Clinical chemistry in district laboratories

The clinical chemistry tests performed in district laboratories will depend on:

1. ▪ The health needs of the community and the requirement for clinical chemistry tests to assist in disease diagnosis and prognosis, monitoring of treatment, and screening to prevent ill-health.

2. ▪ The training and experience of laboratory staff and the support that can be provided by the district laboratory coordinator to ensure clinical chemistry tests are performed correctly with adequate control and safety.

3. ▪ Whether the appropriate equipment is available and affordable (purchasing and running costs) and can be maintained by the user.

4. ▪ Whether the required chemicals and products to make reagents, standards, and controls are available and affordable, and whether the more complex reagents can be provided to district laboratories in ready-made form or in easy to prepare packs that have sufficient stability.

5. ▪ Whether the laboratory has access to or can make its own supply of chemically pure water (see subunit 4.4).

6. ▪ Whether the numbers of tests performed are sufficient to avoid reagents, standards, and controls from being wasted due to their expiry. In some situations it may be possible and more appropriate to send patients’ samples to a larger laboratory for clinical chemistry tests.