Access to pathology and laboratory medicine services: a crucial gap. Issue 10133 (12th May 2018)

• Record Type: Journal Article
• Authors: Wilson, Michael L; Fleming, Kenneth A; Kuti, Modupe A; Looi, Lai Meng; Lago, Nestor; Ru, Kun
• Is Part Of: Lancet. Volume 391:Issue 10133(2018)
• Page Start: 1927
• Page End: 1938
• Publication Date: 2018-05-12
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(18)30458-6
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: As global efforts accelerate to implement the Sustainable Development Goals and, in particular, universal health coverage, access to high-quality and timely pathology and laboratory medicine (PALM) services will be needed to support health-care systems that are tasked with achieving these goals. This access will be most challenging to achieve in low-income and middle-income countries (LMICs), which have a disproportionately large share of the global burden of disease but a disproportionately low share of global health-care resources, particularly PALM services. In this first in a Series of three papers on PALM in LMICs, we describe the crucial and central roles of PALM services in the accurate diagnosis and detection of disease, informing prognosis and guiding treatment, contributing to disease screening, public health surveillance and disease registries, and supporting medical-legal systems. We also describe how, even though data are sparse, these services are of both insufficient scope and inadequate quality to play their key role in health-care systems in LMICs. Lastly, we identify four key barriers to the provision of optimal PALM services in resource-limited settings: insufficient human resources or workforce capacity, inadequate education and training, inadequate infrastructure, and insufficient quality, standards, and accreditation.