Skip to main content
SpringerLink
Log in

Laboratory equipment maintenance: A critical bottleneck for strengthening health systems in sub-Saharan Africa?

  • Original Article
  • Published:
Journal of Public Health Policy Aims and scope Submit manuscript

Abstract

Properly functioning laboratory equipment is a critical component for strengthening health systems in developing countries. The laboratory can be an entry point to improve population health and care of individuals for targeted diseases – prevention, care, and treatment of TB, HIV/AIDS, and malaria, plus maternal and neonatal health – as well as those lacking specific attention and funding. We review the benefits and persistent challenges associated with sustaining laboratory equipment maintenance. We propose equipment management policies as well as a comprehensive equipment maintenance strategy that would involve equipment manufacturers and strengthen local capacity through pre-service training of biomedical engineers. Strong country leadership and commitment are needed to assure development and sustained implementation of policies and strategies for standardization of equipment, and regulation of its procurement, donation, disposal, and replacement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References and Note

  • WHO Health Organization/UNICEF/UNAIDS. (2010) Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector. Progress Report 2010, http://whqlibdoc.who.int/publications/2010/9789241500395_eng.pdf, accessed 3 June 2011.

  • World Health Organization. (2010) Antiretroviral therapy for HIV infection in adults and adolescents. Recommendations for a public health approach, 2010 revision, http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf, accessed 3 June 2011.

  • World Health Organization. (2006) The role of medical devices and equipment in contemporary health care systems and services. June 2006, http://gis.emro.who.int/HealthSystemObservatory/PDF/TechnicalandDiscussionPapers/The%20role%20of%20medical%20devices%20and%20equipment%20in.pdf, accessed 3 June 2011.

  • Petti, C.A., Polage, C.R., Quinn, T.C., Ronald, A.R. and Sande, M.A. (2006) Laboratory medicine in Africa: A barrier to effective health care. Clinical Infectious Diseases 42 (3): 377–382.

    Article  Google Scholar 

  • Nkengasong, J.N. (2010) A shifting paradigm in strengthening laboratory health systems for global health. American Journal of Clinical Pathology 134 (3): 359–360.

    Article  Google Scholar 

  • Clinton, W.J. (2003) Turning the tide on the AIDS pandemic. New England Journal of Medicine 348 (18): 1800–1802.

    Article  Google Scholar 

  • Gayle, H.D. (2003) Curbing the global AIDS epidemic. New England Journal of Medicine 348 (18): 1802–1805.

    Article  Google Scholar 

  • Stevens, W. et al (2008) Role of the laboratory in ensuring global access to ARV treatment for HIV-infected children: Consensus statement on the performance of laboratory assays for early infant diagnosis. Open AIDS Journal 2: 17–25.

    Article  Google Scholar 

  • Abimiku, A.G. (2009) Building laboratory infrastructure to support scale-up of HIV/AIDS treatment, care, and prevention: In-country experience. American Journal of Clinical Pathology 131 (6): 875–886.

    Article  Google Scholar 

  • United Nations. Summit on the millennium development goals, http://www.un.org/millenniumgoals/, accessed 10 December 2010.

  • Nkengasong, J.N. et al (2010) Laboratory systems and services are critical in global health: Time to end the neglect? American Journal of Clinical Pathology 134 (3): 368–373.

    Article  Google Scholar 

  • Halbwachs, H. (2000) Maintenance and the life expectancy of healthcare equipment in developing economies. Health Estate 54 (2): 26–31.

    Google Scholar 

  • Pattanapanyasat, K., Sukapirom, K., Kowawisatsut, L. and Thepthai, C. (2008) New BD FACS Count CD4 reagent system for simultaneous enumeration of percent and absolute CD4 T-lymphocytes in HIV-1-infected pediatric patients. Cytometry Part B (Clinical Cytometry) 74 (1): S98–S106.

    Article  Google Scholar 

  • Abuja Summit to Endorse ADF 2000 Consensus on Fighting HIV/AIDS. Abuja declaration on HIV/AIDS, tuberculosis and other related infectious diseases, http://www.uneca.org/adf2000/abuja%20declaration.htm, accessed 10 December 2010.

  • World Health Organization. The Maputo declaration on strengthening of laboratory systems, http://www.who.int/hiv/amds/amds_maputo_dec_lab_sys.pdf, accessed 12 July 2010.

  • World Health Organization. Guidelines for health care equipment donations. Evidence and information for policy (EIP). Organization of health services delivery (OSD), http://www.who.int/medical_devices/publications/en/Donation_Guidelines.pdf, accessed 10 December 2010.

  • All Africa.com. Ethiopia: Firm signs 25 million Br HIV equipment support deal, http://allafrica.com/stories/201007130385.html, accessed 14 October 2010.

  • Zeh, C.E. et al (2010) Field experience in implementing ISO 15189 in Kisumu, Kenya. American Journal of Clinical Pathology 134 (3): 410–418.

    Article  Google Scholar 

  • Gershy-Damet, G.M. et al (2010) The World Health Organization African region laboratory accreditation process: Improving the quality of laboratory systems in the African region. American Journal of Clinical Pathology 134 (3): 393–400.

    Article  Google Scholar 

  • Yao, K. et al (2010) Improving quality management systems of laboratories in developing countries. American Journal of Clinical Pathology 134 (3): 401–409.

    Article  Google Scholar 

  • The United States President's Emergency Plan for AIDS Relief: New public-private partnership to strengthen laboratory systems (updated January 2009), http://www.pepfar.gov/press/94448.htm, accessed 24 November 2010.

  • Centers for Disease Control and Prevention. Public-private partnership strengthens global laboratory systems, http://www.cdc.gov/globalaids/Success-Stories/BD-Public-Private-Partnership.html, accessed 10 December 2010.

  • Garcia, P.M. et al (1999) Maternal levels of plasma human immunodeficiency virus type 1 RNA and the risk of perinatal transmission. Women and Infants Transmission Study Group. New England Journal of Medicine 341 (6): 394–402.

    Article  Google Scholar 

  • Cooper, E.R. et al (2002) Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. Journal of Acquired Immune Deficiency Syndrome 29 (5): 484–494.

    Article  Google Scholar 

  • Quinn, T.C. et al (2000) Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. New England Journal of Medicine 342 (13): 921–929.

    Article  Google Scholar 

  • Attia, S., Egger, M., Müller, M., Zwahlen, M. and Low, N. (2009) Sexual transmission of HIV according to viral load and antiretroviral therapy: Systematic review and meta-analysis. AIDS 23 (11): 1397–1404.

    Article  Google Scholar 

  • Das, M. et al (2010) Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS One 5 (6): e11068.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, PO Box 1014 Entoto Road, Addis Ababa, Ethiopia

    Peter N Fonjungo, Yenew Kebede & Thomas Kenyon

  2. Ethiopian Health and Nutrition Research Institute, PO Box 1242, Addis Ababa, Ethiopia

    Tsehaynesh Messele, Gonfa Ayana, Gudeta Tibesso & Almaz Abebe

  3. Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, 30333, GA, USA

    John N Nkengasong

Authors
  1. Peter N Fonjungo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yenew Kebede
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tsehaynesh Messele
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gonfa Ayana
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gudeta Tibesso
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Almaz Abebe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. John N Nkengasong
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Thomas Kenyon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter N Fonjungo.

Additional information

The authors examine approaches to assure that laboratory equipment is properly functioning: equipment management policies and a comprehensive equipment maintenance strategy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fonjungo, P., Kebede, Y., Messele, T. et al. Laboratory equipment maintenance: A critical bottleneck for strengthening health systems in sub-Saharan Africa?. J Public Health Pol 33, 34–45 (2012). https://doi.org/10.1057/jphp.2011.57

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/jphp.2011.57

Keywords

Search

Navigation