1. Lead Health Specialist
Raising the Profile of Laboratory Professionals East Africa Public Health Laboratory Networking Project
MIRIAM SCHNEIDMAN
Lead Health Specialist
WORLD BANK
African Society for Laboratory Medicine
Cape Town, December 2, 2012

2. OVERVIEW OF PRESENTATION
Why are laboratory workers critical?
What factors influence the labor market for laboratory workers?
What kind of policies can enhance their career prospects and performance?

3. Why are laboratory workers critical?
Appropriately trained and qualified laboratory personnel are critical to well functioning laboratory systems that provide high quality, timely, and reproducible results both for clinical care and public health functions
Laboratory workers play a particularly key role in resource constrained settings which depend heavily on manual testing
Laboratory workers are the
backbone of quality diagnostics

4. A vicious cycle
Laboratory profession is undervalued
Production of additional lab personnel is modest
Insufficient numbers and low level qualifications
Low wages and poor career structures
Poor work environments , inaccurate results
Clinicians lose confidence in laboratory services, use presumptive diagnoses
Laboratory workers become demotivated
Constrained supply, sluggish demand, relatively low wages

5. What factors influence the labor market for laboratory workers?
SUPPLY
Current pool of different cadres of laboratory personnel in public and private sectors and those who are unemployed
Annual number of graduates from pre-service training institutes
Continuing professional development courses
Labor mobility which is linked to job satisfaction and alternative employment opportunities
DEMAND
Government policies and strategies which promote or impede the recruitment, deployment, retention and recognition
Private sector polices and practices (salaries, benefits, incentives, work conditions)
Practitioner practices, including extent to which clinicians and public health officials value and use laboratory services

7. What are the broad trends in Africa?
Relative scarcity and skewed distribution of highly qualified laboratory personnel with certificate holders dominating the labor market
Predominantly male and moderately young labor force; females overrepresented in the lower cadres
Strong demand for pre-service training but institutions constrained by inadequate space, and shortage of tutors
Limited labor mobility for majority of laboratory workers in light of low qualifications, poor absorption of graduates, and limited availability of alternative employment opportunities

8. What are the broad trends in Africa?
Government policies and strategies to structure the laboratory profession have been modest
Registration and regulation not systematic
Expansion of degree programs is slow
Clear pathways for career development and structured promotional opportunities are inadequate
Private sector institutions offer better working conditions, more attractive salary and benefit packages and innovative incentive schemes yet absorb few graduates
Views and attitudes of clinicians adversely affect the demand for the services of laboratory workers
“They cook results, so we treat based on clinical presentation”
-Job descriptions not standardized
-Salary structures are not consistent
-Policies to promote task shifting remain modest
- Staffing norms are non existent or not enforced

9. Policies and practices to enhance career prospects and performance
Pre Service
Training
Explore different options for expanding pre-service training to produce new graduates (public sector; private sector; regional approaches)
Upgrade current pool of laboratory workers by expanding degree programs
Shift towards competency based curricula endorsed by regulatory bodies
In Service
Promote innovative retraining strategies (work place based mentorship, rotational deployment, e-learning, flexible hours for training)
Adopt clear and transparent criteria for selecting trainees
Pursue joint training of laboratory and clinical staff
Career
Development
Develop clear career paths with well defined promotion prospects
Rationalize job descriptions
Explore feasibility of task shifting for simple tests
Engage civil service officials to discuss capacity to absorb graduates

10. Policies and practices to enhance career prospects and performance
Government
Policies
Ensure that lab professionals becomes an integral part of national HR planning
Improve registration of laboratory workers
Incorporate lab workers in performance review and recognition schemes
Regulatory &
Representative
Bodies
Strengthen national regulatory bodies to monitor quality and ensure governance
Promote use of national and regional accreditation bodies
Make representative bodies more effective
Operational Research
Scale up research to better understand factors which influence the demand and supply of laboratory workers
Determine the effects of HR strategies on recruitment and retention
Explore reasons for gender imbalance in higher laboratory cadres

11. Breaking the cycle is critical to enhancing performance of laboratory workers
Laboratories are mainstreamed in health systems agenda
Production of lab personnel and in service training are expanded
Larger pool of qualified laboratory workers who are integral part of health system
Clear career paths and improved remuneration
Laboratory workers are more motivated better recognized, and more performant
Confidence in laboratory services is restored

12. Acknowledgements Russell Dacombe Jane Carter Martin Matu EAPHLN Team
Consultant Team
HRH Bank Colleagues

13. Laboratory profession is undervalued
Box #1 A vicious cycle
Laboratory profession is undervalued
Production of additional lab personnel is modest
Insufficient numbers and low level qualifications
Poor career structures and low wages
Inadequate work environments
Clinicians lose confidence in laboratory services, use presumptive diagnoses
Laboratory workers become demotivated

14. Laboratories are mainstreamed in health systems agenda
Box #11 A Virtuous cycle
Laboratories are mainstreamed in health systems agenda
Production of lab personnel and in service training are expanded
Larger pool of qualified laboratory workers who are integral part of health system
Clear career paths and improved remuneration
Laboratory workers are more motivated better recognized, and more performant
Confidence in laboratory services is restored