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Implementing a mobile diagnostic unit to increase access to imaging and laboratory services in western Kenya
  1. Roshni Dhoot1,
  2. John M Humphrey2,3,
  3. Patrick O'Meara3,4,
  4. Adrian Gardner2,3,
  5. Clement J McDonald5,
  6. Kelvin Ogot6,
  7. Sameer Antani5,
  8. Joseph Abuya7,
  9. Marc Kohli8
  1. 1 School of Medicine, Indiana University, Indianapolis, Indiana, USA
  2. 2 Department of Medicine, Indiana University, School of Medicine, Indianapolis, Indiana, USA
  3. 3 Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
  4. 4 Wataalamu Repair and Maintenance, Eldoret, Kenya
  5. 5 National Library of Medicine, National Institutes of Health, Bethesda, Maryland, USA
  6. 6 Radiology and Imaging Department, Moi Teaching and Referral Hospital, Eldoret, Kenya
  7. 7 Department of Radiology, Moi University, Moi University, College of Health Sciences, School of Medicine, Eldoret, Kenya
  8. 8 Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Marc Kohli; marc.kohli{at}ucsf.edu

Abstract

Access to basic imaging and laboratory services remains a major challenge in rural, resource-limited settings in sub-Saharan Africa. In 2016, the Academic Model Providing Access to Healthcare programme in western Kenya implemented a mobile diagnostic unit (MDU) outfitted with a generator-powered X-ray machine and basic laboratory tests to address the lack of these services at rural, low-resource, public health facilities. The objective of this paper is to describe the design, implementation, preliminary impact and operational challenges of the MDU in western Kenya. Since implementing the MDU at seven rural health facilities serving a catchment of over half a million people, over 4500 chest radiographs have been performed, with one or more abnormalities detected in approximately 30% of radiographs. We observed favorable feedback and uptake of MDU services by healthcare workers and patients. However, various operational challenges in the design and construction of the MDU and the transmission and reporting of radiographs in remote areas were encountered. Our experience supports the feasibility of deploying an MDU to increase access to basic radiology and laboratory services in rural, resource-limited settings.

  • radiology
  • diagnostic x ray
  • rural
  • sub-saharan Africa
  • Kenya
  • tuberculosis
  • mobile health units

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Handling editor Seye Abimbola

  • Contributors The research and development for aspects of this project was supported by the Intramural Research Program of the National Library of Medicine, National Institutes of Health. The design, equipment and operation of the MDU is supported by a grant from the AbbVie Foundation. This research has also been supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through USAID under the terms of Cooperative Agreement No. AID-623-A-12-0001. It is made possible through joint support of the United States Agency for International Development (USAID).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The contents are the sole responsibility of AMPATH and do not necessarily reflect the views of USAID or the United States Government.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Moi University/Moi Teaching and Referral Hospital Institutional Research and Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data statement No additional data are available.

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