Assessment of Laboratory Services in PHC Units and First Referral Level Hospitals in 5 Governorates, Egypt 2002

Parallel to the development in the promotive, preventive;curative services in primary health care are expected to achievemore specially with the concomitant implementation of thereferral system and family health record.Aim of this study is to assess the laboratory services inPHC and district hospitals and to evaluate the referral link asregards laboratory services between the two levels. This wasa cross sectional descriptive study during 2002. In this study,all laboratories either in PHC units or hospitals in the fivedistricts assigned for the Health System Upgrading Project II. A pre-designed pre-tested questionnaire form includingdata about the laboratory workers, their qualifications, andtraining experience. In addition, data about laboratory basicsanitary requirements, equipments, supplies and its logisticswas collected. Referral system between the two levels willbe investigated among a sub-sample of PHC laboratory ineach district to explore the aspects of strengths and weaknessif it is actually exists.Results: Manpower was mainly laboratory technicianswho were evenly distributed in different districts. The 2 n dmajority was assistant laboratory technician and they weremainly in Dyrute and Somosta (upper Egypt) 51/62 (82.3%).Unqualified laboratory worker comes third. Doctors wereonly 8, and there was one District hospital (somosta) laboratorywithout a clinical pathologist. Although the mean duration ofwork as a laboratory Personnel was 13.3±9.6 years for PHCworkers and 11.9±9.5 years for hospital laboratory personnel,the percentage of those not attending any training course was54.2% (116/214). A declining percentage for attending onecourse, two courses and three courses among PHC personneland still lower of hospital personnel. Basic sanitary needs:were almost satisfactory except for few PHC units in Dyruteand kantara Gharb. Laboratory equipment and laboratorymaterials: PHC laboratory and hospital laboratory are generallysatisfactory. Some vital equipment are deficient in somehospitals. The need for maintenance besides is vital trainingof available personnel to use such equipment. Materials forits proper utilization are essential. Needs for redistribution ofsome materials between hospital laboratories is recommended.Laboratory registration forms: Registration book is the onlyformat we can consider satisfactory. Other format is eithernot available or available and Neglected in some PHC andHospital lab.Recommendations: The need for maintenance is vital,training of available personnel to use such equipment. Materialsfor its utilization are essential. Need for redistribution of somematerials between hospital laboratories is recommended.Foundation for referral link is vital.