The delivery of health laboratory services in Uganda is through a tiered network of laboratories from HC III, IV, General Hospital, Regional Referral Hospital, National Referral Hospital, up to National specialized Reference Laboratories. Testing also happens outside laboratories at HC II and community levels by trained health workers using point of care technologies.
At the national level there are specialized laboratories serving as national referral centers such as the Central Public Health Laboratories (CPHL), Supra/National Tuberculosis Reference Laboratory (S/NTRL), the National STD Reference Laboratory, the Uganda Virus Research Institute (UVRI), the Joint Clinical Research Centre (JCRC), Uganda Cancer Institute (UCI), Mulago Histopathology Laboratory, Uganda Heart Institute (UHI) and the Uganda Blood Transfusion Services (UBTS),Entomology Reference Laboratory. In addition, the National Referral Hospitals at Mulago and Butabika have extended clinical laboratory reference facilities. At the sub-national level there are 16 Regional Referral Hospitals, 112 general hospitals, 197 Health Centre IVs, and 1,289 Health Centre IIIs. To increase access to laboratory services, the country has created and equipped 100 laboratory hubs to facilitate testing and coordination of samples and results in transport through the national sample and results transport referral network (NSRTN)
Anti-Microbial Resistance (AMR) is increasingly becoming a global threat impacting the clinical outcomes of patient care and management thus increased the cost of treatment and limited options with antibiotics. WHO has called upon member states to take necessary steps to address this threat. The recent WHO and GHSA Joint External Evaluation (JEE) for IHR2017 revealed that Uganda still has limited capacity in the areas of antimicrobial resistance detection and surveillance of infections caused by AMR pathogens. To increase Uganda’s capacity in AMR surveillance, five sentinel sites have been identified, namely; Arua, Mbale, Kabale, and Mubende RRH laboratories as well as the national microbiology laboratory at CPHL as the reference center. The National Coordination Centre (NCC) for data on AMR surveillance is based at CPHL National Microbiology Reference Laboratory (NMRL). CPHL/NMRL works with the Infectious Diseases Institute (IDI) on the Global Health Security Partner Engagement Project in Uganda. This project focuses on strengthening laboratory systems in areas of AMR, Biorisk Management, Infection Prevention and Control practices (IPC), and Antimicrobial stewardship at national and sub-national levels.
To bridge the gaps identified in the JEE, the GOU embraced the “One Health” concept and established a Multi-sectoral National AMR Task Force to strengthen country efforts against public health threats in the areas of zoonoses, food safety, and AMR under the International Health Regulations (IHR) and the World Health Organization.
In addition to the laboratories under the public system, there are private health laboratory service providers. These include Private not for Profit (PNFP) laboratories run by NGOs and faith-based organizations such as Uganda Catholic Medical Bureau (UCMB), Uganda Protestant Medical Bureau (UPMB), and Uganda Muslim Medical Bureau (UMMB) as well as those in private health facilities and stand-alone laboratories. There are also laboratories within various medical and laboratory training institutions.