Figure 1.
Figure 2.
Policy and Action Matrix for Decentralized TB Diagnostic Implementation
| Future Direction | Policy Focus | Implementation Level |
|---|---|---|
| Institutionalization in NTPs | Health Policy | National |
| Regulatory & Quality Frameworks | Regulation & Standards | National |
| Sustainable Financing | Health Economics | National/International |
| Capacity Building for Workforce | Human Resources | Regional/National |
| Integration of Digital & AI Tools | Digital Health | National/Facility |
| Community-Centered Models | Public Engagement | Local/Community |
| Global Collaboration | Global Health | Regional/Global |
| Evidence quality and research | Promote high-quality RCTs, prospective studies | National/International |
| Patient-centered design | Incorporate patient feedback and satisfaction measures | Local/Community |
| Regional adaptation | Tailor strategies to local context | National/Regional |
Comparative Features of Centralized vs_ Decentralized Tuberculosis (TB) Diagnostic Models
| Dimension | Centralized Testing | Decentralized Testing |
|---|---|---|
| Test Location | National or regional central laboratories | Primary care settings or point-of-care (POC) sites |
| Turnaround Time | Days to weeks | Minutes to hours |
| Infrastructure | High-complexity set-up with biosafety and cold chain | Low-resource adaptable, portable platforms |
| Sample Logistics | Requires long-distance transport, cold chain | On-site testing, minimal logistics |
| Human Resources | Requires highly-trained laboratory specialists | Operable by general health workers with minimal training |
| Diagnostic Access | Limited in rural and remote areas | High accessibility across decentralized regions |
| Operational Cost | High fixed and variable costs | Lower marginal cost after implementation |
| Scalability | Limited by central lab capacity | Highly scalable across diverse health system levels |
| Patient Perspective | Indirect; limited engagement | Higher satisfaction, reduced travel costs, better adherence |
| Socio-cultural adaptability | Low (standardized protocols, limited cultural tailoring) | High (adaptable to local context, community involvement) |