Background

Laboratory screening of conditions that threaten maternal and child health is a key component of antenatal care (ANC) and crucial to the achievement of health-related Millennium Development Goals (MDGs) such as MDG5 (Maternal Health). The lack of infrastructural and human resource capacity in clinical laboratories in Africa is the main barrier to test utilization. Hence, international and national stakeholders have advocated for the strengthening of laboratories as indispensible to support access to health in resource-poor setting. Despite the current efforts and the impressive resources made available, medical laboratories still face major challenges and have a limited contribution to health care delivery, especially in sub-Saharan Africa (SSA). 

The aim of this program is to contribute to the achievement of MDG5 by understanding the factors that undermine effective laboratory services in antenatal care in West Africa. The overall objective of the program is ‘Contribution to the MDG5 by understanding and alleviating social barriers to medical laboratory services that result into the underutilization of diagnostic laboratory services in ANC.’

The programme aims to identify barriers to effective laboratory services at different levels (i.e. practical, organizational, economic, socialcultural and historical) of the health system, with a specific focus on antenatal care.

Evidence-based recommendations will be formulated for policymakers and other stakeholders with the purpose of up scaling medical laboratory systems, involving all actors of the health system and taking sociocultural context into consideration. The program focuses on antenatal care as part of the health system, in order to contribute to the achievement of MDG5. 

Achievements to date: 

Data collection and analysis has been completed for (i) the biomedical study on the organizational, practical, and functional factors influencing the laboratory services utilization in ANC and (ii) the anthropological ethnographic study on the historical and sociocultural factors influencing the use of laboratory diagnostics in ANC.

Conference Presentations:

1. Winny Koster, Aicha Sarr, Iyane Sow, Robert Pool, Pascale Ondoa, Constance Schultsz.

Barriers to utilization of antenatal diagnostic tests in Senegal: A qualitative study from the perspectives of health providers and clients. The Third Global Symposium on Health Systems Research, Cape Town, South Africa. 30^th September-3^rd October 2014:  Poster presentation.

2. Aicha Marceline Sarr, Winny Koster, Roughyatou Ka, Rokhaya Diagne, Oulimata Diémé, Adja Khady Datt-Fall, Constance Schultsz, Robert Pool, Ahmad Iyane Sow, Pascale Ondoa. Organization and Practice of Rapid Albuminuria and Glycosuria Testing in Senegal: A Barrier to the Optimal Utilization of Laboratory Test in Antenatal Care? African Society for Laboratory Medicine Conference, Cape Town South Africa. 30^th November-4^th December 2014:  Poster Presentation.
3. Aicha Marceline Sarr, Winny Koster, Roughyatou Ka, Rokhaya Diagne, Oulimata Diémé, Adja Khady Datt-Fall, Constance Schultsz, Robert Pool, Ahmad Iyane Sow, Pascale Ondoa.  Barriers to Uptake of Laboratory Services for Antenatal Care Findings from a Multilevel Qualitative Study in Senegal. African Society for Laboratory Medicine Conference, Cape Town South Africa. 30^th November-4^th December 2014: Oral Presentation.
4.  Evaluation of rapid tests in maternal health in Senegal. The International Pharmaceutical Forum of Bamako-Mali. 15^th June 2015:  Poster presentation.

Other successes

In June 2015 the project team completed a factsheet (please link the fact sheet after posting it) on the anthropology findings – in English and French. This will be that was attractively printed and sent to Senegal. The printed copies will be distributed to health facilities that participated in the study and to other stakeholders in Senegal.

The team has gradually built rapport with stakeholders in Senegal, who are now motivated to collaborate on follow-up of SociaLab. The project is preparing for an end-of project stakeholder consultation meeting around November 2015.

There is hope for working on further data analysis and writing of popular and scientific papers – the first scientific paper has been submitted to a journal in July 2015.