Public-private partnership boosts lab services in Taita-Taveta County

Staff at Moi County Referral Hospital - Voi's main lab, which was upgraded thanks to a PPP between Taita-Taveta County and Lancet Group of Labs.

The viability of Public-Private Partnerships in the country is facing increasing questions, but a ground-breaking collaborative project involving the Taita-Taveta County is successfully delivering results in a sector not known for such projects.

The three-year PPP has upgraded the Voi County Referral Hospital’s main laboratory transforming it from a rundown facility that could not meet the needs of the 300,000 county residents. The project has become a model for PPPs in that medical lab sub-sector.

The project contract —inked in April 2015 and ends in March next year— involves the County Government and Lancet Group of Labs, an internationally-accredited medical lab firm with presence in Kenya and 12 other African countries.

The project had initially been piloted for a year under the funding of Worldlife Works Carbon (WWC), an international forests and Wildlife conservation group operating in Taita-Taveta. 

The PPP has seen the lab, originally built in the 1950s; undergo a major refurbishment to meet the required specifications. It has also been equipped with the latest equipment and software. The county lab staff  have undergone specialised training to run the facility professionally and sustainably. 

The upgraded lab is now able to carry out more than 400 different types of routine and specialised tests on site and over 4000 others via free referrals to Lancet reference labs. The expanded menu of tests is offered at subsidised rates to make them affordable to county residents. 

 “Previously, patients would be forced to travel as far as Mombasa and Nairobi to seek crucial lab tests before they could be treated. But now we serve patients not only from Taita-Taveta County but also beyond. We are able to carry out a high-volume of tests within a short time. This has significantly improved healthcare in the county,” says Dr Charles Ndirigiri, the Hospital’s Medical Superintendent. 

He added: "Furthermore, the headache of equipment breakdowns and stock-out of lab chemicals due to poor maintenance and procurement management is no longer there. Not once have we had issues of tests not being done.”

In 2016, the lab conducted 85,027 tests compared to 27,484 in 2013 before the PPP begun while the lab’s revenue in 2016 was Sh23 million up from Sh1.3 million in 2013, showing considerable improved performance. 

Revenues of the lab are shared between Lancet and the hospital till March next year, when the facility will return fully to the hands of the County government. 

“The upgraded lab is the first successful PPP project of its kind in the diagnostic lab sub-sector in the country and the continent.  Thus it is being considered as a model for revitalising rundown laboratory services in public health facilities in Africa and other Third World countries ,” says Dr Ahmed Kalebi, Consultant Pathologist and CEO of Lancet.

The PPP emerged when WWC, which sells carbon credits from Rukinga Wildlife Sanctuary in Voi, sought to invest in a healthcare project as part of giving back to the community. Consultations revealed that absence of reliable and quality lab services in the county was seriously hampering health care provision. 

WWC tapped Lancet to offer advisory and technical assistance in upgrading the public lab including supplying the latest lab equipment and related lab chemicals (reagents) at subsidised rates.

“After consultations, it was agreed that Lancet should rebuild and operate the facility jointly with the county government and  transfer its expertise of running medical labs professionally and sustainably to county staff. It was thus modeled around a build, operate and transfer model,” says Dr Kalebi, who is also a University of Nairobi Honorary Lecturer. 

Lancet provides technical, business and managerial support to the county lab staff to ensure the facility upholds professional best practices and is financially sustainable despite charging subsidised rates  to users. 

Lancet made available for free its custom lab management software to automate lab processes in the public facility including electronic transmission of lab results and remote technical support by Lancet experts in Nairobi and South Africa. 

Taita-Taveta County Executive for Health Mr Grifton Mkaya said the upgraded lab has had a significant impact on health care in the county.

He said the PPP has made life better not only for patients, especially those with non-communicable diseases, but also for doctors in Voi hospital and other facilities in the county who are now able to better diagnose and manage their patients thanks to accurate  and timely lab results. 

He added: “Previously, many doctors posted to Voi found it frustrating to work without a good and reliable lab support. But now, we expect and continue to attract and retain more medical specialists including physicians, paediatricians, surgeons and gynaecologist among others.”