Medical laboratories in Nairobi are charging almost 500 times more than a similar test in a public hospital.
But then in the public sector most tests are not available or patients are re-directed to private facilities linked to government health workers.
A survey in public, private and faith based laboratories in Nairobi shows Kenyans are being ripped off while not being told why they are being tested.
Private laboratories based within hospitals are the most expensive followed by standalone private labs.
“Average prices for all tests were 468 percent in private in-facility laboratories compared to public labs,” says the survey carried out in Nairobi County.
Malaria test, for example, which is among the most commonly requested, is six times more expensive in private labs compared to the public sector.
The survey had assessed 46 of the most commonly requested medical diagnostic tests. However, only about half of the tests were available in the public sector.
The survey is published this week (26 Aug 2021) by among others the Kenya Medical Laboratory Technicians & Technologists Board (KMLTTB). The board is in charge of regulating the sector.
While it is common knowledge, that public health workers redirect patients to labs they have interest in, this may be the first time the regulator has publicly acknowledged the vise.
“Some clinicians have relationships with private laboratories and are incentivized to send their patients to those laboratories,” says the survey in the journal Global Health Action.
The board says it has limited mandate and financial capacity to adequately police pricing and transparency in the sector.
Others in the study were the Wellcome Trust Research Programme, Nairobi, University of Oxford, UK, Aga Khan University Hospital, Nairobi and University of Waterloo, Canada.
Also importantly the study found most of the private laboratories are unlikely to provide the public and patients with information on their prices and or the turnaround time.
“About 85 per cent of the private laboratories in our study did not provide information on price and turnaround time,” says the survey.
This, the authors say makes it difficult for patients to make informed decisions about which laboratories to visit when in need of diagnostic services.
“This opacity results in information asymmetry which, in turn, makes patients vulnerable to exploitation.”
The study found many patients lacked key information regarding the tests they needed: Sixty five percent did not know the purpose of the test while 41 per cent did not know the test price at all.
At least, 28 per cent of the interviewed patients did not know how long they would wait to get their laboratory results.
Generally, almost 40 per cent of the study respondents found it difficult distinguishing good quality laboratories from poor quality ones.
This opaque nature of testing information in the current clinical laboratory market in Nairobi, the authors say limits access to high quality diagnostics. “In turn, this limits the potential for higher quality medical care.”
The data (see diagram) shows FHG – full blood test, urine, malaria, H.pylori and syphilis as the most requested test in Nairobi.
To address the situation the authors want the government to equip public laboratories with adequate capacity to conduct all essential diagnostic tests.
“Equipping public hospital laboratories with the necessary resources would therefore improve patient quality of care while protecting patients from high costs of private sector laboratory diagnoses.”
They also suggest the use a digital marketplace app, in the same way that has been done in other sectors where customers choose taxi drivers, second-hand sellers or holiday lettings.
By Gatonye Gathura