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Wednesday, October 10, 2018

Africa’s Health Challenges: ASLM 2018 To The Rescue!

Nigeria is set to take centre stage as laboratory and medical experts converge for the 2018 African Society of Laboratory Medicine (ASLM) conference in Abuja, the nation’s capital. Slated for December 10 to 13, 2018, the conference seeks to bring together stakeholders in the clinical and laboratory industry in Africa.

The theme of ASLM 2018 is ‘Preventing and controlling the next epidemic and the role of African laboratories’. It is hoped that this conference will be beneficial to the medical laboratory sector in Nigeria, and indeed Africa at large.
According to the 2014 African Regional Report of the World Health Organisation (WHO), Africa presents the world’s most dramatic public health crisis. 
More than 70 percent of clinical decision-making is based on medical laboratory test results. However, there are still numerous challenges on the path to strengthening of laboratory systems and services in Africa.  These range from poor laboratory infrastructure, lack of laboratory networks and equipment, shortage of well-trained laboratory staff to weak supply chain management system, among others.
The importance of laboratory medicine practitioners cannot be overemphasized, hence the establishment of African Society for Laboratory Medicine (ASLM) in 2011.  The association has since inception launched national ASLM offices across different countries. The laboratory systems in Africa are threatened by an acute shortage of health workers who have left the continent for a variety of reasons. For instance, although Sub-Saharan Africa has 24 per cent  of the global disease burden, it has only three per cent  of the world’s health workers.
Issues surrounding the strengthening of laboratory health systems in Africa at present, have reached a peak  and demand very serious and immediate action. For example, South Africa has had an outbreak of Listeriosis, a serious food borne disease, since  2017. Nigeria is one of only three countries in the world still  suffering from wild polio virus transmission, alongside Afghanistan and Pakistan. The increasing rate of HIV/AIDS, Malaria, Cancer and other deadly ailments, has exposed the fragile nature of African clinical services as not being adequately equipped to support the prevention, treatment and management of these diseases.  ASLM exposes the need to place much emphasis on strengthening national health laboratory systems, so as to meet these pressing challenges.
Previously, African countries depended largely on donor funds to strengthen public health laboratories and other health systems. This support reduced with the global recession, as well as competing demands of health and other national agendas.
One way ASLM can help African countries attain their health goals is by these nations reducing their reliance on the global community and investing more in the African laboratory system.  Prof.  Souleymane Mboup, Director, Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formations (IRESSEF), Senegal, states that a lack of investment seems to be a major concern.  “The time has now come for collective action to contain these global health hazards. This should not only be a priority for Africa, but the entire world.  If we hope to avoid another outbreak like Ebola, we need to invest in our health systems”, he said.
Experts suggest that there is need for better collaboration between African countries and donor and implementing partners to ensure better capacity building of indigenous or African-based institutions through  the establishment of public–private partnerships (PPPs) to improve and sustain quality laboratory efforts.
In many African countries like Nigeria, one major challenge facing the laboratory system is the negative impact of laboratory errors on health service delivery. The ASLM conference, which will draw medical laboratory experts  from across  the continent, is expected to act as a policy and advocacy event on the need to strengthen Africa’s public health and laboratory system  as well as build trust and confidence in it.
Also, by being affiliated with several global bodies such as Bill & Melinda Gates Foundation, USAID, WHO and UNICEF, the 2018 edition of ASLM will serve as a platform for the international medical laboratory community to share best practices, acquire knowledge and debate new approaches to the fight against global health threats.  This will also lead to an increase in awareness and development of the structure, tools and processes needed to strengthen  Africa’s laboratory system.
As an aftermath of the 58th session of the World Health Organization Regional Committee for Africa (WHO AFRO) where the 2008 Maputo Declaration for Strengthening Laboratory Systems and Resolution was adopted, laboratory networks have been improving, resulting in an upgrade of diagnostic services for HIV, tuberculosis and malaria.
This led to a 2015 ‘Freetown Declaration’ calling for international and local stakeholders to establish strong laboratory networks, regularly measure progress with a standardized score card, and effectively integrate these networks into disease surveillance and public health institutes.
Stakeholders suggest that human capacity building such as re-training of practitioners is necessary and should be encouraged, noting that in addition to Africa’s medicine shortages and human resources, many staff are often not well-trained.  The Official Journal of the Society to improve Diagnosis in Medicine (SIDM), revealed that  the majority of African health workers have mid-level qualifications and only 9.7 per cent have a degree as a medical doctor.  It stated: “The phenomena generally described for health systems affect clinical laboratories too.  Laboratory medicine should play a critical role in effective and efficient management of healthcare, but this is often not the case in Africa. Laboratory expenditure is frequently prohibitive for most African health systems, which are adversely affected by issues such as lack of resources or corruption.”

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