In Kenya, sexually transmitted infections (STIs) remains a major public health burden, like in many other counties in Sub-Saharan region. For many years, the country has relied on syndromic diagnosis, treating patients based on the pattern of symptoms rather than etiological diagnosis in the laboratory. While this approach is fast and inexpensive, it has significant drawbacks: many asymptomatic infections go undiagnosed and antibiotics are often misused, giving rise to increasing cases of antibiotic resistance (AMR).

Globally, however, the tide is shifting. The World Health Organization now recommends a diagnostic-led approach that integrates point-of-care (POC) diagnostics into primary healthcare. These tests can deliver results quickly, reduce misdiagnosis, cut costs for patients, and improve overall quality of care.

To understand Kenya’s readiness to make this shift, International Centre for Reproductive Health Kenya (ICRHK), in collaboration with Jhpiego and the county governments of Kilifi and Nairobi, conducted a formative assessment. The qualitative study explored the perspectives of national, county, facility-level  and community stakeholders on adopting a diagnostic-led approach to STI management.

What Stakeholders Said

The findings were clear: stakeholders strongly support moving from syndromic management to a diagnostic-led model but only if there is strong evidence of effectiveness, affordability, and feasibility in real-world settings.

• Efficiency and better clinical outcomes: POC diagnostics would enable providers to make informed decisions, reduce unnecessary treatment, and ensure patients receive individualized care.
• Trust and confidence: Accurate diagnosis would strengthen patients’ trust in healthcare providers and improve partner notification and treatment.
• Antimicrobial resistance: A diagnostic-led approach could help curb the misuse of antibiotics, a growing concern under syndromic management.
• Challenges to consider longer consultation time, increased workload for providers, and higher upfront costs for diagnostics were noted as potential barriers. Stakeholders emphasized the need for simple, user-friendly, and affordable devices that can be integrated into existing workflows.
• Sustainability factors: National leadership, political goodwill, stakeholder involvement, and domestic financing are critical for successful rollout. Ensuring consistent supply chains and robust quality assurance systems will also be essential.

Why This Matters

This assessment provides timely evidence for the need to generate conduct more implementation research on STI diagnostics, especially point care. The strong support from stakeholders’ signals readiness to embrace innovations that could transform STI management. However, it also underscores the need for careful planning, investment, and partnership to ensure that POC diagnostics positively transform patient care in primary healthcare settings.