Building Consensus on the National Laboratory Policy
A Policy workshop was held on 19 December 2019 by the Ministry of Health and Wellness in close collaboration with WHO with the aim of building consensus on the National Laboratory Policy. The participation of a wide range of stakeholders including development partners, professional users and technical experts such as laboratory scientists, engineers, clinicians, pathologists, public health experts, health economists and financers was crucial in view of developing an efficient, cost-effective and sustainable quality health laboratory service.
There is need for a National Laboratory Policy to ensure safety and reliability of health laboratories. The policy will also provide a framework for coordinated delivery of quality and accessible laboratory services country-wide. Mauritius is committed to develop and implement its National laboratory policy to ensure quality health to the population.
Dr Bhoshun Ori, Director Health Services at the Ministry of Health and Wellness addressed the audience at the opening of the workshop. The latter highlighted the commitment of the Government of Mauritius in establishing quality laboratory services through strengthened governance, organization and management structures, and supportive legal and regulatory frameworks. The Director Health Services pointed out that a national policy for Laboratory services will reinforce quality and safety of the health laboratory services through improved national laboratory infrastructure and support systems. According to the latter, it will also enhance coordination of laboratory services across disease control programmes to promote rational use of laboratory resources. The National Laboratory Policy will also establish systems for monitoring and evaluating performance to enhance quality and efficiency of the health laboratory services and provide adequate human and financial resources to ensure effective delivery of health laboratory services.
Dr S. Manraj, Director, Laboratory services, made a presentation on the situational analysis of the Laboratory Services in Mauritius and the key content of the draft National Health Laboratory Policy which was developed based on the guidance published by WHO Regional Office for Africa in 2015, and using the participatory approach. During the workshop, participants had an overview of the Health Laboratory System which includes surveillance, diagnosis, treatment, prevention and promotion.
The strengths of the present Heath Laboratory System were highlighted by the Director Laboratory Services. ISO 9001:2008 certification was obtained for the National Blood Transfusion Services and has been maintained till date. The TB lab has been reviewed on the Stepwise Laboratory Improvement Process towards Accreditation in the African region (SLIPTA) (currently at Star 3) and is on the good track to achieve ISO 15189 Accreditation. The laboratory system in Mauritius has undergone long expansion of services and is Technology intensive system.
Dr Manraj highlighted that the absence of an appropriate regulatory framework is a major weakness as well as the lack of Quality Management System and national laboratory guidelines and standards. It was also pointed out that there is sub-optimal Manpower distribution and no proper system for disposal of obsolete equipment. The lack of document control and Biosafety/ Biosecurity system was also noted as it brought the score for the International Health Regulations ( IHR) Joint External Evaluations (JEE) to 1.
On the other hand, Dr Manraj stressed there were quite a number of opportunities observed. The Health sector strategic plan 2019-2023 calls for the sector-wide actions, including improvement of the laboratory standards. Laboratory Information Management Systems (LIMS) is expected to launch as a part of the e-Health project as the systems will integrate fragmented surveillance systems as well as strengthen the health service delivery at the facility level. The emergence and re-emergence of certain diseases, the ageing of the population, donor fatigue, lack of funding and resources, climate change and the Asia-Africa Air corridor are challenges that the country has to face in the future.
Dr Jane Carter, WHO consultant, facilitated the workshop. She highlighted the importance of having a policy for laboratory services which should influence and determine. The vision of WHO ‘to become a regional centre of excellence in health laboratory services’ was emphasized by Dr Carter. Such an important policy aims at providing quality, equitable and accessible laboratory services that meet international standards, and promote improved health outcomes for the people of the Republic of Mauritius through support to patient management, and disease surveillance and control within an integrated health care delivery system. Dr Carter emphasized on the core values of the National Laboratory Policy namely equity, accessibility, relevance, partnership, ethics, timeliness, customer focus and quality testing.
All comments and suggestions received from the participants will be considered before finalizing the National Laboratory Policy. Subsequently, the Ministry of Health and Wellness will elaborate and implement a National Health Laboratory Strategic Plan.
At the end of the workshop, everyone present agreed that it is a must to strengthen and modernize the laboratory services. The need for sub-specialization was also underlined as medical specialists do not master all disciplines. All stakeholders unanimously agreed that the national laboratory system should ensure safe conditions and practices and the infrastructural standards need to be improved as the country gets prepared for Accreditation.