Expansion of COVID-19 RT-PCR Diagnostic Laboratories in Private Healthcare Settings through Public-Private Partnership Approaches in Addis Ababa, Ethiopia

Abstract

Background: The World Health Organization recommended that expanding COVID-19 laboratory testing is one of the disease mitigation mechanisms. In Ethiopia, even though here are few advanced diagnostic laboratories, most of the COVID-19 RT-PCR based diagnostic laboratory service was provided by public laboratories. This situation creates a major gap in the availability of COVID-19 laboratory testing for the wide public majority, and one of the main challenges in the control and prevention of the disease.
Objective: to assess the existing potentials for the expansion of COVID-19 RT-PCR based diagnostic services in private advanced medical laboratories through public-private partnership approaches in Addis Ababa, Ethiopia.
Methods: A cross-sectional study was conducted from May to July 2020, among eight private advanced laboratories in Addis Ababa, Ethiopia. A structured questionnaire and on-site observation were made to assess their experiences on molecular laboratory based diagnostic services, perceived challenges, and their readiness to deliver RT-PCR based COVID-19 laboratory services on the level of trained laboratory personnel and molecular laboratory setups. Besides, discussion with government officials on the feasibility of COVID-19 RT-PCR diagnostic services through public-private partnership was made. The collected data were entered and analysed using SPSS version 20 statistical software. The study was approved by the institutional review board of the College of Health Sciences, Addis Ababa University, and Ethiopian Public Health Institute.
Results: Among eight advanced private laboratories, five of the laboratories had previous experience in molecular laboratory testing which includes viral load testing for HIV/AIDS (5/8,). Regarding COVID-19 service readiness, one laboratory had excellent grades towards starting COVID-19 testing; four private laboratories graded as very good and had great interest to provide COVID-19 testing with very minimal support and arrangement with government body. Cost of molecular tests (6/8,), lack of reliable suppliers (6/8,), lack of technical advisors (5/8,) and policy related issues (4/8) were the major perceived challenges to arrange molecular laboratory testing. Currently Five out of eight , private laboratories are providing RT-PCR based COVID-19 testing services to the public.
Conclusion: In the COVID-19 pandemic era, there is high possibility of expanding COVID-19 diagnostics services in private diagnostic laboratories through mutual benefit and public centred discussion between private laboratories and government bodies through public-private partnership in Ethiopia. This kind of partnership could be a lesson to be considered for any future possible outbreaks, happen to act both public and private Laboratories synergistically.