In this study, a comprehensive evaluation of management for pathogenic microbiology laboratories is performed based on a combination of Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) and Rank Sum Ratio (RSR) methods; in addition, the basis for improving laboratory management is provided. Using the laboratory evaluation tool developed by World Health Organization and a combination of TOPSIS and RSR methods, a system of evaluation indicators for the management of Chinese pathogenic microbiology laboratories is established for comprehensively evaluating the pathogenic microbiology laboratories of seven provincial Centers for Disease Control and Prevention. The evaluation system includes 12 primary indicators and 37 secondary indicators. In terms of laboratory management, the seven laboratories were ranked as D, G, E, C, F, B, and A in descending order. None of these laboratories were evaluated as “good” or “poor.” One of the laboratories was marked as “relatively poor” (A), two as “medium” (B and F), and four as “relatively good” (C, E, G, and D). In this study, a method for evaluating laboratory management using the TOPSIS and RSR methods is proposed, and a basis for comprehensively evaluating laboratory management for pathogenic microbiology laboratories is provided to reflect management practices.
Background
Strong laboratory capacity is essential for detecting and responding to emerging and re-emerging global health threats. We conducted a quantitative laboratory assessment during 2014–2015 in two resource-limited provinces in southern China, Guangxi and Guizhou in order to guide strategies for strengthening core capacities as required by the International Health Regulations (IHR 2005).
Methods
We selected 28 public health and clinical laboratories from the provincial, prefecture and county levels through a quasi-random sampling approach. The 11-module World Health Organization (WHO) laboratory assessment tool was adapted to the local context in China. At each laboratory, modules were scored 0–100% through a combination of paper surveys, in-person interviews, and visual inspections. We defined module scores as strong (> = 85%), good (70–84%), weak (50–69%), and very weak (< 50%). We estimated overall capacity and compared module scores across the provincial, prefecture, and county levels.
Results
Overall, laboratories in both provinces received strong or good scores for 10 of the 11 modules. These findings were primarily driven by strong and good scores from the two provincial level laboratories; prefecture and county laboratories were strong or good for only 8 and 6 modules, respectively. County laboratories received weak scores in 4 modules. The module, ‘Public Health Functions’ (e.g., surveillance and reporting practices) lagged far behind all other modules (mean score = 46%) across all three administrative levels. Findings across the two provinces were similar.
Conclusions
Laboratories in Guangxi and Guizhou are generally performing well in laboratory capacity as required by IHR. However, we recommend targeted interventions particularly for county-level laboratories, where we identified a number of gaps. Given the importance of surveillance and reporting, addressing gaps in public health functions is likely to have the greatest positive impact for IHR requirements. The quantitative WHO laboratory assessment tool was useful in identifying both comparative strengths and weaknesses. However, prior to future assessments, the tool may need to be aligned with the new WHO IHR monitoring and evaluation framework.
Electronic supplementary material
The online version of this article (10.1186/s12889-019-6777-2) contains supplementary material, which is available to authorized users.
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