Assessment of quality assurance in HIV testing in health facilities in Lake Victoria zone, Tanzania

Abstract

Tanzania is currently implementing the antiretroviral treatment programme, and has a target of putting about 400,000 eligible HIV infected individuals on treatment by 2008. This will involve screening a large number of people, which will require non-laboratory personnel to be involved in doing HIV testing. In order to guarantee reliable and quality HIV test results, there is a need to ensure that quality assurance (QA) procedures are followed from specimen collection, testing and reporting of results. In light of the above a survey was conducted to assess QA in HIV testing in health facilities in Lake Victoria zone, Tanzania. A total of 89 health facilities (29 hospitals, 34 health centres, 9 dispensaries and 17 voluntary and counselling testing centres) were surveyed. Only three (10.3%) health facilities reported performing Uniform II ELISA for HIV diagnosis. All other health facilities reported to be using HIV rapid tests Capillus and Determine. Five (5.6%) of health facility laboratories performed CD4 counts. Internal quality control (IQC) were performed in 21 (63.6%) of the hospitals. Kits for HIV testing were reported to be readily available by 54 (60.7%) of the facilities. Only 16 (18%) of the health facilities had standard operating procedures in place. Systems of equipment calibration were reported by 13 (14.6%) of the health facilities. Counselling services were available in all health facilities and all counsellors had received the 6-week mandatory training course. These findings show that most of health facilities in the Lake Victoria zone do not adhere to QA procedures in HIV testing. There is therefore, a need to establish a monitoring system to laboratories performing HIV testing for the purpose of ensuring QA procedures are done. Personnel doing HIV testing should be re-trained at a regular basis to cope with new techniques and ensure QA procedures are followed. ___________________________________________________________________________________________________________

Health worker motivation in the context of HIV care and treatment challenges in Mbeya Region, Tanzania: A qualitative study

“…Yet despite donor support, HIV has put health care delivery under significant strain which has affected the relationship between client and health worker. Several studies have highlighted problems like lack of skills and shortage of drugs as obstacles in scaling up HIV treatment [30,31]. Building on similar findings, this study has shown how problems like the shortage of drugs, long waiting times, short consultation times and poor service affect the health worker-client relationship.…”

An Assessment of Quality Assurance in HIV and AIDS-Related Services in Chivuna Rural Health Facility of Southern Zambia

“…However, as observed before by other qualitative studies in the region [7] [8], the present study identified a number of gaps when compared with the WHO minimum standard guidelines in provision of VCT and ART services. The results from our study do confirm that these inadequacies affected the effective operations of the facility.…”

Performance of health laboratories in provision of HIV diagnostic and supportive services in selected districts of Tanzania

“…Studies conducted in different regions after the roll out of care and treatment plan for HIV/AIDS in Tanzania, showed that most of the laboratories were not properly adhering to good laboratory practice (GLP), with poor laboratory quality control for HIV testing reagents, and were not performing internal and external quality control [22, 23]. Other studies conducted in similar settings also showed that health personnel were dissatisfied with HIV diagnostic services provided by their laboratories with higher dissatisfaction rates in public health facilities than in the private sector [24].…”