摘要：Sample transportation remains a challenge in resource-limited countries. In Nigeria transport was conducted through non-standard, parallel systems, leading to long turnaround times and lack of visibility. A National Integrated Specimen Referral Network (NISRN) - established by the Nigeria Ministry of Health with donor support - as a cost-effective system currently being implemented by GHSC-PSM using third-party logistics (3PLs) providers to transport specimens from collection centers to testing laboratories. This study assesses impact of using the private sector to transport samples in the NISRN. A descriptive method was used to assess 3PL performance. Specimen quantities transported by the 3PLs providers over six months were compared to the quantities transported in the period prior to implementation. Using the 3PLs instead of health facility staff, specimens were moved from facilities with backlogs to laboratories with capacity to analyze specimens quickly through the enhanced laboratory network. Before the NISRN, 116,046 viral load samples were tested, and 6,459 packs of reagents were used to cover 1,700 facilities over six months. During a comparable six months of operationalizing the NISRN, 277,536 viral load samples were tested, and 10,369 packs of reagents used to cover 3,114 facilities, translating into a significant increase of 38% of samples tested, 21% of reagents used; and over 83% increase in the number of facilities receiving testing services. In conclusions, leveraging the private sector to transport samples enhanced testing laboratory network efficiencies. This resulted in substantial increases in viral load samples tested, reagents used, and facilities accessing testing. This approach led to an expansion of services, and a robust optimized sample referral network that can respond more easily to public health emergencies. Utilization of the private sector is a sustainable, cost-efficient framework. Utilizing 3PL providers increases patient access to services and allows facility staff to focus on their traditional role rather than transporting specimens.
