A qualitative evaluation of access to essential laboratory services for communicable diseases at the primary health care level in the Western Pacific Region.

backgroundAvailability and access to quality laboratory diagnostics at the primary healthcare (PHC) level are critical to achieving universal health coverage. However, significant access disparities still exist. This evaluation aimed to understand the current laboratory capacity and infrastructure for communicable diseases testing at the PHC level and identify systemic challenges affecting access.

methodsThis evaluation was conducted in eight low-middle-income countries (Cambodia, China, Lao PDR, Malaysia, Mongolia, PNG, Philippines, and Solomon Islands) in the WHO Western Pacific Region. Data were collected by reviewing existing WHO and country-level policies, guidelines, and reports on laboratory services for communicable diseases at the PHC level, as well as virtual interviews with participants at various levels of healthcare.

resultsMost countries are progressing well towards improving laboratory access at all levels. Activities contributing to improved access include point-of-care testing, integrated sample transport systems to facilitate referral of samples, community engagement, and efforts towards combating stigma and discrimination. Vertical disease programs supported by development partners bridge the funding and capacity gaps for several high-priority public health problems, but these support streams are dynamic and often diminishing. The systemic challenges identified were categorized into three thematic areas: (1) weaknesses in primary healthcare systems; (2) limited community and individual engagement; and (3) persistent socio-economic barriers. Potential solutions and recommendations should include a stepwise approach customized for each country's context in collaboration with all stakeholders.

conclusionDespite the progress already achieved, most countries in the region still face significant challenges in improving access to essential laboratory services for communicable diseases at the PHC level.