Assessment of three medical and research laboratories using WHO AFRO_SLIPTA Quality Standards in Southwestern Uganda: long way to go

Abstract

IntroductionWhile the laboratory represents more than 70% of clinical diagnosis and patient management, access to reliable and quality laboratory diagnostics in sub-Saharan Africa remains a challenge. To gain knowledge and suggest evidence based interventions towards laboratory improvement in Southwestern Uganda, we assessed the baseline laboratory quality standards in three medical and research laboratories in Southwestern Uganda.MethodsWe conducted a cross sectional survey from October, 2013 to April, 2014. Selected laboratories, including one private research, one private for profit and one public laboratory, were assessed using the WHO AFRO_SLIPTA checklist and baseline scores were determined.ResultsThe three laboratories assessed met basic facility requirements, had trained personnel, and safety measures in place. Sample reception was properly designed and executed with a well designated chain of custody. All laboratories had sufficient equipment for the nature of work they were involved in. However, we found that standard operating procedures were incomplete in all three laboratories, lack of quality audit schemes by two laboratories and only one laboratory enrolled into external quality assurance schemes. The SLIPTA scores were one star for the research laboratory and no star for both the public and private-for-profit laboratories.ConclusionWhile most of the laboratory systems were in place, the low scores obtained by the assessed laboratories reflect the need for improvement to reach standards of quality assured diagnostics in the region. Therefore, routine mentorship and regional supportive supervision are necessary to increase the quality of laboratory services.

Review of the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) version 2:2015

“… 12 This finding is corroborated by other studies. 22 , 23 , 24 , 25 , 26 , 27 , 28 They further state that advocacy for laboratory strengthening is key to the SLIPTA process (as it is owned by the ministry of health) and that particularly Francophone and Lusophone countries are not well covered. An explanation for the latter finding might be that SLIPTA was initially implemented through the United States President’s Emergency Plan for AIDS Relief, which is oriented towards Anglophone countries.…”

“…11,12,20,24,25,27,29,30,31,32,33,34,35 Also, SLIPTA can be well combined with other guidance methods for laboratory accreditation as is evident from many studies on SLMTA implementation. 20 , 22 , 27 , 29 , 30 , 33 , 34 , 35 , 36 …”

“…12 This finding is corroborated by other studies. 22,23,24,25,26,27,28 They further state that advocacy for laboratory strengthening is key to the SLIPTA process (as it is owned by the ministry of health) and that particularly Francophone and Lusophone countries are not well covered. The main point for SLIPTA improvement remains the absence of prioritisation of QMS implementation activities.…”

“…11,12,20,24,25,27,29,30,31,32,33,34,35 Also, SLIPTA can be well combined with other guidance methods for laboratory accreditation as is evident from many studies on SLMTA implementation. 20,22,27,29,30,33,34,35,36 A major downside is the indirect accessibility of the SLIPTA programme: laboratories are selected by the ministry of health for participation. Only 27 of the 47 WHO-AFRO member states have established a SLIPTA focal point within their ministry of health.…”

Assessment of Clinical laboratory using WHO AFRO-SLIPTA Quality Standards in a Referral Hospital laboratory in Ghana

“…Although laboratory accreditation guarantees the ability to perform with high quality standards; accredited laboratories in Africa remain scarce [9]. World Health Organization Regional O ce for Africa (WHO AFRO) has established the SLIPTA to strengthen the laboratory systems of its member states [10].…”