Inaccurate and unreliable test results in clinical laboratories have for many years adversely affected people’s health in Tanzania. Since quality health services depend on the accuracy and timeliness of tests, inaccuracy has led to incorrect diagnosis, incorrect treatment and treatment delays, causing tragic consequences such as preventable deaths.
In recognition of the importance of quality laboratory services to the health and welfare of Tanzanians, TUNAJALI decided to complement the government’s efforts in improving laboratory services through the Strengthening Laboratory Management Toward Accreditation (SLMTA) process.
The government launched SLMTA in 2010 with the aim of having laboratories that conform to standards set by the World Health Organization (WHO).
With the generous support of the United States Agency for International Development (USAID) through the U.S. President’s Emergency Fund for AIDS Relief (PEPFAR), the TUNAJALI HIV and AIDS Program is assisting eight hospital laboratories in its regions of operations to take part in the SLMTA process. They include the Morogoro, Iringa, Singida and Dodoma regional hospitals. Others are Turiani Designated District Hospital of Morogoro Region and Ikonda, Ludewa and Makambako in Njombe Region.
In ensuring that these labs achieve the highest levels of accuracy and reliability, thus reaching the 5-star status as required by WHO, TUNAJALI, in collaboration with the staff at the laboratories, set out to identify shortcomings that prevent the facilities from offering services that are of an international standard.
Shortcomings identified include laboratory buildings that did not enable the facilities to conduct tests that are in line with international standards, lack of preventive maintenance of equipment and most importantly workers not adhering to professional procedures and policies.
Since competent and motivated staff is the most important laboratory resource, PEPFAR through TUNAJALI invested in laboratory personnel. A mentorship program was introduced. Two TUNAJALI staff members initially coached two laboratory staff working in Iringa and Morogoro regional hospital laboratories and after on-site coaching the four started mentoring others to perform all processes and procedures in laboratories to the highest standards.
“We knew that with mentorship we’ll never go wrong since practical training is very important. We also wanted to make sure that the momentum in efforts to improve our laboratories is sustained. That is why we introduced mentorship using these resource persons,” says Mr Okumu Were, TUNAJALI Senior Technical Officer for Laboratory Services, who is one of the mentors.
He said the use of resource persons enables knowledge transfer to their peers making it very sustainable and cost effective. The cost of using four resource persons in a year is not more than USD 2000 per site while it costs about USD 34,180 per site per year if a foreign consultant is contracted.
The laboratory manager at Iringa Regional Hospital, Mr. Kimea Myefu, who is also a mentor, says they have been educating laboratory staff during mentoring sessions about SLMTA, the consequences of not being able to conduct accurate tests, benefits of being accredited and what has to be done for their laboratory to get accredited.
“We’re encouraging them to fully participate in efforts to improve laboratory services and appreciate their importance in this process,” he says.
Mr. Myefu adds that apart from increasing the number of workers who strictly adhere to rules governing quality laboratory services, the mentorship has made it possible to establish a pool of mentors who will sustain the transfer of knowledge and, by extension, improve the provision and sustainability of quality laboratory services in the country.
As we know, hard work bears fruit, and efforts to improve services at laboratories supported by TUNAJALI have attained tangible success.
WHO’s framework for improving the quality of public health laboratories in developing countries (WHO-AFRO SLIPTA) assessed 18 laboratories under the SLMTA program, and labs at Singida Regional Hospital and Turiani DDH attained three stars, a commendable feat.
“Thanks to the American people, it is with their support that we are here today. Imagine from zero to three stars in one year! Our laboratory now adheres to quality assurance. My clients are happier, and no more long queues. I’m proud to work here,” says the laboratory manager at Turiani DDH, Mr. Mrisho Javu.
Mr. Paul Laizer, who visited the Turiani laboratory suffering from malaria, said he was very pleased with services at the lab. “I have never seen anything like this. I live in Coast Region and I’m here to visit my mother. I’m very impressed. The staff here are very friendly and fast,” says Mr. Laizer, who wishes all labs were like the one at Turiani.
Commenting on her laboratory, the Singida Regional Hospital Laboratory Manager, Ms. Phoibe Sumari, says “We no longer have broken-down equipment as we have put in place a preventive maintenance system. Before engaging in SLMTA, we had some equipment that was not working and were thus unable to conduct some tests.”
Ms. Sumari adds, “I used to think that provision of quality clinical laboratory services was just a mere dream in a resource-poor country like Tanzania, but I have now changed my thinking. It can be done if all stakeholders play their part. If we’ll go on like these I’m certain that we’ll attain five stars.”