Editorial

If a general lack of preparedness somewhat defined the nation’s healthcare system in the wake of the COVID-19 pandemic, what has equally emerged among its leading correlates is the absence of both capacity and standards in the medical and testing laboratory system in the delivery chain. That, at least, was the crux of the submission by stakeholders at their meeting on the state of laboratory services held in Abuja.

Top among the revelations is that whereas the nation’s landscape could be said to be dotted with ‘laboratories’, most of those routinely passed off as ‘laboratories’ are only so-called for want of appropriate description. The situation was best captured by the Director-General, Nigeria National Accreditation System (NiNAS), Celestine Okanya, when he noted that whereas Nigeria could boast of 3,000 laboratories, only 10 are accredited. The same could be said of the over 7,000 testing and calibration laboratories, of which less than 50 are accredited.

Tosan Erhabor, the registrar, Medical Laboratory Science Council of Nigeria (MLSCN), also confirmed this much when he noted that laboratory accreditation, at least until recently, was not mandatory. His words: “Before now, the requirement is just to get a laboratory, equip it and start business…”.

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The revelation – if it could be so described – certainly comes as no surprise. If anything, it merely affirms what is already a notorious fact about the inadequacy of our health care delivery system, as indeed the inability of those in charge of the policies to rise up to the challenge of giving the nation a befitting health care system. That leaders in the health services industry have all the while passed this off as norm is certainly tragic. That is hardly the way of modern health care systems. We are referring to something with practical implication in the inhibition of the ability of healthcare practitioners to offer quality patient care, with equal capacity to undermine faith in the entire healthcare system.

So much for the legendary clinical expertise of our healthcare professionals, the truth is that medical practice has since moved from one of utmost reliance on clinical skills to one in which laboratory medicine has come to play a major part, chiefly for reasons of the enabling infrastructure of science and technology.  With increasing specialisation has come the need for every segment in the healthcare delivery chain to have some kind of regulation and, by extension, quality assurance without which the ability of the caregiver to render informed opinion is severely limited, if not entirely compromised. With the upsurge in reported cases of misdiagnosis in recent times, Nigerians cannot but wonder about the extent to which this is traceable to the situation.

Of course, with some 3,000-odd laboratories and some 7,000 testing and calibration laboratories spread across the country, the issue would ordinarily seem less of numbers as it is about maintaining such standards as one might come to expect in a modern healthcare system. However, while that relatively small number in a country of 200 million people might seem barely adequate; that a paltry 0.33 % and 0.007% of the available laboratories and testing and calibration facilities, respectively, are accredited obviously says a lot about how this vital segment is yet to be factored into the health delivery equation.

It is a good step that accreditation is now mandatory. That is the way to go. More than mere prescription however, there has to be in place, a mechanism for strict monitoring and enforcement. In the same way that healthcare providers are mandatorily required to undertake some basic accreditation, we expect the same standards to apply to those offering ancillary services so critical to the maintenance of quality health care. That way, they are not only held accountable for their work, but also to strict liability when things go wrong.