Medical Imaging: The Missing Element of National Health Plans

Abstract

Purpose: Access to diagnostics is vital for clinical decision-making but is rarely prioritized in national health services strategic plans (NHSSPs)[1]. Materials and Methods: An analysis was conducted of the inclusion of medical imaging as well as laboratory medicine in current NHSSPs for both low-income countries (LICs) and lower- middle-income countries (LMICs). NHSSPs of 79 countries were examined for the inclusion of key terms relevant to imaging and laboratory medicine. Results: Current and electronically available NHSSPs were found for 33 countries, 14 from LICs and 19 from LMICs. Terminology related to imaging was referenced in very few of the plans, and terminology related to laboratory medicine only slightly more. Imaging or laboratory workforce was discussed in 7% and 8% of the NHSSPs respectively. Imaging equipment, technology, or infrastructure was mentioned in 11% of NHSSPs compared to 19% that referenced “laboratory.” Information on key performance indicators and budgeting relating to imaging and laboratory were included in 12% and 21% of NHSSPs respectively. No countries referred to national radiology plans, and only three (Sierra Leone, Haiti, and Zambia) mentioned national laboratory plans. Diagnostics services are not well covered in NHSSPs and imaging is particularly disadvantaged. Conclusion: The absence of medical imaging in NHSSPs makes it less likely that these services will be incorporated into policy and then funded, hence limiting the success of Universal Health Coverage by 2030. The inclusion of imaging in the World Health Organization Essential Diagnostics List is a critical step to addressing inadequate services.

Keywords

• imaging
• radiology
• laboratory medicine
• universal health care
• diagnostics
• low-income countries
• lower middle-income countries