Process Step 4:


The toolkit for outsourcing laboratory services

In this section, you will learn:

  • the three-step implementation process for outsourcing laboratory services
  • examples of key performance indicators
  • how outsourcing laboratory services was implemented in Nigeria

Three-step implementation process

Implementing the outsourcing contract for laboratories follows a process with three steps for success.

Read more about the three-step implementation process in the OSTK.

Transitioning the organisation

4 to 6 weeks

Performance management

2 to 3 weeks

Governance procedures


Considerations for laboratories

When following the three-step implementation process, laboratories need to consider:

  • Contractual obligations must be specified based on the technicality and complexity of the functional area/s of laboratory services that have been chosen to be outsourced.
  • The need for a smooth transition through transition planning and expertise, alongside accurate performance management against key performance indicators and ongoing governance procedures, remains critical to ensuring the vendor is held to account and relationships between stakeholders are maintained.

The Riders for Health case study is an excellent example of how the implementation phase works for laboratories is outsourced sample transportation in the specimen referral network

Example of key performance indicators and monitoring frequency for a sample transportation contract24

Performance management is underpinned by the key performance indicators and monitored through regular governance procedures.

Establishing a technical working group at either the regional or national level is an effective way to monitor the entire specimen referral system and the performance of outsourcing arrangements. The technical working group should comprise diverse stakeholders from ministries of health, central laboratories, various disease programmes, emergency outbreak response centres, donors, implementing partners, and third-party logistics (where relevant). Written terms of reference should govern it.

Summary of Process Step: Implement

In this Process Step, Implement, you have learned the three-step implementation process and considerations for laboratories. Examples of key performance indicators and monitoring frequency have been provided. Finally, you explored a case study of Riders for Health in Nigeria. The toolkit’s focus for outsourcing laboratory services will now shift to the cross-cutting Enabler Tools, which support the Process Steps.

23Source: Lighthouse Strategic Leadership (LSL) Team Analysis 2020 and Interviews for the Toolkit for Outsourcing Laboratory Services, November 2020.

24Source: Global Laboratory Initiative (GLI) Guide to Specimen Referral Systems and Integrated Networks. Available: