HAS THE STATE OF MEDICAL LABORATORY SYSTEMS IN GHANA CHANGED?

“On the 28^th of September 2017, a historic intervention was made when the Ghana Standard Authority launched the standard document GS ISO 15189:2017 adopted from the ISO 15189:2012 for quality and competency requirements for medical laboratories in Ghana. Before and after ACT 857, PART 1 came into force, Medical Laboratory Professionals quest for standards in their practice have never seen such brightness and positive response. (INTERNATIONAL STANDARDS FOR MEDICAL LABORATORY ADOPTED BY GHANA STANDARD AUTHORITY)”

PRIOR to the adopted standards, Ghana did not have standards for health laboratory services although laboratories play a critical role in health service delivery. This has probably been due to lack of commitment to quality service delivery and resource constraints. This has led to the poor planning of services to include infrastructure, organization and management, human resource, laboratory testing, supplies and equipment, lack of requisite standards, financing laboratory services, biosafety and biosecurity, laboratory information system, disease surveillance and response, operational research, monitoring and evaluation. Lack of requisite standards results in negative consequences for testing and diagnoses, treatment and management of diseases, loss of lives and unnecessary economic burden on Ghanaians due to the poor health state of the populace.

Physicians have a negative perception of laboratory results in Ghana (Kuofie M, PMJG, 2013). Laboratory systems and services can positively inform diagnosis, treatment and management of patients with an effective functioning of the regulatory body (Allied Health Professionals Council, ACT 857-PART 1), provision of appropriate infrastructure, needed investments, instituted standards and quality assurance programmes, professional training and adequate human resource (Kuofie M, PMJG, 2013).

These have been identified to contribute to the unreliability of laboratory results in Ghana. Physicians admit they resort to test results from private laboratories compared to the public laboratories. Even with that, they seek results of the same specimen of the same patient from about three different private laboratories to make decisions (Kuofie M, PMJG, 2013). This is an economic burden that largely ends patients in a more deplorable state than cure them of the many conditions they suffer.

            “In practice, for example; routine test processes and procedures for haemoglobin levels (“blood level”) and blood glucose levels should be checked against standards/controls every four hours or at least once a day. Due to lack of resources, most laboratories in Ghana (about 85%: observation from reports of professionals at general meetings) do not perform quality controls on their analysers before testing patient samples. A few that might be provided may be forced to run these quality checks once in a week for routine testing to diagnose, treat and manage patients (Observation made from our general meetings as professional and at workshops).”

The management of health facilities including the laboratory has been without the involvement of the qualified medical laboratory professional. The outcome is what has been expressed over the years and even a survey in 2009 within the Ghana Health Service revealed same without change.

There is a way out and that is to give autonomy to Medical Laboratory Professionals to manage their own affairs with competence. Such a call should not resort to labour unrest as it is bound to happen from 22nd of May 2018 from a  roadmap I have chanced upon.

The deplorable state has also come as a result of lack of financial support committed to the running of medical laboratories. The laboratories are generally, the most income generating unit in the health facilities. Regrettably, income accrued is used for other operations than re-tooling the laboratories. The laboratories NEED dedicated account which will be used for the purpose of running laboratories than to pay allowances, used for renovations, etc. Patients deserve better than always being told some tests could not be done because reagents have run-out and equipment are down because there is no money.