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

Abstract Introduction: Peripheral blood smear examination is a vital hematological test for diagnosis and monitoring of disorders in blood. Despite the considerable benefits of this test in the battle against the growing burden of communicable and non-communicable diseases, its rate of provision is low. This study aimed to assess the rate of peripheral blood smear examination service provision and its barriers among public hospitals in southern Ethiopia.Method: We have conducted a descriptive cross-sectional study from January 01 to March 31, 2019, among five public hospitals in Southern Ethiopia. We collected socio-demographic data from patients and healthcare providers. We prepared peripheral blood smears from 423 patients with abnormal complete blood cell count. We examined a wright’s stained peripheral blood smear under the microscope to identify abnormality in the morphology of blood cells. We conducted key informant interviews with healthcare providers. We assessed health facilities using a standard checklist. We did descriptive statistical analysis for quantitative data using Statistical Package for Social Sciences (SPSS) version 20.0 software. We transcribed, categorized, and thematically analyzed the qualitative data. We presented the results in tables and figures.Result: The rate of provision of peripheral blood smear examination service was 11.6% (n= 49). Nearly 90% of the eligible patients did not receive this service. Relatively better rate of service provision was seen among hospitals with essential resources for the service, and those participating in Hematology external quality assurance. 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. 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 service.