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.

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)

3. • Quality assurance crucial!
• Lab results usefulness
• Timely
• Reliable
• Reproducible

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

6. • LQIT: 100 close ended question, 12 Sections
 Staff
 Safety
 Equipment/Supplies
 Reagents
 Quality control
 Maintenance
 Inventory
 Sample collection
 Results reporting
 Sample transport
 SOP/Documentation
 Sample processing

7. 4/8/2013 Slide 7

8. 4/8/2013 Slide 8

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

13. (TANZANIA SITE 2011-2012)
100
Visit 1
Visit 2
50
Visit 3
Visit 4
0
Bunda Tarime Muheza SeKou Toure

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