A Systematic Approach to Capacity Strengthening of Laboratory Systems for Control of Neglected Tropical Diseases in Ghana, Kenya, Malawi and Sri Lanka

Abstract

BackgroundThe lack of capacity in laboratory systems is a major barrier to achieving the aims of the London Declaration (2012) on neglected tropical diseases (NTDs). To counter this, capacity strengthening initiatives have been carried out in NTD laboratories worldwide. Many of these initiatives focus on individuals' skills or institutional processes and structures ignoring the crucial interactions between the laboratory and the wider national and international context. Furthermore, rigorous methods to assess these initiatives once they have been implemented are scarce. To address these gaps we developed a set of assessment and monitoring tools that can be used to determine the capacities required and achieved by laboratory systems at the individual, organizational, and national/international levels to support the control of NTDs.Methodology and principal findingsWe developed a set of qualitative and quantitative assessment and monitoring tools based on published evidence on optimal laboratory capacity. We implemented the tools with laboratory managers in Ghana, Malawi, Kenya, and Sri Lanka. Using the tools enabled us to identify strengths and gaps in the laboratory systems from the following perspectives: laboratory quality benchmarked against ISO 15189 standards, the potential for the laboratories to provide support to national and regional NTD control programmes, and the laboratory's position within relevant national and international networks and collaborations.ConclusionWe have developed a set of mixed methods assessment and monitoring tools based on evidence derived from the components needed to strengthen the capacity of laboratory systems to control NTDs. Our tools help to systematically assess and monitor individual, organizational, and wider system level capacity of laboratory systems for NTD control and can be applied in different country contexts.

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

“…This includes the development of a tool to streamline supply chain management, the creation of a dedicated DHL control tower to facilitate clearance through customs and statistical tools to forecast demand [125]. NTD programmes and initiatives have also enhanced the capacity of laboratories to diagnose diseases [126], conduct independent clinical research [127] and has led to the construction of roads, markets, schools and clinics [128]. …”

Developing laboratory capacity for Good Laboratory Practice certification: lessons from a Tanzanian insecticide testing facility

“…These individuals included multiple representatives from each level of the organisation to triangulate different data sources and, hence, determine the reliability of findings. The interview topic guide was based on previous studies of laboratory capacity strengthening 17 , with additional questions derived from the findings of the document review. Questions from the topic guide were selected to match the roles and responsibilities of the interviewee.…”

Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

“…Recent research undertaken by the CNTD suggests a way forward[ 10 ]. Njelesani et al (2014) developed a set of monitoring and evaluation tools to determine the capacity of laboratory systems by analysing, institutions, national governments and international agencies[ 10 ] (see CAHRD paper HS Capacity). This approach highlights the strengths and limitations of not only a particular laboratory system but how its function is influenced by the wider enabling environment.…”