Functionality status and drivers of non-functionality of the standardised laboratory analysers in Tanzania mainland: Findings from a National Equipment Harmonisation and Standardisation Mapping Exercise
- 1Muhimbili University of Health and Allied Sciences School of Public Health and Social Sciences
Abstract
IntroductionReliable, well-maintained laboratory equipment is essential for timely, accurate and reliable laboratory results for patient care, surveillance, and health system resilience. Tanzania implemented the Standard Medical Laboratory Equipment Guideline (SMLEG-2018) to harmonise procurement and improve efficiency across a tiered laboratory system and network. However, equipment functionality gaps remain a critical challenge for healthcare delivery. This study determined the functionality status of standardised laboratory analysers in Tanzania mainland and identified the drivers of non-functionality.
MethodsWe conducted a facility-based cross-sectional study to identify the causes of non-functionality of standardised chemistry, haematology, and urine analysers across mainland Tanzania. We assessed 3,044 analysers and used Pareto analysis to identify the primary drivers of non-functionality.
ResultsOf the 3,044 standardised analysers assessed, 987 (32.4%) chemistry 1,308 (43.0%) haematology, and 749 (24.6%) urine) assessed; 397 (13.0%) were non-functional. Proportionally, urine analysers were the most non-functional (n=176/749, 23.5%), followed by chemistry (n=135/987, 13.7%), and haematology (n=86/1308, 6.6%) analysers, p<0.001. Urine analysers had significantly higher non-functional equipment (23.5%), followed by Chemistry analysers (13.7%), than Haematology analysers (6.6%), p<0.001. Equipment breakdown was the leading cause of non-functionality, accounting for 70.9% (61/86), 70.5% (124/176) and 60.0% (81/135) of the non-functional haematology, urine and chemistry analysers, respectively, among all causes identified for each analyser type.
ConclusionAlthough the SMLEG 2018 implementation identified broad coverage of functional standardised laboratory equipment, persistent equipment breakdowns of more than 10% highlight a systemic, concerning gap that requires immediate corrective action to sustain high performance. Strengthening preventive maintenance, timely repair services and sustainable equipment lifecycle planning is critical to sustaining quality laboratory services for robust preventive and curative care.
Related
- Investigating laboratory capacity and whole genome sequencing practices to inform standardised protocols for bacterial genomic surveillance in Africa.
- The integration of artificial intelligence into computed tomography: from segmentation to the standardisation of clinical decisions
- Heat Exposure Definitions in Temperature-Mortality Studies: Towards a Harmonisation Framework.
- Definitions and reporting of 'failure' after rotator cuff repair: A systematic review of level I and level II evidence and proposal for standardisation.
- Standardisation of stage information collected by European population-based cancer registries: an application to breast cancer survival
BibTeX
@misc{torokaa2026functionality,
title = {{Functionality status and drivers of non-functionality of the standardised laboratory analysers in Tanzania mainland: Findings from a National Equipment Harmonisation and Standardisation Mapping Exercise}},
author = {P. Torokaa and R. Makala and J. D. Kitukulu and E. M. Shija and M. E. Kelly and G. E. Kwavava and R. S. Mkala and I. G. Paul and M. N. Jidayi and R. Y. Massawe and D. M. Ocheng and P. M. Ng'ola and O. D. Panga and L. F. Matata and L. N. Karoli and A. Kyalo and A. S. Magesa and M. Mtebe and A. Joachim and N. Moremi},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.09.26365127},
url = {https://www.medrxiv.org/content/10.64898/2026.10.09.26365127v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Functionality status and drivers of non-functionality of the standardised laboratory analysers in Tanzania mainland: Findings from a National Equipment Harmonisation and Standardisation Mapping Exercise
AU - P. Torokaa
AU - R. Makala
AU - J. D. Kitukulu
AU - E. M. Shija
AU - M. E. Kelly
AU - G. E. Kwavava
AU - R. S. Mkala
AU - I. G. Paul
AU - M. N. Jidayi
AU - R. Y. Massawe
AU - D. M. Ocheng
AU - P. M. Ng'ola
AU - O. D. Panga
AU - L. F. Matata
AU - L. N. Karoli
AU - A. Kyalo
AU - A. S. Magesa
AU - M. Mtebe
AU - A. Joachim
AU - N. Moremi
PY - 2026
DA - 2026/10/09
PB - medRxiv
DO - 10.64898/2026.10.09.26365127
UR - https://www.medrxiv.org/content/10.64898/2026.10.09.26365127v1
AB - IntroductionReliable, well-maintained laboratory equipment is essential for timely, accurate and reliable laboratory results for patient care, surveillance, and health system resilience. Tanzania implemented the Standard Medical Laboratory Equipment Guideline (SMLEG-2018) to harmonise procurement and improve efficiency across a tiered laboratory system and network. However, equipment functionality gaps remain a critical challenge for healthcare delivery. This study determined the functionality status of standardised laboratory analysers in Tanzania mainland and identified the drivers of non-functionality. MethodsWe conducted a facility-based cross-sectional study to identify the causes of non-functionality of standardised chemistry, haematology, and urine analysers across mainland Tanzania. We assessed 3,044 analysers and used Pareto analysis to identify the primary drivers of non-functionality. ResultsOf the 3,044 standardised analysers assessed, 987 (32.4%) chemistry 1,308 (43.0%) haematology, and 749 (24.6%) urine) assessed; 397 (13.0%) were non-functional. Proportionally, urine analysers were the most non-functional (n=176/749, 23.5%), followed by chemistry (n=135/987, 13.7%), and haematology (n=86/1308, 6.6%) analysers, p<0.001. Urine analysers had significantly higher non-functional equipment (23.5%), followed by Chemistry analysers (13.7%), than Haematology analysers (6.6%), p<0.001. Equipment breakdown was the leading cause of non-functionality, accounting for 70.9% (61/86), 70.5% (124/176) and 60.0% (81/135) of the non-functional haematology, urine and chemistry analysers, respectively, among all causes identified for each analyser type. ConclusionAlthough the SMLEG 2018 implementation identified broad coverage of functional standardised laboratory equipment, persistent equipment breakdowns of more than 10% highlight a systemic, concerning gap that requires immediate corrective action to sustain high performance. Strengthening preventive maintenance, timely repair services and sustainable equipment lifecycle planning is critical to sustaining quality laboratory services for robust preventive and curative care.
ER -