Pathology services delivery: policy analysis using a Nigerian tertiary institution as a prototype

Abstract

Laboratory services delivery face criticisms on daily basis by the patients (the beneficiary), the clinicians (the user), and the hospital management (the policy maker). The service provider (the laboratory) is faced with the task of trying to explain her problems. Was to critically do a policy analysis of the problems of laboratory service delivery, with the aim of identifying the causes of these problems and making recommendations to the policy makers. The University of Benin Teaching Hospital, a foremost tertiary institution in Nigeria. George Kent's normative policy analysis model was used to analyse the laboratory guidelines and procedures of sample collection, transportation, analysis and eventual generation of laboratory results. All the steps in the guidelines are analysed using the fifteen steps in Kent's normative model of policy analysis. The policy analysis shows that problems of laboratory services delivery are triangular with the patient at the center of the triangle. The most important finding of this analysis is that there is no formal laboratory service policy to guide all the actors i.e. the hospital management, laboratory staff and the clinicians. Problems arising from the laboratory are solved through the use of circular letters, likened to administrative incremental model of decision-making. There is a need to have a formal policy. A formal policy on laboratory service delivery will guide the provider, the user and the policy makers in solving the problems that originate from the laboratory service on a permanent basis. It will also establish a regular method of evaluating the services that are provided by the laboratory.