The Forgotten Factors Affecting the Expansion of Medical Laboratory Services to cope up the Rising Health Demands in Sri Lanka

Introduction: The government of Sri Lanka identifies health laboratory service as an essential component in the health care service and is committed to providing quality essential laboratory services to healthcare seekers. Ministry of Health, Sri Lanka is responsible for the establishment and enactment of relevant legislation, and for providing technical and managerial guidelines for the maintenance of laboratories which comply with nationally and internationally accepted standards. Epidemiological and demographic transitions in Sri Lanka have compelled it to focus its attention to combat noncommunicable diseases, which are accounting for an estimated 80% of the annual deaths in the country. Improvement of diagnostics was identified as a priority in Health Master Plan 2016-2025 and by Primary Health Care System Strengthening Project.

Methodology and results: Qualitative methods such as key informant interviews, attending meetings and desk reviews were used to collect the factors affecting the expansion of laboratory services and the most crucial factors were identified by using the 80:20 rule. Issues related to the implementation of the National Laboratory Policy, laboratory financing, human resource issues, accreditation, and lack of making sense of data were found to be the most crucial factors that need to be addressed strategically to successfully expand laboratory services across healthcare institutions.

Conclusions: It is essential to improve the competencies and capabilities of the Policy Analysis and Development Unit of the Ministry of Health to facilitate policy analysis, reviews, and preparation of groundwork for National Policy enactment. Lack of accredited health laboratories and a plan to accredit may reflect adversely on the technical competence. Widespread unavailability and compartmentalization of information management systems have led to underutilization of laboratory-related data and this has resulted in a lack of a viable plan for evidence-based laboratory finance allocation and human resource development.