HEALTH SYSTEMS STRENGTHENING IN THE LOCATE PROJECT
———-a quick view at our laboratories
The term Systems Strengthening is synonymous with quality results. Especially important in the health system is the laboratory where diagnosis are carried out. Wrong diagnosis results in wrong treatment and that could be fatal to human life. Our Laboratory Systems Strengthening Advisor, Mr. Olumide Okunoye explains what his team has accomplished in the LOCATE project as a result of strengthening the laboratory system.
Mr. Okunoye explains systems strengthening thus;
“Laboratory System Strengthening entails about 6 building blocks of health. One of it is the infrastructure itself, leadership and governance in the laboratory, financial management in the lab, workforce in the lab, laboratory supplies, information and operational research going on in the lab. All these make up the systems that are working in the laboratory that must be optimal for use. And as systems strengthening implies, we are meant to strengthen all of those systems.”
He goes further to elucidate on what lab systems strengthening involves;
“Talking about the infrastructure, we make sure that the lab is not clustered where people are prone to accidents, equipment are well placed for optimal activity and safety is not compromised. We check the Airconditioner to make sure it is functioning and that it is reducing the ambient temperature to the optimal temperature that is needed for the machines to work effectively. The lab equipment are periodically maintained such that it can produce the right results.
The workforce within the laboratory are trained and are competent to render the services they are meant to. We don’t want a situation where someone who is competent in hematology but not competent in chemistry finds himself running chemistry
We also look at the supplies that go into the laboratory to support the services because without the constant supply of reagents and consumables, the services may run to a halt. The reagents are available in a way that they don’t overstock or understock. We try to have a balance by having an effective and efficient inventory management system
We make sure that the data gathered from clients are kept as confidential as possible, information about clients don’t get into wrong hands. We check the quality of service the client gets at the service point whether it is up to standard or not.”
Mr. Okunoye has this to say on the necessity of Lab systems strengthening;
“The main essence of Laboratory System Strengthening is quality results. Getting quality results entails a lot of things. The result must be accurate in that it must reflect what the actual situation is. The sample must be collected rightly; it must be collected on time; it must be collected with all the necessary precautions. The client and the service provider must be safe in the sense that the environment they operate must be safe. The sample they collect must be safe, the procedure they are using to analyze the sample must be a safe one. The ultimate aim is customer satisfaction. We want the client to go home with the right results at the right time. Systems strengthening controls the lab kits, environment and the competence of the tester such that if all these conditions are okay, whatsoever you do on the samples are valid. In a nutshell laboratory systems strengthening is necessary because it ensures that quality results are released in all the laboratories that we support.”
Finally he outlines the achievements of the LOCATE laboratory system strengthening team as follows;
“So far the Laboratory System Strengthening of ECEWS has been able to achieve several success. We have been able to;
- Secure the buy-in of all stakeholders on implementation of Quality Management System (QMS) in all the supported laboratories, sensitize hospital management and facility staff on the inherent advantages of achieving national and international accreditation.
- Reorganize the laboratories to grant greater access to high quality laboratory service for people with HIV/AIDS/TB infection across all supported sites and support the increase utilization of laboratory services occasioned by PMTCT and ART service scale-up.
- Overhaul the laboratory infrastructure and system by supporting minor structural upgrade, stable power and water supply to the ART sites.
- Reactivate all faulty or moribund equipment, implement an effective and efficient equipment maintenance program for the different equipment in the sites, install new equipment at sites lacking such platform and reactivate a backup for one high volume site.
- Spearhead the production of DTS, preparation of IQA samples and its deployment to HIV POSTs, while also building the capacity of subordinate officers on the process.
- Institutionalize the use of locally prepared known zero-status DTS as IQC samples across ECEWS supported HTC units, which has helped to standardize HIV testing and validate the test outcome.
- Establish internal quality assessment program for all HIV POSTs to improve the quality of HIV results and its reliability for taking clinical/therapeutic decision.
- Institutionalize an effective and efficient CD4 sample referral system to support PMTCT services at the PHCs.
- Reactivate EID services, build capacity of site on DBS collection and overhaul the DBS transportation logistics using the hub and spoke model, which improved the sample referral system from PHCs to ART sites and the PCR laboratory.
- Collaborate with NBTS, Safe blood for Africa on blood safety and link 5 comprehensive sites to the NBTS hospital linkage program for easy access to safe blood for transfusion. This also led to reactivation of some faulty blood banks, improvement in power and water supply, and capacity building for the personnel manning the sites.
- Introduce and distribute color coded biohazard bin liners for waste segregation and mentor site staff on the proper use according to national guideline which has made waste management easy and safe for waste handlers.
- Reinforce proper waste disposal through burn and bury approach using a dug pit in line with national guideline, which has protected the environment, community and prevented recycling of contaminated materials by scavengers.
- Institute viral load as a monitoring test for all ART Clients enrolled into treatment program across all LOCATE supported comprehensive sites via effective and efficient sample referral system to NAUTH PCR Laboratory at Nnewi.”