Assessing Barriers to Medical Laboratory Diagnostic Service Delivery in Mzuzu City

Abstract

Medical laboratories provide confirmatory diagnosis and evidence based management of diseases, essential public health information and disease surveillance. A wide variety of research studies suggest that breakdowns in the diagnostic process result in a staggering toll of harm, patient deaths and wastage of valuable medical resources already constrained in the developing world. The objective of this study was to assess barriers to delivery of optimal laboratory diagnostic services in Mzuzu city. This was a descriptive cross-sectional study using quantitative research approach. Three categories of laboratories were selected from the public, faith based and private health systems. Stratified sampling was used to select laboratory practioners while purposive sampling was used to select administrators from each health facility. The data was analysed by the measures of central tendency mean plus measures of variability, range, standard deviation and standard error, using SPSS version 20. The findings of the study were that laboratory practioners identified several barriers to affect quality diagnostic services: 79% of laboratory staff reported short supply of laboratory supplies, work overloads (69%), frequent equipment failure (22%), scarcity of modern equipment (20%) and others. Administrators (67%) reported a limited budget allocation to the public and faith based hospitals. The study also found that there were some barriers that were more frequent than others such as shortage of laboratory supplies (84%), work overloads (70%), lack of refresher training (34%), frequent equipment failure (28%) and others. The study also found that laboratory practitioners employed several countermeasures to overcome technical barriers to diagnostics. 44% reported that they would stop tests when reagents run out of stock, wait for maintenance of equipment and stop tests (38%), higher cadres would delegate work to lower level cadres (31%), improvise on faulty equipment and expired reagents (26%) and many others. No laboratory had adequate quality management systems in place. The recommendations of this study were to strengthen human resources planning for laboratory professionals, establish or strengthen national laboratory regulatory and representative bodies to improve governance and enhance quality, and promote work and competency based in-service training to ensure that staff skills are up to date and competency is demonstrated.