Diagnostics play a critical role in the detection, monitoring, control, and management of diseases. Poor access to quality-assured laboratory diagnostics has been associated with erroneous diagnosis, ineffective treatment, and avoidable deaths. The situation is dire in low and middle-income countries.
The diagnostics capacity in Africa was put in the spotlight by the COVID-19 pandemic, which revealed that Africa lacked the laboratory diagnostic capacity for successful testing and monitoring of the COVID-19 virus.
However, the challenges faced by African laboratories in diagnosing and combating the Covid-19 infection are not peculiar to the pandemic, but an offshoot of the critical challenges already confronting diagnostics and laboratory medicine in Africa
However, the challenges faced by African laboratories in diagnosing and combating the Covid-19 infection are not peculiar to the pandemic, but an offshoot of the critical challenges already confronting diagnostics and laboratory medicine in Africa.
This is one of the biggest lessons of the pandemic and hopeful it will not be a missed opportunity and the momentum generated in upgrading labs to address testing challenges will be sustained.
Inadequate human resource capacity drives poor diagnostics in Africa
Insufficient numbers of suitably trained, qualified, and motivated laboratory staff in Africa is a major and common challenge. In rural areas, the situation is critical as most laboratories are poorly funded, under-resourced and lack skilled personnel.
Adequate human resource capacity in laboratories is essential to guarantee effective management of diagnostics tools and is also vital to enshrining quality management systems, which guarantees the quality of result generated from the labs.
Also, for any laboratory to get ISO accreditation, suitably trained, qualified and motivated staffs are essential. The process of accreditation is typically labour intensive, requiring the involvement of several staffs.
It is a strong capacity building process for all involved and also requires putting in place a certain level of infrastructure and system. That is why very few medical laboratories on the continent are ISO15189 accredited.
Increasing demand for laboratory diagnostic staff is unmatched by supply
Skilled laboratory staff in Africa are in increasing demand and there often exists a national market where both private and nongovernmental sectors compete with the public sector for a small pool of skilled staff.
The training given to laboratory staff to equip them to support accreditation also means they are highly attractive to other laboratories within the same sector and makes retention of these staff difficult.
Such highly trained staff are often in high demand by other labs. This leads to the circulation of available talents without much addition to the pool.
Strategies to strengthen human resource capacity for diagnostics in Africa
Various strategies must be adopted to strengthen human resource capacity in laboratories across Africa. Chief among these strategies is the training of laboratory staff. There is a crucial need for a significant increase in laboratory staff that are qualified and highly trained to meet international standards of performance.
Training can be achieved using several approaches, including self-training using e-resources, on-site training, centralised in-country training, and out-of-country training. Centralised and on-site training, often combined with supervision visits, are effective for technical and quality management systems (QMS) training.
Centralised in-country training across a network of laboratories can also provide introductory technical training on a new technology platform before it is rolled out. Centralised training can also be structured to allow the sharing of experiences between groups in different locations.
Large country training programmes can be carried out, with established in-country training centres housed at tertiary level facilities. This approach can be used to train a cohort of in-country trainers (‘training of trainers’) who can conduct on-site training. For example, the African Centre for Integrated Laboratory Training, South Africa, focuses on technical training for tuberculosis and HIV, but also provides general courses on QMS, biosafety, and strategic planning.
Apart from training of laboratory staff, performance-based financial incentives, improved salaries, welfare and benefits schemes are also effective strategies to encourage retention of trained staff and motivation for others to pursue careers in the laboratory space.
Bloom Public Health, a role model in building human resource capacity for diagnostics in Africa
Bloom Public Health has been at the forefront, strengthening and building capacity in both analytical and diagnostic laboratories in Africa, and has over the last few months channelled its expertise in providing technical assistance to various laboratories and institutions, recording tremendous success.
Recently, Bloom Public Health partnered with Katchey Laboratories, ND Western Limited, and the Independent Petroleum Producers Group (IPPG) to establish Delta Plus Diagnostics, a novel molecular laboratory in Delta State, Nigeria.
Bloom provided all technical support for the project, including the recruitment and training of all laboratory staff through on-site and supervised training from experts in laboratory quality management systems (QMS).
Bloom Public Health has also in the last few months provided technical support for the achievement of ISO17025 accreditation by a Nigerian independent analytical laboratory.
This involved the recruitment of staff and training in QMS, SOPs, and all documentation procedures to achieve and maintain accreditation. Bloom Public Health is looking forward to scaling its laboratory strengthening interventions across the continent through strategic collaborations and partnerships.
In Conclusion
Although the challenges confronting Africa’s diagnostic system are multifaceted, addressing inadequate human resource will be a major step towards strengthening diagnostics in Africa and moving towards universal health coverage.
