The Success of a Sample Networking Model: Lesson from Migori County

Abstract

The Success of a Laboratory Sample Networking Model: Lessons from Migori County

Levis Wandolo¹, Phillip Apamo², Boniface Olalo³, Agnetta Chepkemoi⁴

¹Laboratory Improvement Specialist, University of Maryland, ²Laboratory Technical Advisor, University of Maryland, ³County Medical Laboratory Coordinator, Migori, ⁴ County Laboratory Logistician, Migori

 Introduction

Migori County has eight sub-counties, with about 180 health facilities consisting of one county referral hospital, eight sub county hospitals and a number of health centers, dispensaries, and faith based hospital and private health facilities. Only 60% of these facilities have laboratory services, with about 90% of these only managing basic microscopy and rapid testing for HIV. Access to proper diagnostic services is majorly achieved via laboratory networking. We present the model we developed for five sub-counties to achieve access to laboratory services in 2019.

Methodology

We mapped the health facilities across five sub counties and linked all non-diagnostic facilities to diagnostic ones. We trained all health care workers on various laboratory sample collection, packaging and transportation methods and SOPs and documentation logs. We also trained community sample riders on the laboratory network and basic biosafety methods. A facility sample networking contact list was developed for all facilities with the help of the facility in-charges. Health workers were also empowered to transport samples between facilities.

Results:

Health facilities were able to access testing for CD4, Early Infant Diagnosis (EID)-Point of Care Test (POCT), Serum Cryptococcal Antigen (SCRAG) test, Gene Expert and Acid Fast bacilli (AFB) microscopy through primary networking. Further, all facilities are able to access viral load and EID PCR testing via secondary networking. Healthcare staffs across the sub counties are able to do sample collection, packaging, documentation, transportation, and result follow up irrespective of their background. We are able to reach far-flung areas such as Migingo Island on monthly schedules. Sample riders are able to do basic sample and documentation audit against available sample acceptance criteria and reject non-suitable samples on site hence minimize time taken to detect and effect such rejections. Consequently, all the eight sub-counties in Migori County as of today are fully networked to diagnostic services through this model.

Discussions

This model has ensured patient results are discussed and filed by health workers, and decisions about patient management made prior to their scheduled visits. The model has also r reduced the turnaround time for all testing, including non-HIV related investigations, with minimal missing results documented.

Conclusion

Sample networking offers alternative in accessing diagnostic services as opposed to setting up laboratories. Equipping of existing laboratories with scheduled and documented networking strategies is essential in improving general health care services.