BOX 9-6
PEPFAR’S Laboratory Systems
Strengthening Initiatives Over Time

In 2007, PEPFAR launched a laboratory systems strengthening initiative to be implemented by a public–private partnership with Becton, Dickinson and Company, the Centers for Disease Control and Prevention (CDC), national ministries of health, and national reference laboratories (OGAC, 2007a; Sturchio and Cohen, 2012). This approach to strengthening laboratories includes technical assistance (training and mentorship), process improvement related to quality management and specimen referrals, curriculum and leadership development, and strategic facilitation of planning meetings and project management (Thompson, 2011). As of July 2012, the initiative had been launched in Uganda, Ethiopia, Mozambique, and South Africa, with plans to expand to more countries (BD, 2012).

In 2009, the CDC launched the Strengthening Laboratory Management Towards Accreditation program, a series of workshops designed to improve laboratory management through a task-based framework and mentoring kit that provides information on the day-to-day tasks necessary for ensuring quality services and achieving accreditation (Yao et al.,2010).

In 2009, PEPFAR partnered with the World Health Organization Regional Office for Africa (WHO/AFRO) to launch a five-step framework to help African laboratories achieve accreditation through a star ranking system (Gershy-Damet et al., 2010; Wenner, 2009). The accreditation process involves assessing laboratories and verifying the implementation of laboratory standards to ensure that services are “accurate, traceable, and reproducible” (Gershy-Damet et al., 2010, p. 394; Palen et al., 2012; WHO, 2007a).

scribed how PEPFAR has supported the strengthening of human resources for laboratory systems, including support for pre-service training (116-7-USG; 116-19-PCACA; 166-6-USG; 166-11-USG; 272-13-USG; 461-18-USG) and in-service training (240-2-USG; 240-15-USG; 240-19-USACA; 331-15-USG; 331-16-USG; 331-28-PCGOV; 116-19-PCACA; 166-11-USG; 272-13-USG; 461-13-USACA; 396-18-USG; 934-28-PCNGO).

Although data were available for only some years of the program, PEPFAR indicators reported to OGAC clearly reflect an increased emphasis on laboratory strengthening. During PEPFAR I, the number of individuals trained in the provision of lab-related activities increased from 3,131 in FY 2004 to 60,037 in FY 2009. During the same time period, the number of testing facilities in partner countries with the capacity to perform clinical lab tests increased from 282 to 7,211 (see Figure 9-6).

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