Technical areas: laboratory, policy

In November 2014, IAPHL members discussed the logistics of maintaining laboratory equipment. This discussion served as a follow up to the earlier discussion on the maintenance of supply chain assets led by Clinton de Souza. In this discussion members looked specifically at the special needs and challenges of maintaining lab equipment to minimize down time and maximize delivery of important services. They also covered reasons for developing a laboratory maintenance strategy, how that relates to a national lab policy, and the essential components of each. The discussion was led by Jason Williams of Partnership for Supply Chain Management. (PFSCM), Farouk Umaru the Senior Laboratory Adviser at the SCMS, and Patrick Msipa Laboratory Logistics Advisor for the USAID DELIVER PROJECT. 

Selected comments from IAPHL members:

“Laboratory equipment maintenance is a risk management practice used to maximize the delivery of critical laboratory services and minimize the overall impact of instrument downtime, commodity loss, and service interruption. Developing a successful laboratory maintenance strategy requires a complete understanding of diagnostic coverage, asset value, existing service contractual agreements, active warranty coverage, documenting and monitoring equipment failure types and ensuring overall maintenance management and vendor monitoring practices.

A cost effective approach to improve laboratory instrument performance and to reduce service delivery interruptions is to introduce effective laboratory network maintenance strategies, which are derived from a national maintenance policy. These policies should be developed using an evidence-based approach to better determine the why, how, and when equipment fails.”–Jason Williams (U.S.)

“There are various types of equipment for different purposes such as biochemistry [wet and dry], haematology machines, cytology analysis machines and so on. These machines have their specific contractor/vendor in which there is a specific contract for each machine catagories.

Contract is designed with the expectation of the user and vendor clearly articulated. We used lessons learnt from previous relationships to improve our contractual agreements. Scheduled visits are designed with appropriate conditions. There are 2 basic types of contract we use:

1. Basic Maintenance and servicing – basically they come and service the machines at the schedule times. Mostly for basic equipments.
2. Comprehensive Model – additional to the basic model is the inclusion of repair with the cost of spare parts replacement. It also include emergency or unscheduled visits.”–Apolosi V (Fiji)

“I for instance work in a State General Hospital. Here, individual laboratories are responsible for maintaining their instruments and where we have a corroborative project, the NGOs have their own arrangements with manufacturers or suppliers to maintain deployed Instruments.

By and large I believe the Medical Laboratory Sciences Council of Nigeria has a major role to play in the formulation of a working national policy of instrument maintenance.”–Abdulkabir Abiodun Fasasi (Nigeria)

“The Ministry of Health or the local health authority may enter into contracts with private partners for the maintenance and operation of laboratory equipment. In addition, contracts could have the advantage of ensuring the immediate replacement of equipment when technological force is already exceeding (eg every three years) and ensure service permanently for a long term.”–Julio Huaira (Peru)

“I just want to stress that a robust equipment maintenance strategy, is firmly rooted in and related to a robust procurement strategy. If we buy well, we are assured of maintaining well, because you contract a relationship and not a product. This way, your supply partner will always stand by you if the relationship is guided and managed well.”–Murtada Sesay (India) 

“The issue of PPP cannot be overemphasized. In any case, most of the
laboratory instruments are manufactured by private companies with
profitability as bottom line. Granted, some of them use their Social
Responsibility initiatives to support public sector services, but that is
limited in scope. Involving the private sector in developing long term
strategic initiatives on instruments maintenance is therefore necessary for
sustainability.”–Farouk Umaru (U.S.)

“You have to dialogue with the Donors to provide the specified lab equipment, if not there is no point buying equipment that can not last or provide services needed.Again, in every stage of the procurement cycle, the specifications should be well defined and green issues like the effects of the Laboratory Equipment on environment, society and economy should be considered as well as its disposal (Green issues).”–Kofi Agbodza (Ghana)

In response to Jonas Firina (Ghana)–

Thank you for your wonderful contribution to the discussion. You raised
very important challenges associated to instruments performance in a
laboratory setting. Longer equipment downtime, local service capacity and
reagents shortages are all important determinants of instruments
performance in a laboratory tiered network. In this discussion, we
acknowledge these challenges as compromising quality of service delivery in
resource-limited setting. This is the reason why we are exploring
innovative ideas in solving these continuous problems in our individual
countries.

It is imperative that, public health programs that are aimed at
addressing inefficiency in existing networks must have strong stakeholder
involvements and agreements in order to maximize the use of limited
resources.”–Farouk Umaru (U.S.)

Maintaining Lab Equipment