Situational diagnosis of clinical laboratories in Ecuador: Analysis of management in these services

Abstract

This is a situational diagnosis of the country's clinical laboratories, which seeks to evaluate their registration system, the human resource that allàlabora and its suitability. For the diagnosis, all 21 provinces of the country were considered, to which a Laboratory Data Collection Form was sent and the information of the remaining Cadastres was requested within a year. Follow-up was carried out through telephone calls to the Provincial Health Directorates.

Only nine of the 21 provinces delivered cadastral information and 14

provinces the Data Collection Forms. Only five provinces send the information from both the Cadastre and the Form. Carchi, Napo and Morona Santiago did not send any type of information.

No province provided complete cadastral information. Pichincha reported the largest number of laboratories (78%). Of a total of 1,001 laboratories registered in the Forms, 452 (46%) did not have an operating permit. In Los Ríos, Pastaza, Esmeraldas and Guayas, the percentage of laboratories without operating permits was equal to or greater than 50%. A difference of 110 laboratories (33%) was demonstrated between those registered in the Cadastre (329) and the laboratories with operating permits that appear in the Forms (219), this difference being more noticeable in some provinces. Clinical laboratories located in private health services (93) represented 76.2% of all laboratories with operating permits. Guayas had the highest percentage of professionals with the appropriate profile to manage clinical laboratories (24.6%), followed by Pichincha (24.3%).

The study evidenced the lack of regulation of clinical laboratories in the investigated provinces, as well as a series of important omissions (adequate infrastructure and human resources). Many of the clinical laboratories in the different participating provinces did not have operating permits. There are laboratories in private health services that may not have the respective permit. In general, the biochemists were the professionals with the appropriate profile for the workload of most of the clinical laboratories in the study provinces, although the fact that many laboratories were managed by support staff is worrying. There is no adequate information system and there is evidence of a lack of registration of clinical laboratories. The MSP does not have an efficient intra-institutional information network and there is no adequate control and surveillance of clinical laboratories located within private services. There is evidence of a breach of the legal framework in relation to the proper functioning of the laboratories.

It is recommended to implement an automated information system in the Provincial Health Directorates and an intra-institutional information network. A census of clinical laboratories in Ecuador is recommended. There must be a review process of the gaps at the corresponding levels and the delivery of information by all the provinces must be guaranteed. It is important to analyze, evaluate and improve the current operating regulations for clinical laboratories and that all have the respective operating permit. Due to the lack of personnel adequate to the load of clinical laboratories, the possibility of a year of rural work for biochemists and pharmaceutical chemists who graduate from the country's college should be studied.