COMMUNIQUE ISSUED AT THE END OF 54TH ANNUAL SCIENTIFIC CONFERENCE OF THE ASSOCIATION OF MEDICAL LABORATORY SCIENTISTS OF NIGERIA (AMLSN) LAGOS STATE BRANCH HELD AT NECA HOUSE, CENTRAL BUSINESS DISTRICT, ALAUSA, IKEJA, LAGOS BETWEEN 30TH JUNE AND 5TH JULY , 2019.
Preamble:
The Association of Medical Laboratory Scientists of Nigeria (AMLSN) Lagos state Branch held her 54th Annual Scientific Conference at NECA HOUSE, Central Business District, Alausa, Ikeja, Lagos Between 30th June And 5th July, 2019. The Conference theme was “Laboratory Diagnosis: The Fulcrum of an Efficient Primary Healthcare Delivery System”. The conference was chaired by world renowned Professor of Clinical Chemistry and Molecular Diagnosis, Professor Oluyemi Akinloye; the keynote address was delivered by the Consultant Public Health Physician, Professor of Community Medicine & Public Health, College of Medicine, University of Lagos, Professor Adebayo Temitayo Onajole. The Conference had in attendance His Excellency Babajide Olusola Sanwoolu, represented by Dr. Titilayo Goncalves, Permanent Secretary, Ministry of Health amongst other notable dignitaries. The Conference recognized the three types of primary health centres within the primary health care system. These include: The Comprehensive Health Centres (CHC); the Primary Health Centres and the Basic Health Clinic (BHC).
We noted with concern the low priority given to improving healthcare services like medical laboratory services due to the perceived functions of Primary Health-Cares (PHCs). Conference affirmed that Medical Laboratory diagnosis is no doubt a lever upon which efficient Primary HealthCare delivery system rotates and if the country is serious about achieving Universal Health Coverage, laboratory care at our Primary Health centres will be given its pride of place. Without medical laboratory intervention, diseases such as diabetes, hypertension, malaria, Tuberculosis, HIV, bacterial infections etc will be poorly managed. It is therefore imperative that medical laboratory should be part of the design of any primary healthcare centre and any attempt for it to be neglected is like playing games with health of the vulnerable which are mainly children and women. It is equally important to phase out all quacks and employ competent, licenced (by MLSCN) and adequate Medical Laboratory Scientists, Technicians and Assistants to man the laboratory at the primary health centres.
Observations/Recommendations
The Conference commended the Federal Government led by President Muhammadu Buhari, GCFR for giving due recognition to the primary level of care by establishing at least one Primary Healthcare centre in each of the 774 wards across the country. The Conference highlighted the factors responsible for RE-EMERGING COMMUNICABLE DISEASES IN AN EMERGING POPULATION which includes; poor hygiene and sanitation, overcrowding, sharing Personal items such as equipment used for tattooing, piercing, needles for injecting drug use, exercise equipment, sewage disposal materials, poverty, and ignorance as potential source of re-emergence/epidemic of communicable diseases in the country. The conference recommends Adequate Surveillance and Response, provision of Drugs and Vaccines at affordable costs, Infrastructure, Prevention and Control Measures, Improved socio-economic conditions that support provision of required amenities will go a long way in preventing infectious diseases and their re-emergence. The conference call on Federal Government to equip Central Public Health Laboratory in Yaba, Lagos with the state of the art diagnostic equipment to serve as referral Centre for diagnosis of infectious diseases while zonal centers should be opened at the six geopolitical zones. The Conference call on Government at all levels to establish and improve Public Health Laboratories with equipment that rapidly detect, diagnose and simplify the identification of putative reservoir hosts. We call on Government at all levels to improve the capacity of Public Health Laboratories for diagnosis and epidemiological surveillance of infectious diseases. The conference also identified PHC as strategy for achieving Health For All where we stressed health as a fundamental human right and stated that health care must accessible, affordable and socially relevant to meet the needs of the people. Conference also highlighted the main functions of Primary Healthcare Laboratory Services which are to provide effective coordination and monitoring of laboratory activities and laboratory personnel in the primary healthcare settings, provide quality assurance, periodic training and evaluation of the laboratory network as well as relevant operational research. It will also develop laboratory national data base for effective referencing. The imperative of this division when established will be obvious with its multiplier effects overtime on the general activities of the agency more so as the country is getting ready for the polio – free certification stage. Conference noted that despite overwhelming evidence that Medical laboratory services are absolutely critical for achieving the MDGs, they remain one of the most neglected components of health systems. The reasons why laboratories have been so neglected range from failure to engage medical laboratory practitioners in key decisions to a limited focus on technology rather than on effective management systems. Consequently patients are mismanaged, drugs are wasted and surveillance data is unreliable. Until Nigeria develops medical laboratory services they can rely on, we will continue to be dependent on externally funded and therefore unsustainable, laboratory technology to monitor disease burden and the impact of disease control programmes. While in developed countries, laboratory-aided preventive, diagnostic and prognostic testing plays a central role in modern medicine. Similar advantages should be possible in developing countries, but this will require the application of appropriate technologies that optimize the use of limited resources. Conference therefore proposed that NPHCDA be strengthened through Medical Laboratory services that would provide the following primary functions; effective coordination and monitoring of all the peripheral laboratories within the NPHCDA domain in line with the Minimum Ward Healthcare Package, regular evaluation of laboratory network, collaborate with all stakeholders on Relevant operational research and publications, knowledge sharing/Continuous learning/ capacity building, credence to the National Surveillance system, results-based programme development and management, analytical and strategic innovations, develop and maintain National data base for effective references, drastic reduction on the heavy dependence on the secondary healthcare level would be assured. Conference further proposed that a division for Medical Laboratory services whose functions shall be the coordination of network laboratories involved in disease surveillance nationally and internationally, this division should be coordinated by a medical laboratory scientist who shall be a Director.
Other staff compliment should include Deputy Director (Polio Laboratories), Deputy Director (Measles Laboratories), Deputy Director (Diagnostics and Peripheral Laboratories) and other supporting staff. At the peripheral laboratories in the model health centers, qualified Medical Laboratory Scientists should also be saddled with task of ensuring quality of Laboratory results to add value to the quality of health care delivery. Conference also decries the method of Biomedical Waste (BMW) management, disposal and auditing particularly in Lagos and Nigeria in general. It is imperative that every health care facility should have a waste management unit / committee/ infection control unit to seriously handle the waste management practice, training and retraining of staff members that are directly connected to the whole processes of waste generation, sorting and disposal must be conducted regularly, material for waste segregation at point of generation using the colour-coded system should be introduced, Standard Operating Procedure (SOP) to be prepared for medical waste management in the hospitals as obtained in developed countries where definite rules and regulations exist at the national, regional and hospital levels, adequate awareness should be created on associated health hazards due to unsafe disposal of BMW to the masses using posters, banners, mass media etc, staff involved in handling of BMW should be provided with PPEs according to WHO recommendation which requires the use of heavy duty gloves, boots and apron.
Establishment of Department of Medical Laboratory Services:
Conference noted with dissatisfaction the inability of leading hospitals in the State, LUTH, Health Service Commission (HSC) as well as Lagos State Ministry of Health (MOH) not having the Department of Medical Laboratory Services. This denial is also applicable in the non-inclusion of Medical Laboratory Scientist on the Primary Health Care Board (PHCB). The Conference affirmed that establishing a Department of Medical Laboratory Services is beyond having a director portfolio for the most senior Medical Laboratory Scientist in service but instituting a system to have him function effectively in co-ordination of Medical Laboratory Services. We hereby call on the managements of LUTH, HSC and MOH Lagos State to establish a Department of Medical Laboratory Services, like in Pharmacy and Nursing. We also want to appeal for inclusion of Medical Laboratory Scientists on the board of HSC and LASUTH. We want to affirm that professional relationships between Medical Laboratory Scientists and Pathologists are complimentary and not supervisory, continual refusal to create Medical Laboratory Services department is making the relationship between the two distinct professionals adversarial.
Plight of private medical laboratory practitioners:
The Conference noted with dismay the multiple taxation of our members who operate private medical laboratories are being subjected to in their Practise. The services they rendered are humanitarian and should enjoy some level of tax rebate. The multiple tax regime is already sniffling operation of many Medical Laboratories making the service more expensive and some laying off their staff thereby increasing the employment burden. We hereby appeal to Lagos State Government to consider downward review of tax, registration of premises, renewal of registration while provision of neon signals and waste disposal materials should be at minimal cost. We are aware of the passage of Lagos State Health Insurance bill into an Act. It is important that AMLSN is represented on the board. We also advise that accredited medical laboratories should be made primary providers.
Employment of more Medical Laboratory Scientists:
The Conference after critical appraisal of submission from various chapters in Lagos State branch discovered gross inadequacy of Medical Laboratory Scientists in Government facilities resulting in work overload of few available personnel. We hereby call for employment of more Medical Laboratory Scientists in Lagos State Health Service Commission, Primary Health Care Centres and Federal Health Institutions.
Employment of interns:
The Conference after listening to the presentation of Young Medical Laboratory Scientists discovered an urgent need for the Federal and State Government Health Institutions in the Lagos State to employ more Interns. The current numbers of interns employed in government facilities is grossly inadequate for training of interns more so that University of Lagos also graduates Medical Laboratory Scientists. We appeal to Health Institutions in the State to employ more Intern Medical Laboratory Scientists.
Funding of medical laboratory services:
The Conference in plenary took a holistic look into alternate funding of Medical Laboratory Services with a view of making the Service more qualitative, available and accessible to common man. The Conference concluded and advises all Health Institutions to embrace Laboratory Revolving Fund (LRF). The Conference condemn in strong terms existence of Private Medical Laboratory in our Health Institutions and regard their prices as callous and exploitative on already impoverished patients more so that they are not adding extra value to the system.
Assassination of Mrs Olufunke Omotuyi:
We call on the new Ag. Inspector General of Police to make all efforts to find all those involved in the gruesome murder of Mrs Olufunke Folashade Omotuyi, former Acting Registrar, MLSCN and bring culprits to book.
Implementation of court judgements:
The Conference in session made it abundantly cleared that the issue of headship of Medical Laboratories has been dispensed with in favour of the Medical Laboratory Science Profession in the Industrial Courts as seen in the cases of AMLSN/NUAHP (formerly NUPMTPAM) vs. Obafemi Awolowo University Teaching Hospital management and others, AMLSN vs. Jos University Teaching Hospital (JUTH) Management and others, AMLSN vs. FMC Asaba Management and others, etc. The Conference further warned all Chief Executives of Health Facilities that they should not take anything less than the full implementation of these judgements.
National minimum wage act:
The conference appreciates and commends Mr. President for assenting to the bill on the National minimum wage Act. However, we use this opportunity to call for immediate implementation of the law, given the fact that this process has dragged on for nearly two years.
Constitution of MLSCN board:
The Conference commends Mr President for the inauguration of the much awaited board of MLSCN.
Brain drain in the health sector
Conference urges the Federal Government to strengthen the nation’s health sector in order to curb brain drain among health professionals. Brain drain has been on the increase and is seriously affecting the nation’s healthcare delivery. Most of our tertiary, secondary and primary health institutions are deteriorating, conditions surrounding work place activities are not suitable and there are no adequate consumables for our health workers to work with. We appeal that urgent steps be taken to rectify the situation.
Poor state of medical laboratory equipment
Conference observes the non-availability of modern equipment and obsolete nature of the existing ones. Many of the present equipment lack required cutting edge technologies for research, training and healthcare delivery. This is about the biggest issue with the Nigerian healthcare system and it is responsible for why medical tourism remain the only option for affluent Nigerians or patients in dire need of the right diagnosis and cure. We demand the purchase of modern medical equipment in our various health institutions and training of medical laboratory professionals to handle the equipment, in order to stem the tide of medical tourism and make health care services available and affordable to all Nigerians. The laboratories at our primary centres must be adequately equipped with the state of the art equipment and stocked with reagents and chemicals that will enable it render laboratory services to the communities for which they are intended to serve. With all these put in place, no doubt the quality of life of the citizenry will be improved and life expectancy will be increased.
State of the Nation
Conference observes with dismay the spate of incessant killings and kidnapping in various parts of the country. Hence, urges the federal government to arrest the situation forthwith and bring the perpetrators to justice.
Appreciation
The conference commended the Lagos State Government for prioritizing the health sector in her delivery of democracy dividends. We are indeed grateful to our patron Dr. D.K. Olukoya for his continuous supports and prayers for the profession.
Conclusion
Primary health care clinics would benefit from the availability of appropriate tests, but this should coincide with improved quality control, waste control and training of medical laboratory professionals. Medical laboratory services in Primary Health Care are therefore a sine quanon!
Signed:
Monsuru K. Adegoke Chairman,
AMLSN Lagos State
Olumide Fconclusionch Secretary
Adeleke Olusegun Olaoluwa (Oluomo)
Chairman, Communique drafting committee
