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Lessons from the Field
A comprehensive district-level laboratory intervention after the Ebola epidemic in Sierra Leone
Submitted: 06 August 2018 | Published: 22 October 2019
About the author(s)
Annelies W. Mesman, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States; and, Partners In Health, Boston, Massachusetts, United StatesMusa Bangura, Partners In Health, Boston, Massachusetts, United States
Sahr M. Kanawa, Ministry of Health and Sanitation, Koidu, Sierra Leone
Joseph S. Gassimu, Partners In Health, Boston, Massachusetts, United States
Kerry L. Dierberg, Partners In Health, Boston, Massachusetts, United States; and, Division of Infectious Diseases and Immunology, New York University, New York, New York, United States
Mohamed M. Sheku, Ministry of Health and Sanitation, Koidu, Sierra Leone
J. Daniel Orozco, Partners In Health, Boston, Massachusetts, United States
Regan H. Marsh, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States; and, Partners In Health, Boston, Massachusetts, United States; and, Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States
Abstract
Background: The 2014–2016 Ebola outbreak exposed the poor laboratory systems in Sierra Leone. Immense needs were recognised across all areas, from facilities, diagnostic capacity, supplies, trained personnel to quality assurance mechanisms.
Objective: We aimed to describe the first year of a comprehensive intervention, which started in 2015, in a public hospital’s general laboratory serving a population of over 500 000 in a rural district.
Methods: The intervention focused on (1) supporting local authorities and healthcare workers in policy implementation and developing procedures to enhance access to services, (2) addressing gaps by investing in infrastructure, supplies, and equipment, (3) development of quality assurance mechanisms via mentorship, bench-side training, and the introduction of quality control and information systems. All work was performed alongside counterparts from the Ministry of Health and Sanitation.
Results: We observed a strong increase in patient visits and inpatient and outpatient testing volumes. Novel techniques and procedures were taken up well by staff, leading to improved and expanded service and safety, laying foundations for further improvements.
Conclusion: This comprehensive approach was successful and the results suggest an increase in trust from patients and healthcare workers.
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