The operation, quality and costs of a district hospital laboratory service in Malawi

Mundy, Catherine, Bates, Imelda ORCID: https://orcid.org/0000-0002-0862-8199, Nkhomal, W., Floyd, K., Kadewele, G., Ngwira, M., Khuwi, A., Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038 and Gilks, C.F. (2003) 'The operation, quality and costs of a district hospital laboratory service in Malawi'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 97, Issue 4, pp. 403-408.

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Abstract

Laboratory services are run down in many low-income countries, severely constraining their input to patient care and disease surveillance. There are few data about the quality and cost of individual components of the laboratory service in poorer countries, yet this information is essential if optimal use is to be made of scarce resources. Staff time, range of tests, workload, and safety procedures were monitored over 12 months (1997-98) in a typical district hospital laboratory in Malawi. Data were collected to calculate the total economic cost of these services. Of the 31203 tests performed, 84% were to support blood transfusion and diagnosis of malaria and tuberculosis (TB). Test quality was reasonable for malaria and TB microscopy and blood transfusion, but poor for haemoglobin estimation. The cost per test ranged from US$0.35 for haemoglobin to US$11.7 per unit of blood issued and the total annual cost of the laboratory service was US$32 618. Blood transfusion and microscopy for malaria and TB comprised the majority of tests. Ensuring that these tests are of the highest quality will therefore have the most impact in reducing wastage of laboratory resources. Inadequate quality of haemoglobin estimations is a particular problem. The findings of this study are likely to be relevant to other low-income countries with similar disease burdens.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WX Hospitals and Other Health Facilities > Clinical Departments and Units > WX 207 Clinical and pathological laboratories
Faculty: Department:	Groups (2002 - 2012) > Clinical Group Groups (2002 - 2012) > Disease Control Strategy Group
Digital Object Identifer (DOI):	https://doi.org/10.1016/s0035-9203(03)90070-8
Depositing User:	Users 476 not found.
Date Deposited:	03 Dec 2012 15:19
Last Modified:	13 Nov 2019 11:21
URI:	https://archive.lstmed.ac.uk/id/eprint/2623

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