Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa
Background: Laboratory services are essential at all stages of the tuberculosis care cascade, from diagnosis and drug resistance testing to monitoring response to treatment. Enabling access to quality services is a challenge in low-resource settings. Implementation of a strong quality management sys...
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| Format: | Article |
| Language: | English |
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AOSIS
2017-03-01
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| Series: | African Journal of Laboratory Medicine |
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| Online Access: | https://ajlmonline.org/index.php/ajlm/article/view/490 |
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| author | Heidi Albert Jean de Dieu Iragena Kekeletso Kao Donatelle Erni Teferi Mekonen Philip C. Onyebujoh |
| author_facet | Heidi Albert Jean de Dieu Iragena Kekeletso Kao Donatelle Erni Teferi Mekonen Philip C. Onyebujoh |
| author_sort | Heidi Albert |
| collection | DOAJ |
| description | Background: Laboratory services are essential at all stages of the tuberculosis care cascade, from diagnosis and drug resistance testing to monitoring response to treatment. Enabling access to quality services is a challenge in low-resource settings. Implementation of a strong quality management system (QMS) and laboratory accreditation are key to improving patient care.
Objectives: The study objective was to determine the status of QMS implementation and progress towards accreditation of National Tuberculosis Reference Laboratories (NTRLs) in the African Region.
Method: An online questionnaire was administered to NTRL managers in 47 World Health Organization Regional Office for Africa member states in the region, between February and April 2015, regarding the knowledge of QMS tools and progress toward implementation to inform strategies for tuberculosis diagnostic services strengthening in the region.
Results: A total of 21 laboratories (43.0%) had received SLMTA/TB-SLMTA training, of which 10 had also used the Global Laboratory Initiative accreditation tool. However, only 36.7% of NTRLs had received a laboratory audit, a first step in quality improvement. Most NTRLs participated in acid-fast bacilli microscopy external quality assurance (95.8%), although external quality assurance for other techniques was lower (60.4% for first-line drug susceptibility testing, 25.0% for second-line drug susceptibility testing, and 22.9% for molecular testing). Barriers to accreditation included lack of training and accreditation programmes. Only 28.6%of NTRLs had developed strategic plans and budgets which included accreditation.
Conclusion: Good foundations are in place on the continent from which to scale up accreditation efforts. Laboratory audits should be conducted as a first step in developing quality improvement action plans. Political commitment and strong leadership are needed to drive accreditation efforts; advocacy will require clear evidence of patient impact and cost-benefit. |
| first_indexed | 2024-04-14T06:31:15Z |
| format | Article |
| id | doaj.art-f54fb9d17dd5489c913f6cfd01621426 |
| institution | Directory Open Access Journal |
| issn | 2225-2002 2225-2010 |
| language | English |
| last_indexed | 2024-04-14T06:31:15Z |
| publishDate | 2017-03-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Laboratory Medicine |
| spelling | doaj.art-f54fb9d17dd5489c913f6cfd016214262022-12-22T02:07:37ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102017-03-0162e1e810.4102/ajlm.v6i2.490158Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in AfricaHeidi Albert0Jean de Dieu Iragena1Kekeletso Kao2Donatelle Erni3Teferi Mekonen4Philip C. Onyebujoh5FIND, Cape Town, Western CapeWorld Health Organisation, African Region Country Office, BrazzavilleFIND, Campus Biotech, GenevaFIND, Campus Biotech, GenevaAfrican Society for Laboratory Medicine, Addis AbabaWorld Health Organisation, African Region Country Office, HarareBackground: Laboratory services are essential at all stages of the tuberculosis care cascade, from diagnosis and drug resistance testing to monitoring response to treatment. Enabling access to quality services is a challenge in low-resource settings. Implementation of a strong quality management system (QMS) and laboratory accreditation are key to improving patient care. Objectives: The study objective was to determine the status of QMS implementation and progress towards accreditation of National Tuberculosis Reference Laboratories (NTRLs) in the African Region. Method: An online questionnaire was administered to NTRL managers in 47 World Health Organization Regional Office for Africa member states in the region, between February and April 2015, regarding the knowledge of QMS tools and progress toward implementation to inform strategies for tuberculosis diagnostic services strengthening in the region. Results: A total of 21 laboratories (43.0%) had received SLMTA/TB-SLMTA training, of which 10 had also used the Global Laboratory Initiative accreditation tool. However, only 36.7% of NTRLs had received a laboratory audit, a first step in quality improvement. Most NTRLs participated in acid-fast bacilli microscopy external quality assurance (95.8%), although external quality assurance for other techniques was lower (60.4% for first-line drug susceptibility testing, 25.0% for second-line drug susceptibility testing, and 22.9% for molecular testing). Barriers to accreditation included lack of training and accreditation programmes. Only 28.6%of NTRLs had developed strategic plans and budgets which included accreditation. Conclusion: Good foundations are in place on the continent from which to scale up accreditation efforts. Laboratory audits should be conducted as a first step in developing quality improvement action plans. Political commitment and strong leadership are needed to drive accreditation efforts; advocacy will require clear evidence of patient impact and cost-benefit.https://ajlmonline.org/index.php/ajlm/article/view/490Tuberculosislaboratoriesaccreditationquality management systemsAfrica |
| spellingShingle | Heidi Albert Jean de Dieu Iragena Kekeletso Kao Donatelle Erni Teferi Mekonen Philip C. Onyebujoh Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa African Journal of Laboratory Medicine Tuberculosis laboratories accreditation quality management systems Africa |
| title | Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa |
| title_full | Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa |
| title_fullStr | Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa |
| title_full_unstemmed | Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa |
| title_short | Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa |
| title_sort | implementation of quality management systems and progress towards accreditation of national tuberculosis reference laboratories in africa |
| topic | Tuberculosis laboratories accreditation quality management systems Africa |
| url | https://ajlmonline.org/index.php/ajlm/article/view/490 |
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