Assessment of the quality of medical laboratory service provision in Kenya
Wachuka Gathigia Wan’gombe- Njoroge
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There has been increasing interest to improve the quality of laboratory services world- wide including in many resource poor countries. In tandem with this need, the Kenya government recognizes the delivery of quality laboratory services as an integral part of the national health care strategy. Towards this goal the surveillance system for quality medical laboratory services in Kenya was instituted by the Kenya Medical Laboratory Technicians and Technologist Board. However, Kenya still has very little concrete and reliable information on the actual standard adaptation, and implementation, or the impact policy guidelines have had on laboratory services delivery. The objective of this study was to address these gaps by carrying out a situational analysis to assess the quality of medical laboratory services delivery in Kenya. The specific objectives of this research were to assess the laboratory practitioner’s competence; to determine the level of compliance to practice standards; to investigate the management of quality systems; and to analyze the extent to which the patient’s needs for quality laboratory services were met. As a representation of each of the regions in Kenya the study areas were situated in Nairobi, Mombasa, Kisumu and Nyeri counties. The study was both an observational and descriptive study using a cross sectional design. Purposeful sampling was used to select the laboratories while as random sampling was used for the laboratory practitioners and patients. The data was analyzed by the measures of central tendency mode, median and mean plus measures of variability, range, standard deviation and variance. Data was analyzed using least squares regression model, t-tests and one way analysis of variance (ANOVA) using Excel spreadsheets and SPSS version 19. The overall assessment was that the quality of medical laboratory services delivery in Kenya was good. The highest level of quality management systems were maintained by private high class laboratories p > 0.052, p > 0.05, α = 0.05 which also had the highest rating of compliance to practice quality p < 0.022, p < 0.05, α = 0.05. Faith based laboratories had the highest rating in competency of practitioners p < 0.027, p < 0.05, α = 0.05. Analysis of patients perception of quality service provided p < 0.039, α = 0.05 indicated that the private low class laboratories fared the best p < 0.030, α = 0.05. Findings of this research were that the laboratory practitioners were competent, the practice characteristics were of good standard and patients perceived the services to be of good quality. The study failed to reject the null hypothesis (p > 0.05) pertaining to the quality management systems in place p < 0.057, α = 0.05. No laboratory had adequate quality management systems in place. The recommendation of this study is there is a need for adequate internal and external quality assurance schemes to be in place to constantly monitor the quality of assay results.