For African public-sector laboratories, a lack of recognition is exacerbated by a dearth of funding and adequately skilled staff, which in turn presents challenges for much-needed infrastructure development in the pathology environment. Despite this, the Namibia Institute of Pathology Limited (NIP) has, since 1999, continued to perform crucial clinical tests that result in providing diagnosis, treatment and prevention of diseases. Along the way, it has notched up an impressive number of local and international recognitions that salute it for best practices, quality, leadership, technology and innovation, and contributions to the fight against HIV/Aids. The NIP has even named ‘Best Company To Work For’.

CEO Augustinus Katiti must take some credit for the latter acknowledgment, especially given that he had been a runner-up in Namibia’s newsmaker awards, and nominated as manager of the year (2016) in the European Society for Quality Research Best Practices awards.

As head of the largest diagnostic pathology service provider in Namibia – which has 40 laboratories across 14 regions – Katiti has been part of the process that has seen the state-owned enterprise realise self-funding by including the private sector among its client base.

The NIP’s success is also attributed to its state-of-the-art facilities, which depend on technology and internet connectivity and are key to NIP operations.

‘They allow our network of laboratories to be interlinked via laboratory information systems,’ he says. ‘Analysers can be interfaced to laboratory information systems, and automation in certain areas can reduce turnaround time and improve efficiencies.

‘New technologies have also contributed to point-of-care testing devices that are relatively small and easy to use, and result in immediate treatment of patients.’

Symmetry can also be found in the use of a short message service or application designed specifically to view patient results. Although, says Katiti, as is often the case with technology, success depends on the stability of telecoms providers.

It’s not only Namibians who benefit from the NIP’s services. The institute works closely with stakeholders and partners, including the Ministry of Health and Social Services, the WHO, USAID, Centres for Disease Control and PEPFAR (the US President’s Emergency Plan for Aids Relief) – providing not only laboratory services but also monitoring of communicable diseases.

‘We strive to be the pathology service provider of choice in Africa, and have organised our technical services in such a way to support professionally managed and well-equipped laboratories. We have also partnered with various international educational institutions in Botswana, Kenya, Uganda, Tanzania and South Africa,’ says Katiti. Angola also features as a growth market for expansion.

The NIP’s partnerships extend to offering services such as haematology, serology, chemistry/immunochemistry; flow cyto­- ­metry; microbiology; and molecular diag­- nostics. It collaborates in combating five major diseases in Africa, namely TB, HIV, malaria, hepatitis and diabetes. Katiti explains that pathology is central to the early detection, prevention, diagnosis and treatment of these diseases as well as cancer and cardiovascular conditions.

‘Research has shown that 70% to 80% of all healthcare decisions affecting diagnosis or treatment involve a pathology investigation. Locally, we participate in various trade and science fairs across the country where we specifically educate and inform the public about NIP service offerings.

‘We also engage the public and our clients through the electronic and print media, where we inform of new offerings and any innovative developments in the healthcare industry.’ One such development is the Strengthening Laboratory Management Towards Accredita­tion (SLMTA) programme, developed by credible global health organisations for African laboratories.

‘It emphasises taking a training approach in laboratory management and quality-management systems, with the goal to produce measurable improvement and prepare laboratories for accreditation based on international clinical laboratory standards,’ according to Katiti.

‘If all African countries embrace SLMTA, the quality of laboratory services being offered on the continent will definitely improve and will further have an impact on the quality of healthcare service delivery.’

Staff training will also help. However, this is somewhat of a stumbling block. ‘Over the years, Africa has lost a number of pathology professionals to retirement or immigration. The consequence is that laboratories lack staff who can offer mentorship and proper training for new students or graduates entering the pathology discipline,’ he says.

‘Link this to the capital limitations for public-sector laboratories and the chance of those almost always falling short of meeting diagnostic challenges becomes a reality, one way or the other,’ says Katiti.

‘Africa still has the opportunity to build state-of-the-art laboratory facilities, like the NIP, that will ensure optimal functioning of laboratory equipment, which in turn will ensure that diseases are accurately diag­- nosed, treated and monitored. Laboratories that are well-built will improve specimen workflow and create a safe and efficient work environment.’

By Kerry Dimmer