Rate of Peripheral Blood Smear Examination Service Provision and its Barriers among Public Hospitals in Southern Ethiopia: A Mixed-Methods Study

Abstract

Aklilu Alemayehu, Tsegaye Yohannes, Tamiru Shibiru, Zeleke Hailemariam

Introduction: Peripheral blood smear examination is a vital hematological test for diagnosis and monitoring of blood disorders. Despite its substantial role in the management of communicable and non-communicable diseases, its utilization is low. We aimed to assess the rate of peripheral blood smear examination service provision and its barriers among public hospitals in southern Ethiopia.

Method: A cross-sectional study was conducted from January 01 to March 31, 2019, in five public hospitals of Southern Ethiopia. Socio-demographic data was collected from patients and healthcare providers. Peripheral blood smears were prepared using capillary blood collected from 423 patients with abnormal complete blood cell count. The smears were stained with Wright’s stain and examined under microscope by 1000X magnification to detect and identify morphological abnormality in the blood cells. A key informant interview was done with healthcare providers. Health facilities were assessed using a standard checklist. The quantitative data were analyzed by SPSS version 20 software. The qualitative data were transcribed, categorized, and thematically analyzed. The results of descriptive analyzes are presented in tables and figures.

Result: The rate of provision of peripheral blood smear examination service was 11.6%. Nearly 90% of the eligible patients did not receive this service. Relatively better rate of service provision was observed among hospitals with essential resources for the service, and those participating in Hematology external quality assurance scheme. Lack of training, shortage of laboratory supplies, and inadequate supportive supervision were identified as barriers to regularly provide peripheral blood smear examination service.

Conclusion: Rate of peripheral blood smear examination service provision is low in the area. A large proportion of eligible patients missed the deserved service. Adequate laboratory supplies, training, and continued supportive supervision should be considered to improve the provision of this vital service.

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