Laboratory quality systems in clinical laboratory practice in Lagos, Nigeria (West Africa): Associated problems and prospects

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Adewoyin, Ademola
Ogbenna, Ann
Harteveld, Cornelis
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Introduction: The quality of the clinical laboratory, defined as accurate, reliable and timely reported test results, has direct impact on patient care. The study tested the state of laboratory quality systems in medical laboratory practice in Lagos, Nigeria in order to identify quality failures and proffer models for improvements. Methods: Twenty (20) private laboratories in Lagos (the most populous state in Nigeria) were studied using a structured questionnaire to assess data on laboratory characteristics and quality system. A quality metric based on selected 15 internationally accepted measures of laboratory quality was used. The study protocol (protocol number: ADM/DCST/HREC/APP/1981) was approved by Institutional Review Board (IRB) of the Lagos University Teaching Hospital. Results: Lagos has an estimated laboratory density of 21 per million population. Only two (10%) of the laboratories had some form of laboratory automation (analyzers). A quarter or less of studied laboratories had dedicated quality and safety officer(s), international accreditation, process control charts, participation in external audit or use of quality indicators (QIs). Only two (10%) laboratories were rated high for quality. Laboratories with automated equipment and wider scope of services had higher quality rating. No direct correlation was observed between length of laboratory operation and quality (p >0.05). Conclusion: Notable quality gaps in man-power, process control systems, customer-oriented service, laboratory audits and use of QIs must be addressed. This will be achieved through global partnerships, functional health insurance, public-private partnerships, health care financing, and a visionary leadership and organization with quest for quality improvement
Clinical laboratory, quality systems, Lagos, Nigeria