Overview: Blood Safety, Laboratories and Health Technology

Laboratory services

Laboratory services are characterized by inadequate staffing, equipment and supplies. These are the main obstacles to early detection of epidemics such as Ebola, Marburg, H1N1 and both multi-drug and extensively drug-resistant tuberculosis. Functioning national health laboratory services rely on effective disease surveillance and prevention of major emerging, re-emerging and endemic communicable and non-communicable diseases

Although progress has been made in strengthening laboratory capacity to support programmes such as poliomyelitis eradication, HIV/AIDS prevention and control, and measles elimination, challenges remain.

These include lack of national policies and strategies for laboratory services, insufficient funding, inadequately trained laboratory staff; weak laboratory infrastructure, old or inadequately serviced equipments, lack of essential reagents and consumables, and limited quality assurance and control protocols. Laboratories are usually given low priority and recognition in most national health delivery systems. The challenge is developing a comprehensive national laboratory policy which addresses the above issues.

Diagnostic imaging

Diagnostic Imaging is one of the pillars of medical diagnostics. However, 80% of resources for radiology are spent for 20% of the world's population. There is a severe lack of safe and appropriate diagnostic imaging services in large parts of the African region. A large number of images are of poor quality and are of no diagnostic use. Many are also misread. In other areas, imaging facilities are simply not available, or not functioning. Countries have to make safe and reliable diagnostic imaging services available to as many as possible, develop and maintain diagnostic imaging services; promote the importance of safe and appropriate diagnostic imaging services. The challenges are lack of awareness, resources, equipment, and qualified staff.

Cell, tissue or organ transplantation is carried out in a small number of countries in the African region, despite the fact that this form of treatment can save life or restore essential functions when there is no alternative. Access to transplantation depends on the availability of human material for transplantation. Globally, the increasing demand has led to a chronic shortage and the emergence of transplantation tourism where cross-boundary traveling of donors or recipients and sometimes of surgeons is only motivated by easy access to an organ, usually obtained for money or goods from a vulnerable individual. Although, the magnitude of these important public health problems is not well known in the African region, low and middle income countries constitute easy targets for the exploitation of poor and vulnerable individuals when they lack legal protection. Middlemen and coercion have been reported in all settings where transplantation takes place in the absence of a legal framework ensuring respect for essential values. The challenge is lack of standards, regulation policy and legal framework on human organ and tissue transplant in most African countries

Patient safety

Understanding of the extent of the problems associated with patient safety is hampered by inadequate data. However, prevalence studies on hospital-wide health-care associated infections from some African countries reported high infection rates, with patients undergoing surgery being the most frequently affected. Most countries lack national policies on safe health-care practices. Inappropriate funding, unavailability of critical support systems including strategies, guidelines, tools and patient safety standards remain major concerns in the Region. There is need for investing to enhance patient safety in health care services. Countries have to ensure that patient safety is a component of all national health systems. Countries have to develop and implement national policy for patient safety; improve knowledge and learning in patient safety; minimize health-care associated infection; ensure safe surgical care; ensure appropriate use, quality and safety of medicines; strengthen surveillance and capacity for research on patient safety.

Blood safety

In the area of Blood Safety the region faces a high demand for blood transfusion due to bleeding related to pregnancy and childbirth, high prevalence of malaria with the attendant complication of severe malarial anemia, high rates of road traffic accidents and other types of injury as well as other indications for blood transfusion.Ensuring universal access of all the population to a safe blood supply faces a number of challenges in the WHO African region. These include a high burden of disease transmissible through blood transfusion, including HIV, HBV, HCV and syphilis; posing difficulties in selecting donors at reduced risk of infection, unstable economies, lack of suitable infrastructure to provide blood services, inadequate human resources as well as lack of conducive career development structures for BTS staff in many member states. Reliance on family replacement donations, limited coverage and quality of testing, inappropriate blood transfusion and poorly developed quality systems pose additional challenges.

Most countries have developed their national blood policies and plan, 73% of total blood collections are from voluntary blood donors, at least 98% of the blood is screened for HIV, 89% for HBV, and about 60% for HCV.

Emergency Surgical Care

In the area of Emergency Surgical Care, the challenge is to attain strengthened capacity in life-saving emergency and essential surgical care and availability and correct use of suitable equipment in primary health-care facilities. The Disability Adjusted Life Years (DALYs) lost due to surgical conditions in sub-Saharan Africa is estimated at 38/1000 population. This is higher than in other regions of the world mainly contributed to by injuries (15/1000), obstetrical complications (6/1000), malignancies (3/1000), perinatal conditions (3/1000), congenital anomalies (3/1000), and cataracts and glaucoma (2/1000). It is predicted that, without greater preventive measures and increased access to surgical services, the incidence of traffic fatalities in sub-Saharan Africa will rise to 109,000 a year.


Telemedicine is at an early stage of development in the African region. Most of the countries lack telemedicine facilities. The challenge is to ensure that Telemedicine is widely used and disseminated to strengthen primary health care, train health care workers and improve national quality of care including laboratory and diagnostic imaging services.

Health technology

In health technology management, rapid advances in technology over the past few decades have placed countries in the Region under intense global market and internal pressures to import modern health technology. The proliferation of these technologies, resulting in a bewildering array of choices, creates demands which tax the limited resources of these countries. Consequently, the introduction of technology in the countries is driven more by pressures from technology producers and users than by country needs.

Demands on the health care system are increasing in all countries of the Region. At the same time, costs are increasing, and the gap between needs and resources is widening. There is therefore need for a clear and comprehensive policy on health care technology. However, due to problems arising from financing, lack of understanding of this situation by decision-makers and health care workers in general, inadequate institutional framework and managerial and technical capacities, it is easier to formulate policy than to implement it.

Apart from problems of human resources and the need to finance recurrent costs, issues concerning the administrative, economic and political environments of African countries impinge on the sustainability of technologies and equipment.

Countries should identify their own needs and priorities in the area of health technology assessment and operational research, and adopt a way of organizing these activities that is most appropriate to its situation and development and health sector reform strategies.

For more information please contact:

altDr Ndihokubwayo
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