Maximising mentorship: Variations in laboratory mentorship models implemented in Zimbabwe

Nzombe, Phoebe; Luman, Elizabeth T.; Shumba, Edwin; Mangwanya, Douglas; Simbi, Raiva; Kilmarx, Peter H.; Zimuto, Sibongile

doi:10.4102/ajlm.v3i2.241

Cited by 13 publications

(27 citation statements)

References 14 publications

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“…Authors noted that also during this timeframe, countries began to develop five-year laboratory strategic plans – Kenya 14,15 and Ethiopia 12,13 in 2005; Botswana 20,28 and Lesotho 21 in 2008; Zimbabwe 30 in 2010; and Ghana 25 and Namibia 19 in 2012. These plans called for laboratory strengthening and development of QMS, some specifying accreditation goals.…”

Section: Resultsmentioning

confidence: 99%

“…13,22,29 Several countries have established departments or workgroups dedicated to the implementation of quality management. For example, Zimbabwe’s National Quality Assurance Program established a Training and Mentorship Department; 30 Kenya’s Ministry of Health created a National Accreditation Steering Committee to coordinate laboratory accreditation activities; 14 and Mozambique established a National Laboratory Technical Working Group to build a framework for a national laboratory quality improvement programme, to lead and coordinate its implementation and to monitor and maintain results. 18 …”

Section: Resultsmentioning

confidence: 99%

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A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities

2014

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BackgroundSince its introduction in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has been implemented widely throughout Africa, as well as in the Caribbean, Central and South America, and Southeast Asia.ObjectiveWe compiled results from local, national and global studies to provide a broad view of the programme and identify directions for the future. The review consists of two companion papers; this paper focuses on content analysis, examining various thematic components of the SLMTA programme and future priorities.MethodsA systematic literature search identified 28 published articles about implementing the SLMTA programme. Results for various components of the SLMTA programme were reviewed and summarised.ResultsLocal and national studies provide substantial information on previous experiences with quality management systems; variations on SLMTA implementation; building human resource capacity for trainers, mentors and auditors; the benefits and effectiveness of various types of mentorship; the importance of management buy-in to ensure country ownership; the need to instill a culture of quality in the laboratory; success factors and challenges; and future directions for the programme.ConclusionsLocal, national and global results suggest that the SLMTA programme has been overwhelmingly successful in transforming laboratory quality management. There is an urgent need to move forward in four strategic directions: progression (continued improvement in SLMTA laboratories), saturation (additional laboratories within countries that have implemented SLMTA), expansion (implementation in additional countries), and extension (adapting SLMTA for implementation beyond the laboratory), to lead to transformation of overall health systems and patient care.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities

2014

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“…9 SLMTA mentorship approaches have ranged from standard short-term visits 10,11 to newer models of peer or embedded mentoring. 11,12 In the standard short-term model, a mentor visits the mentee laboratory and stays in the laboratory for a short stint, often a week or less. During this period, the laboratory quality officer works under the guidance of the mentor to address laboratory quality gaps identified during prior assessment.…”

Section: Introductionmentioning

confidence: 99%

Using standard and institutional mentorship models to implement SLMTA in Kenya

et al. 2014

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BackgroundKenya is home to several high-performing internationally-accredited research laboratories, whilst most public sector laboratories have historically lacked functioning quality management systems. In 2010, Kenya enrolled an initial eight regional and four national laboratories into the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. To address the challenge of a lack of mentors for the regional laboratories, three were paired, or ‘twinned’, with nearby accredited research laboratories to provide institutional mentorship, whilst the other five received standard mentorship.ObjectivesThis study examines results from the eight regional laboratories in the initial SLMTA group, with a focus on mentorship models.MethodsThree SLMTA workshops were interspersed with three-month periods of improvement project implementation and mentorship. Progress was evaluated at baseline, mid-term, and exit using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) audit checklist and scores were converted into a zero- to five-star scale.ResultsAt baseline, the mean score for the eight laboratories was 32%; all laboratories were below the one-star level. At mid-term, all laboratories had measured improvements. However, the three twinned laboratories had increased an average of 32 percentage points and reached one to three stars; whilst the five non-twinned laboratories increased an average of 10 percentage points and remained at zero stars. At exit, twinned laboratories had increased an average 12 additional percentage points (44 total), reaching two to four stars; non-twinned laboratories increased an average of 28 additional percentage points (38 total), reaching one to three stars.ConclusionThe partnership used by the twinning model holds promise for future collaborations between ministries of health and state-of-the-art research laboratories in their regions for laboratory quality improvement. Where they exist, such laboratories may be valuable resources to be used judiciously so as to accelerate sustainable quality improvement initiated through SLMTA.

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“…12 Our analysis did not include mentorship costs, because mentorship was not incorporated in the SLMTA programme for these two cohorts. Bringing in external mentors would increase the cost of the programme substantially; however, given that internal facilitators can receive mentorship training, they could also be used in this capacity to reduce costs and have a positive impact on programme implementation.…”

Section: Discussionmentioning

confidence: 99%

Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators

et al. 2014

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BackgroundIn 2010, the Zimbabwe Ministry of Health and Child Welfare (MoHCW) adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme as a tool for laboratory quality systems strengthening.ObjectivesTo evaluate the financial costs of SLMTA implementation using two models (external facilitators; and internal local or MoHCW facilitators) from the perspective of the implementing partner and to estimate resources needed to scale up the programme nationally in all 10 provinces.MethodsThe average expenditure per laboratory was calculated based on accounting records; calculations included implementing partner expenses but excluded in-kind contributions and salaries of local facilitators and trainees. We also estimated theoretical financial costs, keeping all contextual variables constant across the two models. Resource needs for future national expansion were estimated based on a two-phase implementation plan, in which 12 laboratories in each of five provinces would implement SLMTA per phase; for the internal facilitator model, 20 facilitators would be trained at the beginning of each phase.ResultsThe average expenditure to implement SLMTA in 11 laboratories using external facilitators was approximately US$5800 per laboratory; expenditure in 19 laboratories using internal facilitators was approximately $6000 per laboratory. The theoretical financial cost of implementing a 12-laboratory SLMTA cohort keeping all contextual variables constant would be approximately $58 000 using external facilitators; or $15 000 using internal facilitators, plus $86 000 to train 20 facilitators. The financial cost for subsequent SLMTA cohorts using the previously-trained internal facilitators would be approximately $15 000, yielding a break-even point of 2 cohorts, at $116 000 for either model. Estimated resources required for national implementation in 120 laboratories would therefore be $580 000 using external facilitators ($58 000 per province) and $322 000 using internal facilitators ($86 000 for facilitator training in each of two phases plus $15 000 for SLMTA implementation in each province).ConclusionInvesting in training of internal facilitators will result in substantial savings over the scale-up of the programme. Our study provides information to assist policy makers to develop strategic plans for investing in laboratory strengthening.

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Maximising mentorship: Variations in laboratory mentorship models implemented in Zimbabwe

Cited by 13 publications

References 14 publications

A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities

A comprehensive review of the SLMTA literature part 1: Content analysis and future priorities

Using standard and institutional mentorship models to implement SLMTA in Kenya

Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators

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