Abstract
BackgroundIn 2009, to improve the performance of laboratories and strengthen healthcare systems, the World Health Organization Regional Office for Africa (WHO AFRO) and partners launched two initiatives: a laboratory quality improvement programme called Strengthening Laboratory Management Toward Accreditation (SLMTA), and what is now called the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA).ObjectivesThis study describes the achievements of Rwandan laboratories four years after the introduction of SLMTA in the country, using the SLIPTA scoring system to measure laboratory progress.MethodsThree cohorts of five laboratories each were enrolled in the SLMTA programme in 2010, 2011 and 2013. The cohorts used SLMTA workshops, improvement projects, mentorship and quarterly performance-based financing incentives to accelerate laboratory quality improvement. Baseline, exit and follow-up audits were conducted over a two-year period from the time of enrolment. Audit scores were used to categorise laboratory quality on a scale of zero (< 55%) to five (95% – 100%) stars.ResultsAt baseline, 14 of the 15 laboratories received zero stars with the remaining laboratory receiving a two-star rating. At exit, five laboratories received one star, six received two stars and four received three stars. At the follow-up audit conducted in the first two cohorts approximately one year after exit, one laboratory scored two stars, five laboratories earned three stars and four laboratories, including the National Reference Laboratory, achieved four stars.ConclusionRwandan laboratories enrolled in SLMTA showed improvement in quality management systems. Sustaining the gains and further expansion of the SLMTA programme to meet country targets will require continued programme strengthening.
Highlights
Reliable laboratory services are vital to a high-quality healthcare system; investing in laboratory quality improvement is valuable, but essential.[1]
In order to help address deficiencies in the system, two initiatives were launched concurrently in Kigali, Rwanda in July 2009 by the World Health Organization’s Regional Office for Africa (WHO AFRO) and partners.[4]. These were: Strengthening Laboratory Management Toward Accreditation (SLMTA), an innovative training and mentoring programme designed to facilitate the implementation of laboratory quality management systems in resource-limited settings;[8] and an incremental laboratory accreditation preparation process, which later became known as the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA).[9]
The National Reference Laboratory (NRL) and five of the district hospital laboratories receive additional funding as part of the East African Public Health Laboratory Network (EAPHLN), a World Bank project aimed at controlling epidemics by strengthening laboratory capacity in five East African countries
Summary
Reliable laboratory services are vital to a high-quality healthcare system; investing in laboratory quality improvement is valuable, but essential.[1]. Accreditation is a critical measure of a laboratory’s quality level, as recognised by a series of international conventions, which called for accreditation to be part of laboratory-strengthening efforts in low-income countries.[4,5,6,7] In order to help address deficiencies in the system, two initiatives were launched concurrently in Kigali, Rwanda in July 2009 by the World Health Organization’s Regional Office for Africa (WHO AFRO) and partners.[4] These were: Strengthening Laboratory Management Toward Accreditation (SLMTA), an innovative training and mentoring programme designed to facilitate the implementation of laboratory quality management systems in resource-limited settings;[8] and an incremental laboratory accreditation preparation process, which later became known as the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA).[9]. In 2009, to improve the performance of laboratories and strengthen healthcare systems, the World Health Organization Regional Office for Africa (WHO AFRO) and partners launched two initiatives: a laboratory quality improvement programme called Strengthening Laboratory Management Toward Accreditation (SLMTA), and what is called the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA)
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