Original Research

An oral history of medical laboratory development in francophone West African countries

Winny Koster, Albert G. Ndione, Mourfou Adama, Ibrehima Guindo, Iyane Sow, Souleymane Diallo, Jean Sakandé, Pascale Ondoa
African Journal of Laboratory Medicine | Vol 10, No 1 | a1157 | DOI: https://doi.org/10.4102/ajlm.v10i1.1157 | © 2021 Winny Koster, Albert Ndione, Mourfou Adama, Ibrehima Guindo, Iyane Sow, Souleymane Diallo, Jean Sakandé, Pascale Ondoa | This work is licensed under CC Attribution 4.0
Submitted: 20 December 2019 | Published: 16 March 2021

About the author(s)

Winny Koster, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands; and, Department of Public Health, Faculty of Social and Behavioural Sciences, Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the, Netherlands
Albert G. Ndione, Institut de Recherche pour le Développement (IRD), TransVIHMI, CRCF-Hôpital Fann, Dakar, Senegal
Mourfou Adama, Centre National de Lutte Anti Tuberculeuse (CNLAT), Laboratoire National de Référence des Mycobactéries, Ouagadougou, Burkina Faso
Ibrehima Guindo, Institut National de Recherche en Santé Publique, Bamako, Mali
Iyane Sow, Directorate of Laboratory services, Ministry of Public Health and Social Welfare, Dakar, Senegal
Souleymane Diallo, Centre d’Infectiologie Charles Mérieux, Bamako, Mali
Jean Sakandé, Fondation Mérieux, Ouagadougou, Burkina Faso
Pascale Ondoa, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands; and, Department of Global Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands; and, African Society for Laboratory Medicine, Addis Ababa, Ethiopia


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Abstract

Background: Underdeveloped and underused medical laboratories in sub-Saharan Africa negatively affect the diagnosis and appropriate treatment of ailments.

Objective: We identified political, disease-related and socio-economic factors that have shaped the laboratory sector in Senegal, Mali and Burkina Faso to inform laboratory-strengthening programmes.

Methods: We searched peer-reviewed and grey literature from February 2015 to December 2018 on laboratory and health systems development from colonial times to the present and conducted in-depth interviews with 73 key informants involved in (inter)national health or laboratory policy, organisation, practice or training. This article depended on the key informants’ accounts due to the paucity of literature on laboratory development in francophone West African countries. Literature and interview findings were triangulated and are presented chronologically.

Results: Until around 1990 there were a few disease-specific research laboratories; only the larger hospitals and district health facilities housed a rudimentary laboratory. The 1990s brought the advent of donor-dictated, vertical, endemic and epidemic disease programmes and laboratories. Despite decentralising from the national level to the regional and district levels, these vertical laboratory programmes biased national health resource allocation deleteriously neglecting the development of the horizontal, general-health laboratory. After the year 2000, the general-health laboratory system received more attention when, influenced by the World Health Organization, national networks and (sub-)directorates of laboratories were installed.

Conclusion: To advance national general healthcare, as opposed to disease-specific healthcare, national laboratory directors and experts in general laboratory development should be consulted when national policies are made with potential laboratory donors.


Keywords

oral history; medical laboratory; Senegal; Burkina Faso; Mali

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