Diagnosis 2015; x(x): xxx–xxx *Corresponding author: Giovanni Putoto, MD, DMTH, MAHPP, Head of Planning – Doctors with Africa CUAMM-via San Francesco, 126-35121 Padua, Italy, E-mail: g.putoto@cuamm.org Antonella Cortese and Ilaria Pecorari: University of Trieste, Trieste, Italy Roberto Musi: Clinical Engineer Indipendent Consultant, Vicenza, Italy Enrico Nunziata: BCG – Engineering / WUTIVI Consultores, Maputo, Mozambique Q1: Please sup- ply complete address for authors “Antonella Cortese”, “Ilaria Peco- rari”, “Rob- erto Musi” and “Enrico Nunziata” Original Article Open Access Giovanni Putoto*, Antonella Cortese, Ilaria Pecorari, Roberto Musi and Enrico Nunziata Harmonization of clinical laboratories in Africa: a multidisciplinary approach to identify innovative and sustainable technical solutions Abstract Background: In an effective and efficient health system, laboratory medicine should play a critical role. This is not the case in Africa, where there is a lack of demand for diag- nostic exams due to mistrust of health laboratory perfor- mance. Doctors with Africa CUAMM (Collegio Universitario Aspiranti Medici Missionari) is a non-profit organization, working mainly in sub-Saharan Africa (Angola, Ethiopia, Mozambique, Sierra Leone, South Sudan, Tanzania and Uganda) to help and sustain local health systems. Doctors with Africa CUAMM has advocated the need for a harmo- nized model for health laboratories to assess and evaluate the performance of the facilities in which they operate. Methods: In order to develop a harmonized model for African health laboratories, previous attempts at strengthening them through standardization were taken into consideration and reviewed. A survey with four Italian clinicians experienced in the field was then per- formed to try and understand the actual needs of health facilities. Finally a market survey was conducted to find new technologies able to update the resulting model. Results: Comparison of actual laboratories with the devel- oped standard – which represents the best setting any African health laboratory could aim for – allowed short- comings in expected services to be identified and inter- ventions subsequently prioritized. The most appropriate equipment was proposed to perform the envisaged tech- niques. The suitability of appliances was evaluated in con- sideration of recognized international recommendations, reported experiences in the field, and the availability of innovative solutions that can be performed on site in rural areas, but require minimal sample preparation and little technical expertise. Conclusions: The present work has developed a new, up-to-date, harmonized model for African health labo- ratories. The authors suggest lists of procedures to chal- lenge the major African health problems – HIV/AIDS, malaria, tubercolosis (TB) – at each level of pyramidal health system. This model will hopefully support the non-governmental organization (NGO) Doctors with Africa CUAMM in its activities in sub-Saharan hospitals, providing them with a guideline to programme future interventions. Keywords: Africa; clinical laboratory; harmonization; technology; sustainability. DOI 10.1515/dx-2014-0071 Received December 19, 2014; accepted February 23, 2015 Introduction The majority of African health systems have been inher- ited from colonial governments and were focused pri- marily on the healthcare of colonial administrators and expatriates [1]. Local health systems have also been adversely affected by lack of investments, resulting in a general weakening of health infrastructures. Unfortu- nately foreign aid is unable to solve the issue of the lack of resources, which remain scarce. There are shortages of drugs or medical equipment and human resources are often insufficient in number [2, 3]. Moreover, staff is not always well-trained: the majority of African health workers have mid-level qualifications and only 9.7% have a degree as a medical doctor [2]. The phenomena generally described for health systems affect clinical laboratories ©2015, Giovanni Putoto et al., published by De Gruyter. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.