Abstract:
Background: Anatomic pathology laboratories play a critical role in the diagnosis and
management of various diseases by providing essential diagnostic services, guiding treatment
decisions, and contributing to disease surveillance efforts. These laboratories serve as vital roles
in the healthcare system, supporting clinicians, researchers, and public health officials in delivering
quality care and advancing medical knowledge. Despite its importance, there is a lack of
comprehensive assessments regarding service availability, readiness, and quality of anatomic
pathology laboratories in Addis Ababa, Ethiopia. Understanding the current status of these
facilities is crucial for identifying gaps, addressing challenges, and improving overall healthcare
delivery and patient outcomes.
Objective: The study aimed to assess service availability, readiness, and quality in anatomic
pathology laboratories in Addis Ababa, Ethiopia.
Methods: A facility based cross-sectional study was conducted in Addis Ababa. The study was
conducted in 32 selected health facilities (15 public & 11 private hospitals, and 6 advanced
diagnostic laboratories) expected to provide anatomic pathology service. Data were collected
using manual paper based structured questionnaire and it was transferred to open data kit (ODK)
to support analysis. Descriptive data analysis (frequency and percentage) was conducted using
Stata version-14.
Results: Cytology, histology and immunohistochemisy (IHC) services were available in 71.8%
(23/32), 46.9% (11/ 32), and 15.6% (5/32) assessed health facilities respectively. The overall
readiness (availability of equipment, trained manpower, and reagent & supplies) of anatomic
pathology laboratories for providing cytology & histology services were 100% while it was 40%
for IHC service. Selected quality indicators also showed the occurrence of service interruptions
due to equipment failure (17.4%) and/or reagent stockout (17.4%-60%), low internal quality
control (IQC) testing practice (34.9%) with irregularity in testing, and significant turnaround time
variations (2 hr-30 days). Additionally, the study highlighted the availability of non-standardized
document management system in most sites (91.3%), very low or no external quality assessment
(EQA) participation practice (4.3%), and absence of accredited anatomic pathology laboratory
(0%) in Addis Ababa.
Conclusion & Recommendations: Availability of anatomic pathology service was low in Addis
Ababa especially for histopathology and IHC services while the readiness of facilities for
providing anatomical pathology service was very good except IHC. There was also lack of well
developed LQMS implementation practices in anatomic pathology laboratories. High attention
should be given by higher officials to improve anatomic pathology laboratory service availability,
readiness and quality in Addis Ababa.
............. Thesis available at ACIPH Library