Scoping review on public health laboratory services
Project details
Year: 2024
Client: World Health Organization - Headquarters (Lyon Office)
Objectives: The review explored the use of the term “public health laboratory” in published documents and which public health functions and services are expected from laboratories.
Deliverables:
Scoping review report and its evidence tables providing:
- a compilation of identified definitions and terms used for the concept of “public health laboratory services”;
- a consolidated list of public health laboratory characteristics and of functions and services to be provided by laboratories for public health purposes.
Performed activities
Laboratories are essential for health emergency prevention, preparedness, response and resilience, intervening at all stages of an outbreak to confirm the causative agent, monitor its progression and inform response measures. Yet, the term “public health laboratory services” is used inconsistently across the literature, with no shared understanding of what it covers.
This review aimed to clarify the use and concepts behind this term through a twofold approach:
- A review of published documents mentioning the term “public health laboratory”.
- A review of terms and definitions from 29 guides and tools used for monitoring or evaluating public health laboratory services.
Following a search of the worldwide web, the WHO IRIS bibliographic database and the institutional websites of major actors in public health, fifty-two documents mentioning the term “public health laboratory” were included (figure 1).
Figure 1. Flow chart of the search and selection of documents mentioning the term ‘public health laboratory’
The term “public health laboratory” was mostly used in a systematic manner in the United States of America, while in other countries the term was used rarely and inconsistently. Both in the United States and in global guidance, it was recognized that distinguishing between public health and clinical laboratories is challenging:
- “public health laboratories” often provide clinical services for individual patients, such as specialized testing, while
- “clinical laboratories” participate in public health activities, such as public health surveillance.
The term “public health laboratory” was thus found to lack specificity, obscuring the contribution of clinical laboratories in public health activities and the resulting need for collaboration across different types of laboratories at all levels of the health system.
We consolidated all the reviewed information into a list of functions and services provided by laboratories for public health purposes (figure 2). Core public health laboratory functions and services were: supporting public health surveillance and response, including emergency preparedness and response; providing specialized testing when specific equipment, technical skills or safety practices are required; strengthening country laboratory capacities, foremost in relation to training and quality assurance; and supporting public health research.
Figure 2. Mentioned public health laboratory functions
The final output was a comprehensive review report, with companion evidence tables, to inform a forthcoming consensus among experts on the definition of the term and concept of “public health laboratory services”.