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The Role of the Government in
strengthening accreditation and
Quality Heath and social care
delivery
Sejojo Phaaroe
SADCAS...
PRESENTATION OVERVIEW
• This presentation constitutes a snapshot –,
• What is accreditation
• Why- Remove Barriers' to fre...
June 9, 2015 marks World
Accreditation Day
• June 9, 2015 marks World Accreditation Day as a global
initiative, jointly es...
What is accreditation?
• Accreditation is defined as the procedure by
which an authoritative body gives formal
recognition...
Why accreditation?
• At the international level, the purpose
of Accreditation is to remove technical
barriers to trade by ...
Why accreditation
• Accreditation also improves the quality and
reliability of services provided to local users
of conform...
Client tale
• Insurances
• Drs
• Food Handlers
• Travellers
• Job SEEKERS
• Marriage couples
• New born
• ANC,
• FP,
• PAT...
Proactive to Prevent
Paparatzi after a Medical Lab Scandal ?
International and national structures
and activities for improving health
care
• What international support for quality im...
International - Multilateral Recognition
Arrangement Documents (ML Series)
• purpose of IAF is to establish Multilateral R...
• Quality and accreditation in health
care services:
• International Society for Quality in Health Care
(ISQua) under cont...
Pro-active
Quality Health
management
delivery
system
Patient Sales and
marketing
Accredit
ation
Infustructure
and
equipmen...
Health systems and programs
MDG’s
Community
involvement
Competent
motivated Health
professionals
Quality
Patients
programs
Health Departments
1. Administration-
2. Clinical Services
laboratory ,
pharmacy,
dental,
nursing ,
mental health, and Med...
Call for Government strengthening
Quality health care
• Government expenditure on health has in recent years
gone toward h...
GOVERNMENT SUPPORT
New public health bill
• Developing new regulations and requirements
• Measuring compliance with regula...
COHSASA - Improving health care through standards & accreditation
The Council for Health Service
Accreditation of Southern...
Facilities and Safety - Module 2 19
Organization
Personnel
Licensed/certified
Equipment
Purchasing
&
Inventory
Process
Con...
Personnel
Performing specific Medical Laboratory tasks
Qualified Professional
Education
CBE Training
Professional
Experien...
Measurement of Quality health care
• Measurement Compliance with the above expectations
has been assessed by:
• questionna...
Legislation within the workplace
LAW RIGHT
Employment Equity
Act (EEA)
a) Right not to be unfairly
discriminated against o...
Accreditation of Southern Africa
(COHSASA)
The Council for Health Service is the only
internationally accredited quality
i...
COHSASA
• Think Tank Trainings and motivation-
proposalscohsasa_hospital_standards_-
_certificate.pdf
LFL
• To encourage one-to-one interaction of all testing, calibration and inspection
laboratories in order to guide in wor...
accreditation services for SADC Member States aimed at:
• Supporting regional and international trade;
• Enhance the prote...
Structures of support• ISO
• International Accreditation Forum (IAF) and International Laboratory
Accreditation Cooperatio...
REGIONAL SUPPORT
• SADC Member States aimed at:
• Supporting regional and international trade;
• Enhance the protection of...
The SADCAS MLAP
The SADCAS Medical Laboratories Accreditation
Programme (MLAP)
– Established in June 2010
– A multi-discip...
ISO 15189 Technical Assessors- SADC-EU.
Botswana ; LESOTHO CANDIDATES 2010-
12
Technical systems, and process control
The SADCAS MLAP – Accreditations by Country
32
Levels of care needing quality
View larger version:
Figure 3
The SADCAS MLAP - Applications
by Scope
34
Improve Systems and programs – to address MDG’s ,
PRD’s,
• International health
Regulation ,
regulators, policies,
laws, B...
YES WE CAN!!!!!
Our voices should be heard !!!!!!!!
after this Gap analysis
International Networking events and
Collaborations- BENCHMARKING
Needs for applications
• Application for Good Clinical Practice (GCP) Compliance
Status
• Application for Good Laboratory ...
Way Forward and Call to Action
• Excellent medical laboratories AND OTHER
CLINICAL SERVICES are vital to ensure accurate
d...
Recom
• Government officials and health care professionals
in these countries should agree on the importance
of creating s...
Laboratories Quality Systems
Laboratory quality systems are critical to the
success of any laboratory service.
The most im...
• A focus on strengthening laboratories could
change largely empiric algorithm-based
clinical care to rapidly confirmed di...
• “The Medical Laboratory is a place where ,
under rather difficult conditions , we create a
protected island where togeth...
Case 2
• It is Early January, Food handlers attend the
Public Health screening clinic before they could
receive the School...
• Thank you
The role of the government in strengthening accreditation ready
The role of the government in strengthening accreditation ready
The role of the government in strengthening accreditation ready
The role of the government in strengthening accreditation ready
The role of the government in strengthening accreditation ready
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The role of the government in strengthening accreditation ready

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June 9, 2015 marks World Accreditation Day as a global initiative, jointly established by the International Accreditation Forum (IAF) and the International Laboratory Accreditation Cooperation (ILAC), to raise awareness of the importance of accreditation.
This year’s theme focuses on how accreditation can support the delivery of health and social care.
the day was celebrated across the world with the hosting of major national events, seminars, and press and media coverage, to communicate the value of accreditation to Government, Regulators and the leaders of the business community.

What international support for quality improvement is available to Lesotho national health care initiatives?
• To what extent do national governments around the world specify quality improvement in legislation and published policy?
• What are the distinguishing structures and activities of national approaches to quality improvement within countries?
• What resources (in the form of organizations, funding, training and information) are available nationally?
What maintenance or implementation pathways are available , to prove to the world that Lesotho health care services are of excellence???

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The role of the government in strengthening accreditation ready

  1. 1. The Role of the Government in strengthening accreditation and Quality Heath and social care delivery Sejojo Phaaroe SADCAS- Technical Advisory Committee Member SANAS-SADCAS-EU trained Technical Assessor MLS- REGULATORY BOARD FOCAL PERSON
  2. 2. PRESENTATION OVERVIEW • This presentation constitutes a snapshot –, • What is accreditation • Why- Remove Barriers' to free trade • World accreditation day - Advocacy for quality, and accreditation services support in health care in • structures and processes that are built help to inform local improvement of health services • Strengthening of accreditation activities nandsscape • What Lesotho has been doing in the Health sector SUPPORTING ACCREDITATION
  3. 3. June 9, 2015 marks World Accreditation Day • June 9, 2015 marks World Accreditation Day as a global initiative, jointly established by the International Accreditation Forum (IAF) and the International Laboratory Accreditation Cooperation (ILAC), to raise awareness of the importance of accreditation. • This year’s theme focuses on how accreditation can support the delivery of health and social care. • the day was celebrated across the world with the hosting of major national events, seminars, and press and media coverage, to communicate the value of accreditation to Government, Regulators and the leaders of the business community.
  4. 4. What is accreditation? • Accreditation is defined as the procedure by which an authoritative body gives formal recognition that an institution/organization/body or person is competent to carry out specific tasks. • The key words from the above definition in the process of accreditation are “authoritative”, • formal recognition” • “competent”, there is NO national authority in Lesotho for granting accreditation to conformity assessment bodies involved in calibration, testing, inspection and certification
  5. 5. Why accreditation? • At the international level, the purpose of Accreditation is to remove technical barriers to trade by ensuring that the results of conformity assessment are accepted and recognized among trading partners.
  6. 6. Why accreditation • Accreditation also improves the quality and reliability of services provided to local users of conformity assessment bodies and is thus important at the national level for the protection of the health and safety of the population and for the protection of the environment. • ISO STANDARD 15189
  7. 7. Client tale • Insurances • Drs • Food Handlers • Travellers • Job SEEKERS • Marriage couples • New born • ANC, • FP, • PATIENTS • Private Doctors • Community • Criminal investigations • Legal agencies • Out patients • Health programs • Government departments • Health planners • Development partners • Economic planners • Health planners • Donor agencies • Bond contractor's
  8. 8. Proactive to Prevent Paparatzi after a Medical Lab Scandal ?
  9. 9. International and national structures and activities for improving health care • What international support for quality improvement is available to Lesotho national health care initiatives? • • To what extent do national governments around the world specify quality improvement in legislation and published policy? • • What are the distinguishing structures and activities of national approaches to quality improvement within countries? • • What resources (in the form of organizations, funding, training and information) are available nationally? • What maintenance or implementation pathways are available , to prove to the world that Lesotho health care services are of excellence???
  10. 10. International - Multilateral Recognition Arrangement Documents (ML Series) • purpose of IAF is to establish Multilateral Recognition Arrangements (MLA) between its accreditation body members in order to contribute to the freedom of world trade by eliminating technical barriers to trade. • cover all accreditation bodies in all countries in the world, • thus eliminating the need for suppliers of products or services to be certified in each country where they sell their products or services (certified once accepted everywhere).
  11. 11. • Quality and accreditation in health care services: • International Society for Quality in Health Care (ISQua) under contract to the World Health Organization. • structures and activities at national and international levels around the world to promote quality in health care. • catalogues quality concepts • Gives representation in International Quality Forum . ILAC. AMCOA , SADCAS and LFL • African Centre for Integrated Laboratory Training (ACILT- accreditation HAS BEED IDENTIFIED BY DEVELOPING- SMLTA as an assistance to developing countries like Lesotho
  12. 12. Pro-active Quality Health management delivery system Patient Sales and marketing Accredit ation Infustructure and equipment Finance /budget s OUT REACH AND Education Policy makers Laws ; vision, mission, values, norms, location Environment and climate change RISK MANAGEMENT REGULATORY AGENCIES COMMUNITY INFORMATION mngt International Collaborations Human Resource Job seekers Recruitment Public relations Medic al staff
  13. 13. Health systems and programs MDG’s Community involvement Competent motivated Health professionals Quality Patients programs
  14. 14. Health Departments 1. Administration- 2. Clinical Services laboratory , pharmacy, dental, nursing , mental health, and Medical, ) 2. Health Planning 3. HIV/AIDS Directorate and disease control 4. Human Resource 5. Primary Health Care 6. Procurement 7. Social Welfare
  15. 15. Call for Government strengthening Quality health care • Government expenditure on health has in recent years gone toward healthcare services, improvement and refurbishment of clinics, and other activities aimed at addressing the effects of HIV/ AIDS and tuberculosis (TB) and improving access to healthcare services. • Accessibility of good quality healthcare services is a cornerstone of Lesotho’s Vision 2020 framework. • This combination of funding and policy emphasis has led to infrastructure improvement in the form of new facilities, particularly in the primary healthcare sector THROUGH MCC.
  16. 16. GOVERNMENT SUPPORT New public health bill • Developing new regulations and requirements • Measuring compliance with regulatory and legal requirements: • Allocating resources, both technical and financial- parliamentary cluster ASSESSING THE QUALITY OF HEALTH SERVICES • QUALITY ASSURANCE UNIT – MOH/COHSASA • SECTOR WIDE APPROACH- Partners, suppliers, CHAL, NGO’s • SLMTA run by ACILT
  17. 17. COHSASA - Improving health care through standards & accreditation The Council for Health Service Accreditation of Southern Africa (COHSASA)
  18. 18. Facilities and Safety - Module 2 19 Organization Personnel Licensed/certified Equipment Purchasing & Inventory Process Control Information Management Documents & Records Occurrence Management Assessment Process Improvement Customer Service Facilities & Safety The Quality Management System
  19. 19. Personnel Performing specific Medical Laboratory tasks Qualified Professional Education CBE Training Professional Experience + Demonstrated Skills + Passed Board Exam MLS Regulatory Board License
  20. 20. Measurement of Quality health care • Measurement Compliance with the above expectations has been assessed by: • questionnaires and medical examinations before and during employment; • staff satisfaction surveys; • exit interviews when staff resign; • routine indicators of sickness, absence and turnover; • safety audits, such as handling of glutaraldehyde and cytotoxic chemicals; • quality circles; • statutory inspectorates; • external certification of personnel management function.
  21. 21. Legislation within the workplace LAW RIGHT Employment Equity Act (EEA) a) Right not to be unfairly discriminated against on the basis of your HIV status b) Right not to be tested for HIV unless your employer ahs applied to the Labour Court for authorisation c) Do not have to disclose HIV status Occupational Health and Safety Act Right to a safe working environment
  22. 22. Accreditation of Southern Africa (COHSASA) The Council for Health Service is the only internationally accredited quality improvement and accreditation body for healthcare facilities based in Africa. In the past 20 years over 600 facilities throughout the continent have entered the COHSASA programme to improve the quality and safety of the healthcare services they provide to patients.
  23. 23. COHSASA • Think Tank Trainings and motivation- proposalscohsasa_hospital_standards_- _certificate.pdf
  24. 24. LFL • To encourage one-to-one interaction of all testing, calibration and inspection laboratories in order to guide in workplace Laboratory capability, development of skills , infrastructure and assessment necessary for accreditation • To represent the experience, knowledge and formulated opinions of all Lesotho laboratories on a technical, ethical and commercial level . • To assist in the interpretation of accreditation requirements, to identify generic national accreditation needs and to resolve issues on such matters for all Laboratories in Lesotho • To establish a singular interface of representation of its members with SADCAS and ILAC. • To establish effective communication channels for technology transfer with organizations that have similar objectives to the NLA-L • To provide and encourage International professional recognition for scientific work and provide appropriate training in Quality management systems and all issues of accreditation. • Liaise with SADCAS and other International Organizations, for all government Laboratories and private laboratory facilities in matters related to accreditation, capacity building and on going personnel certification.
  25. 25. accreditation services for SADC Member States aimed at: • Supporting regional and international trade; • Enhance the protection of consumers and the environment; and Improve the competitiveness of SADC products and services in both the voluntary and regulatory areas. • SADCAS offers programmes for the accreditation of testing/calibration laboratories, certification bodies (management systems/product/personnel) and inspection bodies
  26. 26. Structures of support• ISO • International Accreditation Forum (IAF) and International Laboratory Accreditation Cooperation (ILAC) • AMCOA- , ASLM, AMLSA, AMLSCSA • SADCAS is recognized by the SADC Council of Ministers as a subsidiarity organization of SADC. • to raise awareness of the importance of accreditation‐related activities IN Lesotho • make sure structures will be in place for Lesotho and other SADC COUNTRIES to establish its own capacity state of art conformity assessment body like Mauritas and SANAS • ..ISO 15189 STANDART.doc- SADCAS ASSESSORS TRAININGS • Review of new public health bill • MLS -Regulatory board • Lab policy , quality manual initiation and biosafety manaul • ACILT • SLMTA • Readiness of laboratories to apply for SADCAS certificate= - • Advocacy, awareness, Assessments and mentorship activities
  27. 27. REGIONAL SUPPORT • SADC Member States aimed at: • Supporting regional and international trade; • Enhance the protection of consumers and the environment; and • Improve the competitiveness of SADC products and services in both the voluntary and regulatory areas.
  28. 28. The SADCAS MLAP The SADCAS Medical Laboratories Accreditation Programme (MLAP) – Established in June 2010 – A multi-disciplinary accreditation program operated in accordance with ISO/IEC 17011 – The fields of accreditation under the SADCAS MLAP include: Biochemistry; Cytology; Hematology; Histopathology; Immunology; Microbiology; Pathology; Virology; Serology; Andrology 29
  29. 29. ISO 15189 Technical Assessors- SADC-EU. Botswana ; LESOTHO CANDIDATES 2010- 12
  30. 30. Technical systems, and process control
  31. 31. The SADCAS MLAP – Accreditations by Country 32
  32. 32. Levels of care needing quality View larger version: Figure 3
  33. 33. The SADCAS MLAP - Applications by Scope 34
  34. 34. Improve Systems and programs – to address MDG’s , PRD’s, • International health Regulation , regulators, policies, laws, Biosafety and biosecurity • political science . • Economics, Acriculture • trade stds, accreditation, basic living, income diversification, lifestyles, • Environment • Biodiversity , Biotechnology, • Industry , hydrogeology, town planning • Community • Culture , education, sociology Medical and nursing Laboratory medicine Health planning, HR, Administration Pharmacy, physiotherapy Information mgt ( I C T)
  35. 35. YES WE CAN!!!!!
  36. 36. Our voices should be heard !!!!!!!! after this Gap analysis
  37. 37. International Networking events and Collaborations- BENCHMARKING
  38. 38. Needs for applications • Application for Good Clinical Practice (GCP) Compliance Status • Application for Good Laboratory Practice (GLP) Compliance Status • Application for Inspection Body Accreditation to ISO/IEC • Application for Medical Laboratory Accreditation to ISO 15189:2012 • Application for Proficiency Scheme Provider Accreditation to ISO/IEC 17043F • Application for Reference Material Producer Accreditation to ISO Guide 34F • Application for Testing and Calibration Laboratory Accreditation to ISO/IEC 17025
  39. 39. Way Forward and Call to Action • Excellent medical laboratories AND OTHER CLINICAL SERVICES are vital to ensure accurate diagnoses and to identify pathology at early disease stages. • It is essential to embark on solid operational research to identify the root causes of poor laboratory service AND OTHER CLINICAL SERVICES to develop practical models for not only building, but also maintaining medical laboratory capacity and services in developing countries.
  40. 40. Recom • Government officials and health care professionals in these countries should agree on the importance of creating strong medical diagnostic capabilities. • The need for quality laboratories is often not considered a priority in improving a struggling health care system. • A significant investment should be made in laboratory systems and financial accountability to ensure universal access to efficient, accurate laboratory testing.
  41. 41. Laboratories Quality Systems Laboratory quality systems are critical to the success of any laboratory service. The most important prerequisite for the establishment of an effective laboratory quality system is to create and/or adopt medical laboratory standards and regulations specific for each country’s unique setting. Currently, some, follow international laboratory standards such as the International Organization for Standardization (ISO 15189), Good Clinical Laboratory Practices (GCLP),
  42. 42. • A focus on strengthening laboratories could change largely empiric algorithm-based clinical care to rapidly confirmed diagnoses with targeted curative treatment and cost savings. • . Building and maintaining a strong, sustainable medical laboratory infrastructure in RLS will help build and strengthen the whole medical system by ensuring sufficient diagnostic capacity to produce accurate and reliable laboratory results that improve patient outcomes
  43. 43. • “The Medical Laboratory is a place where , under rather difficult conditions , we create a protected island where together with our younger collaborators , we use all our mental power and energy , to be an active part of medical development and to enjoy the thrill of new discoveries in modern science to benefit mankind”. Sejojo Phaaroe 1997
  44. 44. Case 2 • It is Early January, Food handlers attend the Public Health screening clinic before they could receive the School feeding and Catering contract and are sent to the Laboratory for Widal test, VDRL and Stool culture . The Widal test of One of the handler test Positive , so she bribes the Laboratory Technologist to report it falsely as Negative as she desperately needs to win a school feeding tender. • An out break of Typhoid erupts in one of the schools when the school open late January and vertical investigations continue. • What would be the ethical case scenario and consequences of the case. ?
  45. 45. • Thank you

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