Healthcare is a chain of decisions.
A patient presents with symptoms, a physician assesses the patient, investigations may sometimes be requested, consideration of treatment is done, and the monitoring of treatment is carried out.
During that whole journey, information which is provided by laboratory medicine helps turn clinical questions into evidence.
This is the reason why laboratory medicine needs to be considered an important part of the broader conversation about healthcare in Namibia.
The World Health Organization estimates that diagnostic results influence around 70% of healthcare decisions, but diagnostic services account for only around 3–5% of health budgets globally.
Laboratory medicine does not only diagnose, but also helps screen, monitor, treat, and respond to public health matters
In 2024 for example, an estimated 10.7 million people worldwide developed TB, while approximately 1.23 million people died from the disease.
A significant TB burden continues to be experienced in Namibia, with WHO reporting an estimated incidence of approximately 468 cases per 100,000 people in its country profile.
Diagnostic forms an important part of the response.
It helps establish a diagnosis and, where necessary, identify drug resistance so that treatment can be appropriately guided.
That is TB only being one example of the much broader role of laboratory medicine.
The same principle applies to HIV, where laboratory testing helps to diagnose and monitor the treatment.
The same happens with diabetes, anaemia, kidney and liver diseases.
In cancer care, the laboratory helps classify the types of cancers.
In blood transfusion, the laboratory is important for blood grouping and compatibility testing.
During disease and virus outbreaks, the laboratory services help identify infections and generate information that supports public-health responses.
Laboratory medicine is therefore not limited to answering the question, “What disease does this patient have?” It can also help answer, “Is the treatment working?”, “Has the disease changed?”, “Is this medicine appropriate?”, “Is this patient at any risk?” and, at a population level, “What is happening to the health of our communities?”
This is where laboratory quality becomes important.
A strong Laboratory Quality Management System (QMS) provides structured framework through which a laboratory controls and continually improves its services’ quality.
It brings together areas such as personnel competency, equipment management, purchasing and inventory, process control, internal quality control, external quality assessment, document and record management, occurrence management, internal audits and continual improvement.
Quality starts, even before the patient’s sample reaches the test area.
The correct patient identification must be done, the appropriate specimen collected, the sample properly labelled and transported under stipulated conditions.
During testing, equipment and reagents must perform as expected and quality-control processes must pick any problem, if there is any.
After the sample has been processed, the results must be reviewed, authorised and accurately reported to the right parties.
International standards such as ISO 15189 (2022) provide laboratories with a framework for demonstrating competence and maintaining consistent quality.
However, quality management should not be viewed merely as an accreditation exercise or a collection of documents on a shelf.
Its ultimate purpose is patient safety and confidence in the information being provided.
This means, mistakes and events that are unexpected may occur in laboratory medicine, but a good quality system should be able to pick up nonconformities, investigate, record, come up with corrective and preventive actions.
This is to ensure that they do not happen again.
In the future, medical laboratories will increasingly depend on technology.
Automation, molecular diagnostics and digital systems have increased what can be detected and how swiftly information is produced.
This does not suggest that trained and well experienced Medical Laboratory Scientists should be replaced by sophisticated instruments. Human development and technological advances must coexist.
For Namibia, strengthening laboratory medicine is not simply about acquiring more analysers or introducing more sophisticated tests. It is about building sustainable systems around those technologies.
It means skilled professionals’ development, strengthening quality management, encouraging research, maintaining reliable supply chains and ensuring that diagnostic services remain accessible, dependable and reliable.
As the country addresses tuberculosis, HIV, non-communicable diseases, antimicrobial resistance, maternal health needs and emerging health threats, reliable laboratory information will remain essential.
Laboratory medicine may operate largely behind the scenes, but its contribution reaches far beyond the laboratory. Every specimen represents a patient.
Every result represents information, and every reliable result can support a better-informed healthcare decision.
That is why strengthening laboratory medicine is not simply an investment in laboratories.
It is an investment in the quality, safety and future of healthcare itself.
- Nickodemus Shigwedha, a Medical Laboratory Scientist
Email: shigwedhanico@gmail.com
