LEVELS OF LABORATORIES
In India, the laboratory services are integrated with the 3-tier public health system at
the primary, secondary and tertiary levels. Besides these, there are Reference
Laboratories, Research Laboratories and Specific Disease Reference Laboratories
to provide services for complex and special tests. The private sector provides laboratory
support at all levels of health care both in rural and urban areas. Each laboratory
should identify the scope, functions and the capacity of the services offered by it and
appropriate infrastructure with requisite biosafety measures should be planned.
Qualified and trained staff should be employed with periodic up-gradation of their skills.
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Primary Level
Simple laboratory tests such as haemoglobin estimation and urine examination for
albumin and sugar are carried out at Primary Health Centers (PHCs) and Urban Health
Centers (UHCs) by laboratory technicians. Most PHCs and UHCs also have
microscopy facilities and trained technicians for examining blood smear for malarial
parasite and sputum for acid-fast bacilli (AFB) and a cold chain system. The Community
Health Centers (CHCs) receive referrals from PHCs and the laboratory technicians
are trained and equipped to handle additional laboratory investigations for the
management of medical and surgical emergencies and making etiological diagnosis
of RTIs/STIs. Facilities for screening of G6PD deficiency, sickle cell anaemia and
thalassemia are also available for vulnerable communities. Under IDSP, training will
be provided for diagnosis of typhoid using kits, detection of chlorination levels and
fecal contamination in water samples. -
Secondary level
The district hospitals have facilities and manpower for carrying out pathology, clinical
pathology, biochemistry, serology, and microbiological investigations. They also carry
out tests of water quality and receive referrals from primary level facilities. The laboratory
staff includes pathologists, microbiologists, cytotechnicians, laboratory technicians,
blood bank technicians and laboratory attendants. -
Tertiary level
The medical college hospitals and non-teaching large hospitals are equipped with
sophisticated diagnostic and investigative facilities to provide tertiary level health care.
These hospitals receive referrals from the primary as well as the secondary levels. -
Reference Laboratories, Research Laboratories and Specific Disease
The Reference Laboratories, Research Laboratories and Specific Disease Reference
Laboratories provide services in a specialized field or area of importance. These may
be located in a medical college, research institution or a private institution. They set
and should maintain high standards of quality in one or more particular area and
therefore receive referrals specific to that field. They also offer consultancy, standardize
diagnostic tests and carry out training pertaining to that specific area.
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