GLI Kumasi (Ghana)
In 2012, within the framework of the Global Laboratory Initiative (GLI) program, the Probitas Foundation began a project in Kumasi, the second most important city in Ghana and capital of the Ashanti region in the central-southern area of the country. The project was carried out at the Maternity and Children's Public Hospital (MCPH), also known as the Children's Welfare Clinic (CWC). This center is specialized in the diagnosis and treatment of malnutrition and severe under-nutrition.
With a population of 27 million Ghana ranks 140 out of 188 in the Human Development Index (HDI). Its inhabitants have a life expectancy of 61 years and a mortality rate of 9%. For every 1,000 births, 34 children die 350 mothers die for every 100.000 labours; figures that differ greatly from countries with enough resources.
Ghana is a clear example of a consolidated democracy and an economic and political model for other African countries. Nevertheless, its progress conceals considerable inequality as more than 70% of the population lives in rural areas on less than $1 a day. Whilst it is one of the few African countries with a minimum public health system there is still a considerable difference between the countryside and large cities.
The CWC, the Foundation's counterpart, is located in the center of the Kumasi metropolitan area and belongs to the Ghana Health Services (GHS), the country's public healthcare system which only covers some basic needs.
The objectives of the Probitas Foundation in Kumasi are, on one hand, to reinforce the capacity of the diagnostic laboratory in the MCPH in order to improve prenatal control and childbirth care. And, on the other hand, to offer healthcare to the most vulnerable rural communities which have limited access to this service. Currently, the project is in the third phase and personnel are being trained.
During the first phase, needs assessment, a number of limitations were detected in the MCPH laboratory service which made it practically ineffective.
- The existence of small, physically separate cubicles.
- The lack of an appropriate area for blood collection which was carried out in the laboratory itself.
- A shortage of equipment and reagents leading to the installation out of use.
From this moment the requirements for the second phase were identified. They included the improvement of infrastructures and installations, and the purchase of the necessary equipment. The following actions were carried out:
- The installation of seven laboratory components among which were a biosecurity cabin, a semi-automatic biochemical machine, refrigerators, a centrifuge, and the purchase of the necessary reagents for the equipment.
- Amplification of the laboratory with two boxes for blood collection, an area for the handling of samples, and a new waiting room.
- Reinforcement of the electrical system with a generator and an electrical current stabilizer.
With regard to the third phase, action has been taken to start with training and capacity-building of the local personnel with the aim of making them self-sufficient.
- Specific hands-on techniques, diagnostic methods, calibrating equipment, validation of analytical results and the like.
- Advanced training in the management and handling of the laboratory. An initial, introductory course was held followed by the installation of GLI-software in the first trimester of 2014. Currently, the laboratory at Kumasi already works with this new system.
- Training in microbiology: a course in basic microbiology was held in October, 2015, in order to reinforce diagnostic techniques for parasitology and bacteriology.
- Training in microbiology and haematology, and course in the use of cultures in bacteriological diagnostics. Purchase of Bactec equipment to perform blood cultures.
2018 saw completion of GLI phase 5 to measure efficacy, efficiency and impact, with a final project evaluation that concluded that the GLI programme had delivered a very significant improvement in the centre's diagnostic service, while noting the need to strengthen biochemistry and bacteriological cultures.