The document outlines key equipment requirements for various levels of health laboratories in Uganda, detailing specific needs for health center III, IV, general hospitals, and regional referral hospitals. Each section lists essential equipment types and quantities necessary to perform various diagnostic tests while adhering to specified biosafety levels. It also highlights the importance of proper laboratory management, equipment selection, and maintenance for effective healthcare service delivery.

1. The National Health Laboratory
Network—Uganda:
Key Equipment Requirements
Muni University Department of
Medical Laboratory Sciences
Instructors: William Edema
Winnie Akiteng

2. The National Health Laboratory Network—Uganda

3. The National Health Laboratory Network—Uganda

4. Level specific considerations
 Health Centre III Laboratory
 The Health Center III is the lowest health facility level where a
formal laboratory services is offered, the laboratory facility at
this level has the basic facilities for laboratory diagnosis, a basic
biosafety requirements as detailed below:
 Basic Services: Routine tests:
Hb estimation, WBC count, Sickle cell screening, ESR,
ABO/Rh grouping;
Sputum for AFB, Gram staining, Wet prep;
Blood slides for haemoparasites, Urine chemistry and
microscopy, basic serology (HIV, Hepatitis B and C, Urine
HCG, Syphilis, TB LAM, Cryptococcal antigen), RBS, EID POC,
CD4, CD8 count and ratios, stool analysis.

5.  Basic Equipment—HCIII Lab:
No Equipment type Number of equipment
1 Binocular microscope 3
2 Centrifuge 1
3 Refrigerator with freezing compartment 2
4 portable autoclave/pressure cooker 1
5 Bunsen burner and gas cylinder 1
6 Fire extinguisher 3
7 Haemocytometer 1
8 Kerosene stove 1
9 HB Meter 1
10 Spirit lamp 1
11 POC equipment for HIV tests 1
12 Glucometer 1
13 Blood grouping Tiles 1
14 ESR stand 1
Level specific considerations

6. Health Centre IV laboratories:
Major activities:
Laboratory expected to perform basic microscopy, FBC, HB,
Sickle cell, bleeding, clotting and prothrombin time, ESR, ABO
grouping and compatibility tests
CD4 Percentage, AFB, stool and urine analysis,
heamoparasites, Swabs, HIV, Syphylis, TB LAM, Brucella,
Typhoid, Helicobacter pylori, Heptatis: A,B & C, cyrptococcal,
Malaria
TB,LFTS, RFTS, Lipid profile, Electrolytes, pancreatic tests,
CNS analysis serology by rapid/agglutination tests/agglutination
tests as well as blood banking and PoC
Biosafety level: Biosafety level II
Level specific considerations

7. Sketch of Proposed Laboratory Design for Health Centre IV

8.  Basic Equipment—HCIV Lab:
Specific Equipment Number of
Equipment
Laboratory Refrigerators 6
Blood Bank Refrigerators 1
Water Bath 1
Binocular Microscopes
(100X, 40X, 10X, 4X)
1 Flourescent and
3 Electical
Binoculars
Hematology analyser 1
Chemistry analyser 1
CD4 analyzer 1
Electrical Centrifuges
(One for Blood Bank)
2
Autoclave (in wash up) 1
Fire safety equipment 3
Bunsen burner with
gas cylinder
1
Blood mixer 1
Incubator 1
Hot air oven 1
Deep freezer -
20o
C 1
Shaker 1
Vortex 1
Biosafety cabinet 1
Hot plate 1
Distiller 1
Freezer 1
Eyewash station 1
Emergency shower
station
1
Flow cytometer 1
POC for TB, HIV,
HEPTATIS, HPV etc
1
Level specific considerations

9. General Hospital Laboratories:
 Major activities:
Laboratory expected to perform basic microscopy,
automated hematology, CD4 testing and chemistry as
well as serology by rapid/agglutination tests, blood
transfusion services and microbiological culture and
sensitivity.
 Biosafety level: Biosafety level 2
Level specific considerations

10. General Hospital Laboratories:
Minimum equipment requirements:
 6 Laboratory Refrigerators; 1 Blood Bank refrigerator; 1 Water Bath
 3Binocolar Microscopes(100X, 40X, 10X, 4X)
 1 hematology analyzer
 1 chemistry analyzer
 1 CD4 analyzer
 2 Electrical centrifuges (One for blood bank)
 1 Autoclave (in wash up)
 Fire safety equipment
 1 Water distiller ( 8 Litres per hour) Bunsen burner with gas cylinder Blood
mixer
 Incubator
 Hot air oven
 Deep freezer -20oC
 Shaker
 Vortex
 Biosafety cabinet Hot plate
 Gene expert
Level specific considerations

11. Regional Referral Hospital Laboratories:
 Major Activities:
 The laboratory is expected to perform all testing done at
the General Hospital.
 In addition, the laboratory should perform molecular
diagnostics as well as process specimens for histology
and cytology.
 The laboratory shall also coordinate external quality
assurance activities within its area of service and shall
distribute proficiency panels in the area as well as re-
examine a portion of tested materials.
 Biosafety level: Biosafety level 3.
Level specific considerations

12. Sketch of Proposed Laboratory Design for a Regional Hospital

13. Regional Referral Hospital Laboratories:
Major equipment (categorized according to sections)
General equipment:
6 Centrifuges
4 Water baths
2 Autoclaves (1 in wash up room and 1 as back-up )
2 hot air oven (in wash up room)
2 Bunsen burners
5 Reagent refrigerators (Hematology microbiology and Chemistry)
2 Freezers (- 80 deg Cel and -20 deg. Cel).
1 Distiller
1 Deionizer
pH meter
4 Fire extinguisher (Fire blanket, Bucket with Sand and 2 CO2 Cylinders)
4 Balance (2 Precision Balance and 2 Ordinary Balance)
15 networked computers
1 printer
1 Photocopier
Level specific considerations

14. Regional Referral Hospital Laboratories:
Hematology:
 2 Hematology analyzers
 1 CD4 analyzer
 1 Automated coagulation
machine
 1 Binocular Microscope
for Haemo-parasites films
 2 sets of ESR Rack and
tubes
 1 Automated
shaker/mixer
 2 Stop Clocks/Timers
 Electrophoresis machine
 1 fume hood
Chemistry:
2 Chemistry analyzers
Immunochemistry analyzers
2 refrigerators
1 centrifuge
1 fume hood
Level specific considerations

15. Regional Referral Hospital Laboratories:
Microbiology, Mycology and
Parasitology:
2 Water Bath (in media preparation
room and examination room)
2 incubators (CO2 and non-CO2) –
Space for CO2 tanks required
3 Microscopes (1 Inverted, 1 Phased
contrast and 1 Ordinary)
1 centrifuge
1 Bunsen burner - Space for gas
cylinders required
1 ELISA washer and reader
1 serology shaker
1 Biosafety cabinet (1.3M wide,
located away from area of busy traffic)
Microbiology, Mycology and
Parasitology:
1 Gene expert machine (at least Four
Model)
1 LED microscope
1 flourescent microscope
Automated blood culture instrument
2 Refrigerators (1 for Specimen,
Reagents, Storing media and storing
Primary plates) or 1 with several
compartments ·
1 Hotplate
3 Electrical Furnace
Rotary platter
Disc Dispenser
Media Dispenser
Level specific considerations

16. Regional Referral Hospital Laboratories:
Histology/Cytology
 Disposable grinder (Grind
and dispose to sewer)
 Tissue basket
 Staining Machine
 Hotplate
 Coplins Jars
 Automated cover slipper
 1 Microtome
 1 Frozen section
microtome
 1 histokinette
Histology/Cytology
Embedding machine
 Racks for storage of paraffin
blocks
 Paraffin Jars
 Water baths
 Museum for tissue archiving
 Microscope
 Fume cabinet
 Specialized storage space for
Methanol, Formalin and Ether
treated specimen
Level specific considerations

17. Importance of Laboratory Proximity to
Healthcare Facilities
 Faster turnaround time for test results.
 Improved patient care and timely treatment
decisions.
 Enhanced communication between lab staff
and clinicians.
 Accessibility for emergency and critical care
cases.

18. Test Specialization in Medical Laboratories
 Clinical chemistry
 Clinical microbiology
 Hematology
 Blood banking and serology
 Histopathology and cytopathology
 Molecular biology
 Public health testing (water analysis, environmental
toxins)
 Endocrinology
 Fertility, nutrition, fitness, and wellness testing

19. Laboratory Equipment
Management

20. Introduction
 Many factors need to be considered when
selecting, and subsequently utilising,
laboratory equipment;
 Initial Selection Assessment
 Budgeting
 Installation & Training
 Laboratory Evaluation
 Documentation
 Maintenance & Servicing
 Trouble-shooting

21. Biomedical Instruments
 Instruments and equipment are essential for the
functioning of any medical laboratory.
There should be no confusion with these two terms-
equipment and instruments.
All instruments are equipment but all equipment is not
instruments.
 Laboratory equipment refers to various tools used by a
laboratory worker in a laboratory.
 Laboratory equipment is generally used either to perform
an experiment or to take measurement and gather data.

22. Biomedical Instruments
 Classification of Biomedical Equipments
 Diagnostic equipment
 Therapeutic equipment
 Clinical equipment
 Laboratory equipment
 Research equipment
– Clinical Instrumentation
Basically devoted to the area of:
 Diagnosis
 Patient care
 Treatment of Patients ( Therapeutic use )

23. Biomedical Instruments
Research Instrumentation
 It is used primarily in the search for new knowledge
related to various systems that compose the human
organism.
Some instruments can be used in both areas.
Measurement in biomedical instrumentation can be
divided in to two:
– Vivo: Measurement is made on or within the
human body e.g. device inserted in to the blood
stream to measure pH of blood.
– Vitro: Measurement is performed outside of the
body e.g. measurement of blood pH from blood
samples.

24. Biomedical Instruments
Some Examples of Specific Lab Instruments:
Autoclaves
Centrifuges
Laboratory Water Baths
Anaerobic Jars
Microscopes
Spectrophotometers and Colorimeters
Ion Selective Electrodes and Potentiometry
Hot Air/Box Ovens
ELISA Readers
Refrigerators
Laboratory Mixers
Polymerase Chain Reaction (PCR) Machines
Laboratory Incubators
Microtomes

25. Biomedical Instruments
 Flame photometer
 Analytic balance
 Filtration
 Distillation plant
 Flow cytometer
 Immuno
fluorescence
 Electrophoresis
 Chromatography
 Auto analyzer
 Blood gas analyzer
 Cell counter
 pH-meter
 Flow cytometer
 Immuno
fluorescence
Some Examples of Specific Lab Instruments:

26. Instrument Selection
• Laboratory instruments have become
increasingly complex.
• Selecting the correct system for your
needs requires a detailed programme of
assessment and evaluation.

27. Initial Selection Assessment
 Laboratory instruments have become
increasingly complex.
 Selecting the correct system for your needs
requires a detailed assessment and
evaluation.
Range in cost, complexity & function.
Extremely important to select the
CORRECT instrument for your needs

28. Initial Selection Assessment
Selection considerations;
 Throughput (sample capacity)
 Range of applications
 Versatility; able to use different sources
of reagents or spares
 Sample volume
 Sample preparation
 QC and calibration requirements
 Level of technical skill required

29. Initial Selection Assessment
Selection considerations….;
 Power and other service requirements
 Environmental requirements: Temp &
humidity
 Adequate space available, remember
ventilation
 Running costs; reagents, spares,
maintenance & service, power
consumption.
 Reliability & reputation

30. Initial Selection Assessment
Selection considerations...;
 What level & quality of support/ backup
is available for;
o Training
o Technical advice
o Service & Preventative Maintenance
o Rapid call out
o Reliable supply of reagents & spares

31. Budgeting
• Very important to consider TOTAL costs
when budgeting for a new instrument;
• Instrument:
• Outright purchase vs Rental
• Delivery & installation
• Running costs;
• Service contract & emergency call-out
• Reagents, consumables & spares
• Controls & calibrators
• Services – electricity, water, gases
• Staffing requirements
• Backup system – purchase & running costs?

32. Installation
 Wherever possible a new instrument
should be installed and commissioned
by the supplier.
 If the customer is to install, detailed
information must be supplied by the
manufacturer, including;

33. Installation
 Installation considerations;
 Procedures for unpacking the instrument
 Detailed component list
 Instructions on what to do if the
instrument is damaged - insurance?
 Specifications of service requirements;
Voltage and power backup (UPS?)
Water pressure & purity
Gas supply
Drainage
H&S requirements - PPE

34. Installation
 Installation considerations (cont’d);
• Specifications for physical environment;
Temperature tolerances
Humidity
Dust
Vibration
load bearing
Light, direct sun
Space & ventilation

35. Training
 Detailed training and instruction should be
provided by a competent manufacturer’s
representative, particularly in the case of major
equipment.
 It is crucial that all operators are fully trained in
all stages of the instruments operation including;
Start-up & shut-down procedures
Cleaning & maintenance
Sample preparation & handling
QC & calibration procedures
Trouble shooting
Data acquisition and storage

36. Laboratory Evaluation
 Before an instrument is placed into routine
operation, a period of observation and
staff familiarisation must be provided.
 This will help identify any inherent defects
in the machine and allow staff to fully
understand its capabilities and restrictions.

37. Laboratory Evaluation
 For analytical instruments, a full performance
evaluation must be undertaken before
patient/study samples can be analysed and
the data utilised. This should include;
 Detailed instrument & assay validation
 Establish IQC procedures and determine
control limits for all methods.

39. Documentation
 All important details & documents must be
filed and retained as part of your
Equipment Inventory system;
Dates, make, model, Serial No., Warranty,
service supplier details and schedules,
essential spares list, lab location, Service
history logs.
 Detailed operational procedures/SOPs
should be developed and implemented
during the training and evaluation phases.

40. Develop a Maintenance Plan
 Routine Maintenance: Develop and document a
detailed schedule of routine maintenance
according to manufacturers instruction.
 Scheduled Maintenance: includes service repair
by manufacturer, calibration,
 Function check plus any other problems
 Trouble Shooting:
Occurrence Logs; details of all problems
encountered and steps taken to rectify the
incident – Corrective Actions –
DOCUMENT.!

41. Preventive Maintenance
 Routine cleaning
 Adjustments
 Replacement of equipment parts
Instrument / Assay Backup
 Must ensure comparability of results with an
equal level of IQC in place.
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42. Equipment Inventory
Record:
 Instrument type, model number,
serial number.
 Location in laboratory.
 Date purchased.
 Manufacturer and
 Vendor contact information.
 Warranty,
 Note expiration date
 Spare parts
11/02/25 42

43. Equipment Management: Benefits
High-level
Performance
Test results
Ensures
Quality
Reduced
Down-Time
Lowers
repair costs
Lengthens
lifespan