This document discusses using Laboratory Quality Improvement Tools (LQITs) to improve laboratory capacity and quality in sub-Saharan Africa. It notes that laboratories play an important role in disease diagnosis and treatment monitoring, but many rural laboratories lack quality assurance. The LQIT uses a 100 question assessment across 12 areas and targeted mentoring visits to identify issues and implement tailored improvements. Initial LQIT scores provide baselines and subsequent visits track quality improvements. While LQITs have shown success in strengthening diagnostic processes, regular site visits are needed and funding remains a challenge.
Juliana Hagembe - Institute of Human Virology, University of Maryland School of Medicine, USA
1. INNOVATIVE TOOLS FOR
IMPROVING LABORATORY
CAPACITY & QUALITY IN SUB-
SAHARAN AFRICA
JULIANA HAGEMBE, MPH, MSC
2. • Laboratories play important
role in fighting diseases
• HIV
• HIV test
• Viral Load
• CD4 cell count
• Kidney Function text (Toxicity)
• Drug resistance assay (Monitor)
4. Rural labs - Limited National Quality assessment participation
5. • PROBLEM
• 60% in Rural Areas
• Cannot be linked to central services
• Persisting Issues related to reliability of diagnostic
services
• SOLUTION
• Laboratory Quality improvement tools ( LQITS)
• Targeted Mentoring approach
• Strengthen the pre-analytical, analytical and post
analytical stages of total diagnostic process
10. • Initial LQIT scores used as
baseline
• Labs visited on a regular basis
and graded
• Quality of services provided
• Personal skill/knowledge level
• Tailored site-specific
interventions during TA visits
• Improvements in the quality of
tests for diagnostics monitored
11. • Major gap in the primary
laboratories by LQIT
• Better planning of trainings
• Continual development/
maintenance of quality
• Step closer to meeting
international accreditation
(e.g. WHO-AFRO)
12. Nigeria Rwanda Uganda Tanzania Zambia Kenya
100
50
0
14. • Funding to ensure regular visits to sites
• Competing priorities
• Routine use of LQIT valid approach for
ingraining CQI activities
• Maintain high quality of diagnostic services
at primary level facilities
Editor's Notes
Key interventions (training, technical support, provision of resources, referrals and linkages etc)
Data shows LQIT Potential to drive continuous quality improvement / build laboratory capacityQuick identification of gaps to be addressed during on site visits & through targeted trainings
Routine use of LQIT by either external assessors or by laboratory staff represents a valid approach for ingraining CQI activities with the overall goal of reaching and maintaining high quality of diagnostic services at primary level facilities in Sub-Saharan Africa, where about 80% of the patients are referred