DEPARTMENTS
ADMINISTRATION
EPIDEMIOLOGY AND DISEASE CONTROL
HOSPITAL EQUIPMENT AND MAINTANANCE
PUBLIC HEALTH LABORATORIES
Mission
We are committed to improving health care for the majority of Zimbabwe's population by providing a diverse spectrum of diagnostic pathology services in an as timely, accurate, and cost effective manner as possible.
Table of Contents
1. Background
2. Structure and Function
3. Current Status and Services
4. Diagnostic Medical Laboratory Services
5. Autopsy and Forensic Services
6. Public Health Services
7. Teaching, Training and Research
8. Further Information
Background
The Public Health Laboratories collectively constitute the Ministry of Health & Child Welfare's major provider of Diagnostic Pathology Services to its hospitals, from district to central level, throughout Zimbabwe. In 1987, they were gazetted as the National Health Laboratory Services. However, the old name has continued to retain popular use.
The laboratories play a vital role in the clinical management of patients, as well as the epidemiological surveillance of infectious diseases such as TB, cholera and diarrhoeal diseases. A lack of adequate laboratory facilities can contribute to inaccurate diagnoses, misdirected use of already scarce resources, as well as negatively impacting upon the morbidity and mortality of patients.
On the above premise, adequate funding and management of laboratory services will ultimately lead to a relative reduction in national health expenditure, while simultaneously contributing to quality patient care and raising national health status.
Structure and Function
The Public Health Laboratories currently operate as a department under a Director responsible to the Principal Medical Director in the MOH&CW. They are organised into Parirenyatwa & Harare Hospitals National Health Laboratory - in Harare, and Mpilo & UBH Hospitals National Health Laboratory and the Tuberculosis National Reference Laboratory - in Bulawayo.
A new Laboratory is under construction at Harare Central Hospital. It is scheduled for completion by the year 2000 and will house a Microbiology National Reference Laboratory, as well as co-ordinate national Public Health work for the Department of Disease Control and Epidemiology.
The MOHCW is currently exploring possible modalities for the commercialisation of the Central Laboratories.
Peripheral to these is a network of 7 Provincial and 60 functional District Laboratories. The aggregate group of facilities makes for the largest group of laboratories in Zimbabwe, with over 350 Medical Laboratory Scientists, Pathologists and Support Staff.
Plans are under way to allow for a Provincial Laboratory Representative on the Provincial Health Executives.
Current Status and Services
The Public Health Laboratory Services comprise the following:
- Diagnostic Medical Laboratory Services
- Autopsy and Forensic Services
- Public Health Services
- Teaching, Training and Research
Diagnostic Medical Laboratory Services
Diagnostic laboratory work is organised into six disciplines:
- Microbiology
- Haematology
- Chemical Pathology
- Immunology
- Histopathology
- Autopsy Service & Forensic Pathology
These departments are fully represented at the central level and less so at the provincial and district levels. Services not catered for at the district or provincial levels can be accessed centrally, via a specimen referral system.
A database that includes the minimum level of tests available at the District and Provincial levels and established in 1996, is currently being updated, using information fed into computers at the Provincial level.
Microbiology
This department investigates specimens for micro-organisms pathogenic to humans, namely bacteria, viruses, protozoa and fungi. The main workload of the microbiology department concerns the growing of organisms from submitted specimens (blood, urine, stool etc) until a sufficient quantity can be detected and recognised. Thereafter, testing for sensitivity to various antibiotics is performed.
There is presently, a single qualified medical Microbiologist employed within the Parirenyatwa laboratory. The services of Phd scientists with special clinical laboratory expertise in fields such as Mycology and Virology are also available within the University of Zimbabwe staff establishment in Harare.
Haematology
This department's work deals with the function, composition, and diseases of the blood. The bulk of the workload concerns the study of blood cells. Automated cell counter machines and separates are used so that only a small proportion of the samples have to be examined manually on microscope slides. In addition, tests for bleeding disorders are also carried out. Monitoring of cancer patients on therapy is also a crucial function of the department.
The Department of Haematology in Harare provides a comprehensive haematology service to the nation, including Flow Cytometry and Cytochemistry. The department also houses a national Reference haemostasis laboratory which offers Functional Coagulation Factor Assays and Platelet Aggregation/Function Tests.
The Department is involved in the World Health Organisation National External Quality Assessment Scheme in Haematology, the Zimbabwe National External Quality Assessment Scheme, the Standardisation for Immunologists Flow Cytometry Scheme and the Canadian Quality Assurance.
There are no Consultant Haematologists currently employed by the MOHCW. However, the services of Consultant Haematologists within the University of Zimbabwe staff establishment in Harare are available.
Chemical Pathology
Also known as Clinical Chemistry, this department is concerned with the study and science of the chemical changes which take place in the diseased body. The investigations in this department involve analysing blood serum and other body fluids and tissues. The bulk of the analyses are processed automatically using chemistry analysers, while some of the tests are done manually.
There are no MOHCW Consultants within this department, although PhD Scientists with clinical laboratory expertise in this field are present within the University of Zimbabwe department in Harare.
Immunology
This is the study of defects in the human immune system using specialist techniques such as radioimmunoassay and elisa tests. A major part of the workload in this department involves testing blood samples for the presence of antibodies to HIV and other pathogens.
Histopathology
This department is concerned with the microscopic study of issues. It comprises morbid anatomy, which is the study of the cause of death and histology which is the study of tissues to determine the presence and nature of disease. Investigation of tissues sent as biopsies, for the presence of cancer and other disease, through examination of microscope slides is a major aspect of the work carried out in this department.
Autopsy & Forensic Services
All the forensic autopsy services for the Zimbabwe Republic Police are provided for by the Public Health Laboratory. One MOHCW and one University Consultant Forensic pathologist are collectively responsible for supervising this service. Medical interest autopsies requested by hospital doctors both for government patients and for patients dying in private institutions, are supervised by a team of Consultant Histopathologists employed by MOHCW and the University of Zimbabwe.
Public Health Services
The Public Health Laboratories are involved in disease control and surveillance and they work closely with departments of Environmental Health and Epidemiology and Disease Control in the Ministry of Health. The main aspects of this work include the provision of raw data for the monitoring of infectious diseases throughout Zimbabwe, as well as monitoring epidemics.
The laboratories also provide a Public Health Service to Environmental Health Officers, provincial, district and municipal medical officers, particularly with regard to the bacteriological testing of water, food and dairy produce (at the central level, some of this work has been absorbed by the Government Analyst Laboratory).
Teaching, Training and Research
The National Health Laboratory in Harare is the major training centre for medical laboratory scientists in Zimbabwe. While the groundwork of theory is provided by the University Department of Medical Laboratory Sciences, most of the practical bench training is provided by the National Health Laboratory in Harare. Rotations for final year students will soon be extended to selected Provincial laboratories.
The laboratory assists in the design of curricula for medical laboratory scientists' training programmes and trainee pathologists. In-service training for medical laboratory staff in the provinces and districts is also provided through workshops and seminars that are held throughout the year.
The National Health Laboratory provides research facilities for government and university staff as well as providing data for various, approved, clinical research projects.
| Acting Director Public Health Laboratories email: Dr. B. Mhlanga Tel.: +263-4-792979 |
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