Program Areas

Clinical Services

Laboratory Services

NUMAT lab photo

NUMAT strengthens laboratory infrastructure at low level health centers to provide laboratory testing and diagnostic services for communities in rural areas.

Health laboratory services form an integral part in the provision of life-saving HIV diagnosis and care, and are part of the Uganda National Minimum Health Care Package. Results from the 2004 national survey on laboratories indicated that 60% of the functional health center III and IV laboratories are run by unqualified staff. These laboratories also suffer from poor infrastructure, weak technical support, and ineffective quality assurance systems.

Specific Activities

Based on these findings and working within the existing system, NUMAT’s support for laboratory services focused on addressing the gaps identified and ensuring sustainability by:

  • Improving laboratory infrastructure
  • Refurbishing laboratory counseling rooms to meet MOH standards
  • Ensuring availability of essential equipment and supplies to support laboratory services
  • In-service training for health workers (laboratory and clinical) to enhance provision of quality health care
  • Pre-service training for laboratory personnel
  • Strengthening quality assurance through supportive supervision and quality control by proficiency testing and re-reading stored slides and samples
  • Health care waste management

Results

Overall there was an increase in the utilization of laboratory services from an average of 42% in the fourth year of NUMAT to 57% in the final year. Laboratory utilization for selected tests (i.e. HIV, TB, rapid plasma regain, and blood smears) also increased by an average of 18%. Use of labs for malaria diagnosis increased by 36%, while syphilis diagnosis increased by 8%. This has a bearing on the rational management of patients. There was also a sizeable increase in the number of tests being performed routinely, including blood smears for malaria, all cases of fever, and HIV as part of routine counseling and testing.

The number of laboratories implementing internal quality control measures increased to 80% (60 out of 75). The accuracy and reliability of laboratory results were improved, increasing the confidence of clinicians in using laboratory services to make decisions for client management. In 100 health units (HCIII and above), supplies were provided for health care waste management, waste was segregated according to standard color codes, and awareness on the importance of ensuring safe final waste disposal was created. This resulted in an increase in demand for appropriate disposal facilities (such as incinerators and waste pits).

In addition, there were improvements in records management, which allowed health facilities to project consumption and make timely and appropriate requests for reagents and supplies through the MOH credit line. Lastly, the number of laboratories with at least one qualified laboratory staff member increased from 75 to 96.


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