By David Kipkorir
Low and middle-income countries are experiencing shortages in meeting health workforce requirements for Universal Health Coverage (UHC).
Chief Government Pathologist Dr Johansen Odour decried the low number of practicing pathologists in the country, pointing out that with a population of over 40 million people, Kenya has about 150 practicing pathologists.
He said it is difficult for the clinicians to provide disease specific care to patients owing to insufficient number of pathologists.
Pathologists ensure patients are correctly diagnosed and given appropriate treatment, but its inadequacy means treatment is presumptive.
Access to efficient pathology and laboratory medicine (PALM) services is crucial to support healthcare systems, charged with achieving UHC goals.
“When you mention the word pathologist, the general belief is that a pathologist only handles dead bodies,” he said.
Dr Odour explained that pathology is a broad specialty. Some pathologists opt for haematologist, microbiology, clinical chemistry, molecular biology and histopathology, leaving few for autopsy.
It is estimated that there is one pathologist for every one million patients in sub-Saharan Africa, a ratio 50 times lower than in high-income countries.
Lancet Journal notes that inadequate laboratories and medical tests lead to misdiagnosis and inappropriate treatment.
Pathology and laboratory medicine services provide foundation to safe, effective and equitable health-care delivery, population health and global security.
Pathology services include biochemistry, microbiology, haematology, and histopathology. They also include imaging, autopsies and forensic pathology to determine cause of death.
It is central to detecting, treating and monitoring infectious diseases.
It is also key in non-communicable disease, like diabetes, which cannot be detected on basis of clinical history or physical examination alone.
Cancer requires pathology for specific classification and staging.
WHO estimates that Non-communicable diseases like diabetes and cancer account for 7 out of 10 deaths worldwide, and the rates are growing in low- and middle-income countries.
Identifying an accurate cause and manner of death is crucial to public health policy development, to treatment-related research programmes, and education of clinicians.
Autopsies play an important role in hospitals in low-income and middle-income countries.
PALM services in Kenya are inhibited by insufficient human resources, inadequate education and training, inadequate infrastructure, and insufficient quality standards and accreditation.
The cost of shortage of this crucial staff is high for both patients and the health sector.
Speaking on the way forward to improving pathology practice in the country, Dr. Odour said there are challenges facing pathology at the moment; one of the most significant is convincing enough talented young people to enter the field.
He said pathology has always been viewed as not a lucrative venture. Policy makers must make sure that pathology is very visible in medical curricula.
There are fewer physicians trainees pursue postgraduate training in pathology.
It is estimated that at current rates of education and training, it could take up to 400 years for sub-Saharan Africa to match the pathologists-to-population ratio of the UK or US.