point: ‘This improvement has been most pronounced in the reduction of polypharmacy and in more appropriate use of laboratory tests observed in all three states since the introduction of PACK Nigeria: “*Before PACK I used to prescribe 6-7 drugs per patient, but now I prescribe only* *1-2 drugs per patient*”.

Managers reported that the routine prescription of Amoxil antibiotics alongside ACTs (Artemisinin-based Combination Therapy) in the treatment of malaria has been eliminated in Fufore Local Government Area (LGA) since the pilot began.’’

Joseph Ana.

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

Email: jneana AT