Implementation of the laboratory strategic framework to strengthen health laboratory services in Eastern Mediterranean Region, 2016-2023.

Background: Laboratories and diagnostics services are critical to universal health coverage and public health response. We assessed the extent of the implementation and functionality of the 2016-2023 Eastern Mediterranean Region (EMR) laboratory strategic framework. Intervention: Documents and reports from World Health Organization country offices were examined between September 2022 and November 2022, supplemented by stakeholder-provided documents, to enhance data collection and reporting across the framework's five goals. An intervention using a performance evaluation scorecard assessed the progress of EMR Member States (MSs) towards strengthening health laboratory services, with findings validated during the December 2022 regional public health laboratory directors' meeting in Egypt. Lessons learnt: We analysed results from 21 of 22 MSs. Three (14%) MSs, all high income, had the capacity to implement all indicators, while only one of five low-income (20%) MSs could not demonstrate any capacity across all five goals evaluated. Irrespective of income category, the least implemented domains were: (1) availability of either or both fully implemented laboratory policy, and (2) a fully implemented integrated national laboratory strategic plan, both of which were implemented in only 50% of MSs. Recommendations: Addressing the identified gaps requires concerted efforts, collaboration, and sustained investment to ensure the delivery of high-quality laboratory services and advance public health outcomes across the EMR. Implementation of laboratory strategies should be coordinated through the specific laboratory department or unit at the Ministry of Health level, above the central public health laboratories and with the support of a national laboratory technical working group. What this study adds: This study revealed substantial gaps in implementing laboratory policies and strategic plans in the EMR, with full implementation achieved by only 50% of MSs. It underscores the necessity for coordinated efforts and sustained investment to enhance laboratory services and promote effective laboratory practices in EMR.