Government sets up 77 laboratory hubs

By Martha Kagimba and John Agaba

THE Central Public Health Laboratories (CPHL), mandated to co-ordinate all disease diagnoses in the country, has set up a total of 77 laboratories across the country to increase access to quality laboratory services and improve accuracy and immediacy in disease diagnoses.

The laboratory hubs, the first of their kind, are equipped with modern laboratory equipment and can do chemistry, haematology and also carry out viral load test (CD4) services.

Speaking to journalists at the health ministry on Thursday, where the strategy was recognised as one of the better innovations in facilitating accurate and immediate disease diagnoses in the country (they won the African Society for Laboratory Medicine best practice award in Lab Medicine ), Sarah Opendi, the state minister for health (primary health care), explained that the ‘hub based sample transport network’ was designed by creating local networks based at hospitals with adequate laboratory capacity at the sub district level.

The hub is given a motorbike and a bike rider, who through scheduled visits reaches out to all the sites (30 sites per hub) in its catchment, which is within a radius of 30 to 40km. At each visit, the rider picks all samples and delivers them to the hub. 

At the hub, samples that can be run are sorted out, and those that can't be run are referred to more specialised laboratories through courier services, Opendi said in a statement.

Already 77 hubs have been setup across the country, reaching over 2300 health facilities, she said.

The hubs have all had infrastructural improvement and received additional laboratory personnel and have enrolled in the quality improvement program — SLMTA. 

All the 2300 sites through the sample transport system readily access national reference and specialised laboratories VHF, TB, Sickle Cell, Viral Load, Early Infant Diagnosis for HIV (EID), Pathology, EPI, and Bacteriology, she said.

Steven Aisu, the head of the CPHL lab located on Buganda Road in Kampala commended the strategy. He explained that it was cost effective and fast in disease diagnosis.

"The bike rider collects all the samples from the health facilities (HCII, HCIII, and HCIV) and brings them to the hub. So, we work on them (samples) to determine the disease and send back the results. Those samples that can't be tested at the hub are sent to specialised labs, for example to the UVRI and other labs," he explained.

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Sarah Opendi handing over an award to African Society for Laboratory Medicine Ambassador (ASLM) Charles Kiyaga, Coordinator  Head of Central Public Health laboratories Aisu Steven for the best Central Public Health Laboratories. Photo by Mary Kansiime

"Initially, it took us about 21 days to diagnose some samples (from when we draw the sample from the patient to when we deliver to them the results). But, with this strategy, the maximum we can delay to accurately diagnose a disease is seven days."

The strategy has impacted on delivery of services and case management, especially in treating children born with HIV, Aisu said.

The CPHL rolled out the sample transport network in 2011. Now they have over 77 laboratory hubs reaching over 2300 health facilities across the country.

And during the second scientific conference of the African Society for Laboratory Medicine held in Cape Town, South Africa, from Nov 30 to Dec 4 last year, CPHL won the best practice award in Lab Medicine, courtesy of this innovation.

ASLM is a pan-African professional body whose major objective is to promote the strengthening of laboratory services on the African Continent.

During the same conference, the Uganda Virus Research Institute (UVRI), located in Entebbe, also won the best practice accolade, in respect of the Viral Haemorrhagic Fever (VHF) Detection and Control Laboratory. 

And the National Tuberculosis Reference Laboratory, in Wandegeya, attained international accreditation, meaning it can accept TB samples from all over the world.

Dr. Jane Ruth Aceng, the director general of health services, said the recognitions "improve confidence" in the general population about Uganda's health system.

Dr. Alex Opio, the commissioner national disease control, explained that the model, which was innovated in Uganda, was awarded best practice because it has "transformed the paradigm of laboratory services and the entire health system in Uganda."

"It has greatly improved the coordination of laboratory services in the country. Instead of having laboratories all over the place, which are difficult to manage efficiently with proper quality systems, the sample transport system has enabled reorganisation of the lab services to fewer service points, which are efficient, with proper quality system and yet are accessible by most sites in the country," he said.