THE POCKET LABORATORY IN PRACTICE: A SOCIO-TECHNICAL REVIEW OF SMARTPHONE-BASED POINT-OF-CARE DIAGNOSTICS IN LMICs
Implementation, Task Shifting, and Last-Mile Challenges in Infectious Diseases
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5713Keywords:
Smartphone Diagnostics, Point-of-Care Testing, Low- and Middle-Income Countries, Task Shifting, Infectious Diseases, mHealthAbstract
Background: Infectious diseases remain a leading cause of mortality in low- and middle-income countries (LMICs), where nearly half the global population lacks adequate access to diagnostics. Smartphone-based point-of-care (POC) diagnostic technologies have emerged as a promising response to this gap, leveraging the rapid expansion of mobile phone ownership across resource-limited settings. However, a critical disconnect persists between the pace of technological innovation and the complex socio-technical realities of deploying such tools in resource-limited settings.
Objective: This narrative review synthesizes the literature on smartphone-based POC diagnostics for infectious diseases in LMICs, adopting a socio-technical systems perspective that extends beyond analytical performance to examine the human, organizational, and contextual determinants of implementation success.
Methods: A narrative review was conducted drawing on PubMed, Scopus, Web of Science, Google Scholar, and grey literature from WHO and partner agencies. The analysis was guided by a socio-technical systems framework and WHO’s REASSURED criteria for evaluating point-of-care diagnostic readiness.
Results: The review identifies four principal technological approaches — imaging-based, sensor-based, molecular, and data-driven diagnostics — and evaluates them against the WHO REASSURED criteria. Three models of task shifting to community health workers are proposed, each carrying distinct implications for training, governance, and quality assurance. Five categories of last-mile barriers are documented: infrastructural, regulatory, socio-cultural, economic, and technological. While proof-of-concept evidence is abundant, real-world implementation data from scaled programs remain scarce. The persistent gap between technological capability and population-level health impact is attributable not to engineering deficits but to systemic implementation failures.
Conclusions: Transitioning from pilot projects to sustainable, nationally integrated diagnostic programs requires coordinated action across regulatory harmonization, workforce development, user-centered design, and domestic financing — a shift from technology-centric to socio-technical approaches.
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Copyright (c) 2026 Damian Danilczuk, Szczepan Półchłopek, Kacper Szpanelewski, Radosław Kołodziej, Anna Kołodziej, Szymon Lulek, Jakub Klecha, Emilia Kucab, Katarzyna Dziki, Izabella Kula, Joanna Ciemięga, Wiktor Adamiec
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