Without quality laboratories, there cannot be accurate clinical testing or reliable results.
Without reliable results, correct diagnosis becomes a hit or miss scenario, wasting vast sums of money and putting millions of lives at stake. Identified as one of the pillars of the African Society for Laboratory Medicine (ASLM) and one of the organisation's four strategic goals in its 2020 vision, laboratory accreditation is crucial for achieving the standardisation of quality testing across the African continent.
The landmark ministerial call-to-action signed during the conference endorsed the promotion of laboratory accreditation in line with ISO15189 using the Stepwise Laboratory Quality Improvement Towards Accreditation (SLIPTA) process as a framework.
SLIPTA is an initiative driven by the World Health Organisation's African regional office, Centers for Disease Control and Prevention (CDC) and ASLM. It helps countries improve their medical laboratory services, build proficiency in the latest methods of disease prevention and control, and work towards achieving the ISO15189 accreditation standard.
Hand in hand with SLIPTA is the Strengthening Laboratory Management Towards Accreditation (SLMTA) programme, launched in 2009 to promote immediate, measurable improvement for laboratories in developing countries.
Developed by the CDC in partnership with the American Society for Clinical Pathology and the Clinton Health Access Initiative, this programme is a training tool that provides a framework for laboratory management that prescribes managerial job tasks and forms the basis of hands-on, activity-based curriculum.
Three years since inception, SLMTA is taking the laboratory world in developing countries by storm: the programme has been adopted in 36 countries (20 in Africa, 14 in Latin America and the Caribbean, and two in south-east Asia). Other countries that have expressed interest in adopting the programme include Mauritius, the Seychelles, Sudan, Egypt and Morocco. A brainchild of the CDC's Dr Katy Yao, SLMTA helps laboratory staff to improve their own laboratories by using existing resources, communicating more with clinicians and hospital administrators, and pushing for system strengthening.
"SLMTA training is activity-based, task-oriented and very prescriptive. Before SLMTA, laboratorians were trained on the theory of quality improvement, but had no guidance on the practical approach. SLMTA teaches exactly that. Using a very clear road map, the curriculum specifies 66 management tasks and offers 100-plus tools and job aids and teaches when and how to perform those tasks," said Yao.
Supplemented by a train-the-trainer approach and mentoring, the programme equips laboratory staff for accreditation. The laboratory programmes manager at Global Health Systems Solutions in Ghana, Beatrice van der Puije, said the process empowers laboratorians to improve their own work environment. "There's much to be said for what SLMTA does to improve quality assurance and bring labs up accreditation status. But far more than that has been the contribution it is making towards the recognition of labs as a primary role player in the healthcare system.
"In Ghana, for example, laboratories did not feature on hospital organograms. Laboratorians did not feel part of the system at all; they were invisible. But through SLMTA, labs have been brought to the forefront — people are realising that if they want to ensure good healthcare, they need effective laboratories," said Van der Puije.
Senior laboratory consultant with the Foundation for Innovative New Diagnostics Talkmore Maruta described the feedback he received during a recent visit to a laboratory in remote Bamenda, Cameroon: "The response from lab workers of all levels about how SLMTA has changed their work environment and perception was overwhelming. Comments like 'Quality never used to exist in our vocabulary' and 'Our patients have ceased to be patients, they're now our clients' gave a clear reflection of the positive impact the programme has enabled."