An evaluation of clinical laboratory services in sub-saharan Africa: Ex africa semper aliquid novi?

• Published in: Clinica chimica acta Vol. 267; no. 1; pp. 103 - 128
• Main Authors: Gray, I.Peter, Carter, Jane Y
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 06.11.1997
• Subjects: Africa South of the Sahara; Clinical laboratories; Epidemiology; Health Care Costs; Humans; Laboratories - economics; Pathology; Quality of Health Care; Services evaluation; Sub Saharan Africa; Workforce; Clinical laboratories; Sub Saharan Africa; Services evaluation
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/S0009-8981(97)00180-0

Pathology services represent the rational, scientific basis of the practice of clinical care. It does not represent deus ex machina, an implausible solution to a complex plot, but rather the way in which clinical care can be audited, controlled, guided and kept appropriate to the funds and the skills available. Arguments are presented to support this statement as well as to analyse what is wrong with health care, from the point of view of laboratory medicine, in sub-Saharan Africa. In most African countries `first world' technology has to be imported by economies barely able to sustain the basic requirements of human life. Badly needed foreign exchange is obtained by growing export crops at the cost of traditional lifestyle, disenfranchising communities, urbanisation, and even at the cost not being able to grow food. War, corruption, lack of accountantability even in the Western sense of being able to go to the polls every so often, lack of empowerment, low literacy rate etc all debase the communities, with minimal exceptions, of Africa. Health care is under the same capricious rule as all other public services: investment in laboratories is poor and most have no access to a professional laboratory at all. More investment, not less; expansion of pathology services not restricting them, is needed throughout the continent.