Integrating Resources to Reinforce Overall Laboratory Diagnostic Capacity: The Experience of PEPFAR AIDS Relief Program in Ethiopia

Abstract

As part of the transition of PEPFAR Track 1.0 Programs to local ownership, AIDSRelief consortium provided system, infrastructure, material and human resource capacity support to one district Hospital and five health centre laboratories in Ethiopia's South-west Showa Zone to address service gaps and strengthen their overall capacity. AIDSRelief's proprietary laboratory assessment tool, Laboratory Quality Improvement Tools (LQITs) and on-site evaluation methods were used to identify service gaps and design targeted interventions. Baseline indicators were collected to determine whether the laboratories increased services delivery. Limited laboratory testing services, lack of automated equipments to monitor patient's antiretroviral therapy (ART), unknown accuracy of test results and potentially hazardous specimen and waste handling procedures were the major gaps. Laboratory tests that would be provided at each health center level increased from 45.8% to 90%. Access to automated equipment for ART monitoring testes increased from 0% to 80% by adopting sample referral system. Waste management system and incinerator coverage increased from 50% to 100%. HIV point of service testing organized with workspace, supplies and trained man power increased from 39% to 100%. At the time of the baseline assessment, the malaria diagnostic was unsatisfactory (below 65%) at all six laboratories, while the TB diagnostic score was unsatisfactory at five and good (between 75% and 84%) at one health center laboratory. By the 18th month of the project, all six laboratories scored above 85% for TB and malaria diagnostics, indicating an excellent performance in both areas. By providing systems, material and infrastructure, and human resources support to health facilities, AIDSRelief consortium followed an integrated approach to ensure quality of laboratory services and meet its goal of providing ideal care to individuals.