By
Linda
Mujuru
For
more
than
two
weeks,
Magawa
took
the
prescribed
medication,
but
her
condition
only
worsened.
“I
tasted
death,”
she
recalled.
The
diagnosis,
she
later
learnt,
was
wrong
after
a
different
doctor
ordered
new
blood
tests,
which
were
analysed
at
another
laboratory.
When
the
retests
were
done,
they
showed
that
she
did
not
have
a
kidney
problem,
but
rather
a
minor
urinary
infection.
By
then,
she
had
already
been
admitted
to
a
public
hospital.
Her
experience
is
not
unique.
Across
Zimbabwe,
patients
and
doctors
are
raising
alarm
over
inconsistent
test
results
from
medical
laboratories,
a
problem
linked
to
the
rapid
growth
of
diagnostic
testing
facilities
that,
doctors
say,
do
not
always
meet
professional
standards.
In
early
2020,
Zimbabwe’s
testing
capacity
was
limited
to
a
few
public
laboratories.
But
by
December
that
year,
the
Ministry
of
Health
and
Child
Care
(MoHCC)
had
licensed
29
private
laboratories
for
COVID-19
testing,
bringing
the
total
number
of
approved
centres
(public,
NGO,
and
private)
to
58.
The
centres
included
those
owned
by
the
government,
non-governmental
organisations
and
the
private
sector.
By
mid-2021,
hundreds
of
smaller
clinics
were
offering
rapid
tests,
and
daily
testing
volumes
reached
new
highs.
This
rapid
expansion
filled
a
critical
need,
but
also
exposed
weaknesses.
Some
new
labs
lacked
trained
staff
or
validated
equipment
to
perform
reliable
tests.
Others
used
rapid
antigen
kits
with
limited
sensitivity,
leading
to
false
negatives
and
false
assurances.
The
ministry
itself
warned
that
any
result
from
an
unauthorised
laboratory
would
be
treated
as
invalid
under
the
Health
Professions
Act.
After
COVID-19,
many
of
these
labs
continued
operating,
offering
a
range
of
other
medical
tests.
Even
now,
patients
often
take
multiple
tests
at
different
laboratories,
sometimes
paying
in
scarce
US
dollars
to
confirm
a
diagnosis,
several
doctors
confirmed
during
this
investigation.
Many
clinicians
said
they
now
hesitate
to
trust
results
from
lesser-known
or
smaller
labs.
667
health
institutions
registered
in
2025
Alois
Muzvaba,
a
medical
doctor
and
member
of
the
Zimbabwe
Hospital
Doctors
Association
(ZHDA),
said
he
receives
between
two
and
three
questionable
test
results
from
his
patients
each
day.
“In
those
instances,
we
say
90%
of
the
diagnosis
comes
from
what
the
patient
is
telling
you,”
Muzvaba
said.
“But
such
test
results
confuse
the
doctor
and
delay
treatment
because
most
of
the
time
we
have
to
request
a
retest
at
a
different
laboratory.”
According
to
the
Zimbabwe
National
Health
Laboratory
Policy,
the
country
has
more
than
170
formally
registered
diagnostic
centres
operating
at
various
referral
levels,
from
national
reference
laboratories
to
district
hospitals.
Clotilda
Chimbwanda,
secretary
General
of
the
Health
Professions
Authority
(HPA),
said
the
authority
does
not
track
the
number
of
medical
laboratories
specifically,
but
monitors
health
institutions
in
general.
“To
date,
we
have
a
database
of
more
than
3
500
institutions
in
Zimbabwe,”
Chimbwanda
said.
“For
the
year
2025,
we
have
successfully
registered
667
new
health
institutions.
“This
follows
approximately
420
new
institutions
that
were
opened
and
registered
during
the
previous
year.”
She
said
each
year
there
has
been
a
steady
increase
in
the
number
of
facilities.
Doctors
said
the
consequences
of
this
influx
and
weak
regulations
were
visible
in
their
daily
work.
Dr
Moyo,
a
general
practitioner
who
operates
a
private
clinic
in
Harare
and
requested
to
be
identified
only
by
his
last
name
for
fear
of
losing
clients,
said
he
frequently
encounterd
cases
where
clinical
data
and
patient
symptoms
do
not
align
with
laboratory
results.
“In
such
cases,
I
end
up
requesting
a
retest
and
sending
the
blood
to
a
different
lab,”
Moyo
said.
“It
increases
costs
for
the
patient,
but
to
treat
them
properly,
I
need
reliable
test
results,
and
most
of
the
time
the
new
results
come
back
different
from
the
first
ones.”
He
noted
that
it
was
often
the
smaller
laboratories
that
produce
unreliable
results,
though
larger
ones
occasionally
face
problems
too.
“I
think
all
labs
at
times
have
issues.
But
for
the
mainstream
laboratories,
what
I’ve
noticed
is
that
such
misleading
results
don’t
go
on
for
long,”
Moyo
said.
“It
could
be
a
machinery
issue,
perhaps
a
batch
of
tests
done
within
a
certain
timeframe
when
maintenance
was
due.
For
other
laboratories,
it
may
reflect
poor
standards
of
practice
across
the
whole
facility.
“What
I
have
seen
recurring
are
more
and
more
discrepancies
in
results
for
the
same
tests
and
the
same
patients.”
Esther
Dongo,
a
laboratory
technician,
described
frequent
requests
to
rerun
tests
from
patients
who
were
confused
or
doubtful
after
receiving
conflicting
results.
Earlier
this
year,
while
working
at
Chitungwiza
Hospital,
she
witnessed
an
incident
where
a
private
laboratory
based
in
Chitungwiza
falsified
a
patient’s
medical
test
results.
Dongo
said
this
reliance
on
external
labs
by
public
hospitals
stems
from
the
lack
of
adequate
testing
facilities
within
hospitals,
a
gap
that
ultimately
affects
patients.
Poorly
staffed
laboratories
Zimbabwe’s
public
health
system
continues
to
face
major
gaps
in
laboratory
diagnostic
capacity,
particularly
at
the
primary
care
level.
According
to
data
published
in
Frontiers
in
Public
Health
(2022),
about
92%
of
the
country’s
1,696
primary-level
hospitals,
rural
health
centres,
and
clinics
lacked
full
laboratory
facilities,
offering
only
limited
rapid
tests
for
diseases
such
as
HIV,
malaria,
and
tuberculosis.
The
Fleming
Fund’s
situational
analysis
(2025)
noted
that
only
about
25%
of
public
laboratories
have
adequate
staff,
equipment,
and
reagents
to
carry
out
culture
and
antimicrobial
susceptibility
testing.
These
constraints
limit
diagnostic
accuracy
and
timeliness
in
public
hospitals,
often
forcing
patients
to
seek
services
from
private
laboratories,
which
can
be
significantly
more
expensive.
Investigations
by
CITE
revealed
disparities
in
the
cost
of
laboratory
tests,
a
pattern
that
Moyo
said
it
reflected
poor
regulation
of
pricing
and
quality.
For
example,
a
U&E
test,
one
of
the
tests
Magawa
underwent,
costs
US$25
at
Lancet,
US$10
at
Interpath,
US$20
at
Progressive
Diagnostic
Laboratory,
and
US$15
at
Biogene
Laboratory.
Moyo
said
there
was
need
for
standardisation
of
both
prices
and
service
quality.
“What
happens
is
the
public
will
try
to
seek
cheaper
alternatives.
So,
that
huge
disparity
is
also
a
reflection
of
the
quality
of
care,”
he
said.
Muzvaba
added
that
some
laboratories
charged
as
little
as
US$5
for
a
full
blood
count
test,
even
though
the
reagents
and
chemicals
required
cost
about
US$7.
“These
reagents
should
be
changed
daily,
and
machines
calibrated
daily,
and
such
prices
reflect
some
kind
of
shortcut,”
he
said.
The
regulatory
framework
for
laboratory
services
is
clear
on
paper.
The
registration
process
begins
with
the
relevant
professional
body,
in
this
case,
the
Medical
Laboratory
and
Clinical
Scientists
Council
of
Zimbabwe
(MLCSCZ).
Practitioners
must
be
registered
and
hold
a
valid
practising
certificate,
as
required
by
the
Health
Professions
Act
(Chapter
27:19),
which
prohibits
unregistered
persons
from
giving
medical
advice
or
performing
diagnostics.
Once
the
council
accepts
an
application,
it
forwards
it
to
the
Health
Professions
Authority
of
Zimbabwe
(HPA)
for
inspection
against
the
minimum
standards
outlined
in
the
HPA’s
inspection
manual,
Chimbwanda
said.
In
2025,
the
government
launched
the
National
Health
Laboratory
Strategic
Plan
(2025–2030),
aimed
at
strengthening
accreditation,
digital
tracking,
and
external
quality
assessment.
But
experts
caution
that
without
increased
funding,
staffing,
and
enforcement
capacity,
the
plan
may
fall
short.
The
huge
cost
of
misdiagnosis
Muzvaba
said
a
single
misdiagnosis
can
mean
the
difference
between
timely
care
and
tragedy.
It
can
also
erode
trust
in
the
health
system,
driving
patients
toward
informal
remedies
or
delaying
treatment.
“As
long
as
we
have
public
hospitals
not
running
simple
tests
such
as
a
full
blood
count,
there
will
always
be
questionable
labs
coming
up
because
public
hospitals
serve
the
bulk
of
patients,”
he
said.
“If
hospitals
can
perform
these
basic
tests,
it
will
reduce
overreliance
on
private
labs.
“Once
patients
receive
standard
and
good-quality
healthcare,
everything
else
will
fall
into
place.”
For
Magawa
and
many
others,
those
systemic
failures
translate
into
personal
pain.
“The
experience
has
made
me
feel
sceptical
about
the
quality
of
care
and
reliability
of
testing
facilities,”
she
said.
“I
am
almost
always
compelled
to
seek
a
second
opinion
for
any
tests
I
get
done
because
I
have
no
faith
in
the
credibility
of
the
results.”
Kathryn