Uganda’s laboratory human resource in the era of global health initiatives: experiences, constraints and opportunities—an assessment of 100 facilities
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Human Resources for Health
Abstract
Laboratories are vital in disease diagnosis, prevention, treatment and outbreak investigations. Although
recent decades have seen rapid advancements in modernised equipment and laboratory processes, minimal investments
have been made towards strengthening laboratory professionals in Africa. This workforce is characterised by insufficient
numbers, skewed rural-urban distribution, inadequate qualifications, inadequate skill-mix and limited career opportunities.
These factors adversely affect the performance of laboratory professionals, who are the backbone of quality services. In the
era of Global Health Initiatives, this study describes the status of laboratory human resource and assesses the experiences,
constrains and opportunities for strengthening them in Uganda.
Methods: This paper is part of a study, which assessed laboratory capacity in 21 districts during December
2015 to January 2016. We collected data using a laboratory assessment tool adapted from the WHO and
USAID assessment tool for laboratory services and supply chain (ATLAS), 2006. Of the 100 laboratories, 16
were referral laboratories (hubs). To assess human resource constraints, we conducted 100 key informant
interviews with laboratory managers and in charges.
Results: Across the facilities, there was an excess number of laboratory technicians at Health Center (HC) IV
level by 30% and laboratory assistants were in excess by 90%. There was a shortage of laboratory technologists with
only 50% of the posts filled at general hospitals. About 87.5% of hub laboratories had conducted formal onsite training
compared to 51.2% of the non-hub laboratories. Less than half of HC III laboratories had conducted a formal onsite
training; hospital laboratories had not conducted training on the use and maintenance of equipment. Almost all HC III
laboratories had been supervised though supervision focused on HIV/AIDS. Financial resources, workload and lack of
supervision were major constraints to human resource strengthening.
Conclusion: Although opportunities for continuous education have emerged over the past decade, they are still
threatened by inadequate staffing, skill mix and escalating workload. Moreover, excesses in staffing are more in favour
of HIV, TB and malaria. The Ministry of Health needs to develop work-based staffing models to ensure adequate staff
numbers and skill mix. Staffing norms need to be revised to accommodate laboratory technologists and scientists at
high-level laboratories. Training needs to extend beyond HIV, TB and malaria.
Description
Keywords
Human resource, Laboratory sector, Uganda
Citation
Kiwanuka, S. N., Namuhani, N., Akulume, M., Kalyesubula, S., Bazeyo, W., & Kisakye, A. N. (2020). Uganda’s laboratory human resource in the era of global health initiatives: experiences, constraints and opportunities—an assessment of 100 facilities. Human Resources for Health, 18(1), 1-10. https://doi.org/10.1186/s12960-020-0454-5