Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators
Background: In 2010, the Zimbabwe Ministry of Health and Child Welfare (MoHCW) adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a tool for laboratory quality systems strengthening. Objectives: To evaluate the financial costs of SLMTA implementation using two...
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| Format: | Article |
| Language: | English |
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AOSIS
2014-11-01
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| Series: | African Journal of Laboratory Medicine |
| Online Access: | https://ajlmonline.org/index.php/ajlm/article/view/248 |
| _version_ | 1811302369609121792 |
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| author | Edwin Shumba Phoebe Nzombe Absolom Mbinda Raiva Simbi Douglas Mangwanya Peter H. Kilmarx Elizabeth T. Luman Sibongile N. Zimuto |
| author_facet | Edwin Shumba Phoebe Nzombe Absolom Mbinda Raiva Simbi Douglas Mangwanya Peter H. Kilmarx Elizabeth T. Luman Sibongile N. Zimuto |
| author_sort | Edwin Shumba |
| collection | DOAJ |
| description | Background: In 2010, the Zimbabwe Ministry of Health and Child Welfare (MoHCW) adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a tool for laboratory quality systems strengthening.
Objectives: To evaluate the financial costs of SLMTA implementation using two models (external facilitators; and internal local or MoHCW facilitators) from the perspective of the implementing partner and to estimate resources needed to scale up the programme nationally in all 10 provinces.
Methods: The average expenditure per laboratory was calculated based on accounting records; calculations included implementing partner expenses but excluded in-kind contributions and salaries of local facilitators and trainees. We also estimated theoretical financial costs, keeping all contextual variables constant across the two models. Resource needs for future national expansion were estimated based on a two-phase implementation plan, in which 12 laboratories in each of five provinces would implement SLMTA per phase; for the internal facilitator model, 20 facilitators would be trained at the beginning of each phase.
Results: The average expenditure to implement SLMTA in 11 laboratories using external facilitators was approximately US$5800 per laboratory; expenditure in 19 laboratories using internal facilitators was approximately $6000 per laboratory. The theoretical financial cost of implementing a 12-laboratory SLMTA cohort keeping all contextual variables constant would be approximately $58 000 using external facilitators; or $15 000 using internal facilitators, plus $86 000 to train 20 facilitators. The financial cost for subsequent SLMTA cohorts using the previously-trained internal facilitators would be approximately $15 000, yielding a break-even point of 2 cohorts, at $116 000 for either model. Estimated resources required for national implementation in 120 laboratories would therefore be $580 000 using external facilitators ($58 000 per province) and $322 000 using internal facilitators ($86 000 for facilitator training in each of two phases plus $15 000 for SLMTA implementation in each province).
Conclusion: Investing in training of internal facilitators will result in substantial savings over the scale-up of the programme. Our study provides information to assist policy makers to develop strategic plans for investing in laboratory strengthening. |
| first_indexed | 2024-04-13T07:26:54Z |
| format | Article |
| id | doaj.art-599304b414584c71a254ca072a1a3ee0 |
| institution | Directory Open Access Journal |
| issn | 2225-2002 2225-2010 |
| language | English |
| last_indexed | 2024-04-13T07:26:54Z |
| publishDate | 2014-11-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Laboratory Medicine |
| spelling | doaj.art-599304b414584c71a254ca072a1a3ee02022-12-22T02:56:27ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102014-11-0132e1e610.4102/ajlm.v3i2.24873Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitatorsEdwin Shumba0Phoebe Nzombe1Absolom Mbinda2Raiva Simbi3Douglas Mangwanya4Peter H. Kilmarx5Elizabeth T. Luman6Sibongile N. Zimuto7Zimbabwe National Quality Assurance Programme (ZINQAP) TrustZimbabwe National Quality Assurance Programme (ZINQAP) TrustZimbabwe National Quality Assurance Programme (ZINQAP) TrustMinistry of Health and Child Welfare (MoHCW)Ministry of Health and Child Welfare (MoHCW)US Centers for Disease Control and Prevention (CDC)U.S. Centres for Disease Control and Prevention (CDC)Zimbabwe National Quality Assurance Programme (ZINQAP) TrustBackground: In 2010, the Zimbabwe Ministry of Health and Child Welfare (MoHCW) adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a tool for laboratory quality systems strengthening. Objectives: To evaluate the financial costs of SLMTA implementation using two models (external facilitators; and internal local or MoHCW facilitators) from the perspective of the implementing partner and to estimate resources needed to scale up the programme nationally in all 10 provinces. Methods: The average expenditure per laboratory was calculated based on accounting records; calculations included implementing partner expenses but excluded in-kind contributions and salaries of local facilitators and trainees. We also estimated theoretical financial costs, keeping all contextual variables constant across the two models. Resource needs for future national expansion were estimated based on a two-phase implementation plan, in which 12 laboratories in each of five provinces would implement SLMTA per phase; for the internal facilitator model, 20 facilitators would be trained at the beginning of each phase. Results: The average expenditure to implement SLMTA in 11 laboratories using external facilitators was approximately US$5800 per laboratory; expenditure in 19 laboratories using internal facilitators was approximately $6000 per laboratory. The theoretical financial cost of implementing a 12-laboratory SLMTA cohort keeping all contextual variables constant would be approximately $58 000 using external facilitators; or $15 000 using internal facilitators, plus $86 000 to train 20 facilitators. The financial cost for subsequent SLMTA cohorts using the previously-trained internal facilitators would be approximately $15 000, yielding a break-even point of 2 cohorts, at $116 000 for either model. Estimated resources required for national implementation in 120 laboratories would therefore be $580 000 using external facilitators ($58 000 per province) and $322 000 using internal facilitators ($86 000 for facilitator training in each of two phases plus $15 000 for SLMTA implementation in each province). Conclusion: Investing in training of internal facilitators will result in substantial savings over the scale-up of the programme. Our study provides information to assist policy makers to develop strategic plans for investing in laboratory strengthening.https://ajlmonline.org/index.php/ajlm/article/view/248 |
| spellingShingle | Edwin Shumba Phoebe Nzombe Absolom Mbinda Raiva Simbi Douglas Mangwanya Peter H. Kilmarx Elizabeth T. Luman Sibongile N. Zimuto Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators African Journal of Laboratory Medicine |
| title | Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators |
| title_full | Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators |
| title_fullStr | Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators |
| title_full_unstemmed | Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators |
| title_short | Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators |
| title_sort | weighing the costs implementing the slmta programme in zimbabwe using internal versus external facilitators |
| url | https://ajlmonline.org/index.php/ajlm/article/view/248 |
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