Medical Laboratories in Nigeria (Part 1): Assessment of Quality Management Practices and Accreditation Status

Background: Given observed challenges with the quality of results, this study was aimed at assessing the current level of the use of aspects of quality management practices by medical laboratories in the south-south region of Nigeria. Methods: This was a cross-sectional survey of 80 randomly selected medical laboratories from the 6 states of south-south Nigeria. Self-administered questionnaires on aspects of quality management practices were given to selected staff of each laboratory. Results: Out of the 80 questionnaires, only 42 were completed. None (0%) of the laboratories were accredited for quality service delivery. Only 88% of the laboratories were licensed by relevant authorities. 90% of the laboratories used quality control (QC) sera for their operations. 30% used commercial QC. 70 % used unreliable locally-produced QC. 90% reported that their equipment was regularly maintained (66% by Biomedical Engineers and 24% by Medical Laboratory Scientists). 90% of the laboratories claimed to calibrate their equipment regularly by Biomedical Engineers (66%) and Laboratory Scientists (24%). 74% of the laboratories were headed by Laboratory Scientists; 26% by Pathologists. 62% of the laboratories used de-ionized water; 13% distilled water; 7% used both interchangeably. 60% bought their water commercially; 40% produced their water locally. Only 10% of the laboratories had means of monitoring the water quality. Only 21% were enrolled on EQA schemes. 80% bought their reagents in the open market. 90% used the poor-quality national grid as their main source of electricity supply. Only 40% had training/re-training programs for their staff. Only 45% of the laboratories used SOPs in their operations. Conclusion: The results of this study indicate that currently, the majority of the medical laboratories in south-south Nigeria have not sufficiently embraced the use of several aspects of the quality management essentials in their routine operations. This state of affairs is a recipe for unreliable and poor-quality results that may lead to wrong diagnoses and mismanagement of patients.