Gaps in Laboratory Quality Management Systems in the Volta Region of Ghana

Abstract

Background and Aim: Laboratories play a key role in the control and prevention of diseases through the provision of accurate, reliable and timely results. Coordinated activities to direct and control the laboratory with regard to quality is Quality Management Systems (QMS). The study assessed gaps in the QMS of some district laboratories in Ghana. Study Design:  Non-interventional exploratory study. Place and Duration of Study: Volta Region of Ghana, February to March 2016. Methodology: The Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist by World Health Organization’s Regional office for Africa (WHO/AFRO) was used to assess six district laboratories in the Volta Region of Ghana. The six facilities were randomly selected to include laboratories from each of the three sectors (northern, middle, and southern) of the region. The northern sector laboratories were designated N1-HMH and N2-NDH, middle sector (M1-HMH, M2-ADH), and southern sector (S1-SDH, S2-ADH). Results: The SLIPTA scores for the facilities were all < 55% (0-142points) which is a zero star in the 0-to-5 star rating using the WHO/AFRO laboratory strengthening tool. The S1-SDH laboratory recorded a total score of 17.4% (45points), S2-ADH 11.6% (30points), M1-HMH 17.8% (46points), M2-ADH 9.7% (25points), N1-HMH 5.4% (14points), and N2-NDH 4.7% (12points). M1-HMH had the highest SLIPTA score whilst N2-NDH reported the least score. The Quality System Essentials (QSEs) measured were below 50%. “Management Reviews”, “Internal Audit”, “Corrective Action”, “Client Management and Customer Service” were not performed by any of the facilities whilst “Organization and Personnel” was highly performed. On the average SLIPTA score, the southern sector laboratories performed better whilst the northern sector laboratories exhibited the least performance in relation to QMS. Conclusion: The star level recorded by the facilities is zero (0) based on 0-to-5 star rating. This implies that the total laboratory QMS is very weak and various stakeholders are encouraged to focus on strengthening district laboratories for effective healthcare delivery. This is a detailed baseline data for measuring improvement through future interventions.