Analytical Framework for Health Technology Assessment of Point-of-Care Diagnostic Devices in Low-Resource Nigerian Clinical Settings

Point-of-care diagnostic devices are transforming clinical care delivery in resource-limited Nigerian settings, but existing health technology assessment frameworks developed for high-income country laboratory contexts do not adequately capture the value dimensions most relevant to low-resource point-of-care deployment. This study develops and applies an analytical framework for health technology assessment of point-of-care diagnostic devices specifically designed for low-resource Nigerian clinical settings, addressing the gap between available assessment tools and the practical decision-making needs of Nigerian health procurement and policy authorities. The framework was developed through a systematic review of existing point-of-care HTA methodologies, stakeholder consultation workshops in Abuja and Ibadan involving clinicians, procurement officers, health economists, and laboratory scientists, and expert panel review. The framework specifies seven assessment dimensions with Nigerian low-resource weighting adjustments: diagnostic accuracy under field conditions, operator technical requirements, power supply independence, infrastructure requirements, cost per test including total system cost, supply chain robustness, and contextual clinical impact on patient management decisions. The framework was applied to three point-of-care diagnostic technologies, namely a portable haematology analyser, an integrated malaria PCR system, and a portable echocardiography device, using data from field evaluations conducted at hospitals in Enugu, Kano, and Bayelsa states. Application demonstrated that the framework generated systematically different and more context-relevant technology rankings than a standard clinical accuracy-only assessment approach. The study provides a practical analytical tool for evidence-based point-of-care device investment decisions by Nigerian health technology authorities. Keywords: health technology assessment, point-of-care diagnostics, low-resource settings, Nigeria, analytical framework.