Implementing and Measuring the Level of Laboratory Service Integration in a Program Setting in Nigeria
Date
2014
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Abstract
Background: The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as
parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing
fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an
approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory
services and highlight some key intervention steps taken, to enhance service integration.
Method: A quantitative before-and-after study conducted in 122 Family Health International (FHI360) supported health
facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment
utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was
used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no
integration, 1 = partial integration, 2 = full integration) for each service package. A composite score grading expressed as a
percentage of total obtainable score of 14 was defined and used to classify facilities (#80% FULL, 25% to 79% PARTIAL and
,25% NO integration). Weaknesses were noted and addressed.
Results: We analyzed 9 (7.4%) primary, 104 (85.2%) secondary and 9 (7.4%) tertiary level facilities. There were statistically
significant differences in integration levels between baseline and 3 months follow-up period (p,0.01). Baseline median total
integration score was 4 (IQR 3 to 5) compared to 7 (IQR 4 to 9) at 3 months follow-up (p = 0.000). Partial and fully integrated
laboratory systems were 64 (52.5%) and 0 (0.0%) at baseline, compared to 100 (82.0%) and 3 (2.4%) respectively at 3 months
follow-up (p = 0.000).
Discussion: This project showcases our novel approach to measure the status of each laboratory on the integration
continuum.
Description
Research Article
Keywords
Laboratory Service Integration, HIV&AIDS epidemic, Nigeria
Citation
Citation: Mbah H, Negedu-Momoh OR, Adedokun O, Ikani PA, Balogun O, et al. (2014) Implementing and Measuring the Level of Laboratory Service Integration in a Program Setting in Nigeria. PLoS ONE 9(9): e107277. doi:10.1371/journal.pone.0107277