Strengthening national laboratory health systems in the Caribbean region

Abstract

The President's Emergency Plan for AIDS Relief (PEPFAR) programme for the Caribbean Region was established in 2008 to address health system challenges, including fragile laboratory services and systems. The laboratory component of this programme consisted of several phases: assessment of laboratory needs of all 12 countries engaged in the programme; addressing gaps identified during the assessment; and monitoring and evaluation of the progress achieved. After one year of PEPFAR collaboration with national governments and other partners, laboratory services and systems greatly improved. Some of the milestones include: (1) the accreditation of a public laboratory; (2) improved access to HIV diagnosis with faster turnaround time; (3) establishment of capacity for platforms for DNA PCR, viral load and HIV drug resistance; (4) development of the laboratory workforce; and (5) establishment of a framework for implementation of sustainable quality management systems for laboratory accreditation. The progress recorded in strengthening laboratory health systems after one year of initiating this collaboration shows that with a rigorous initial assessment, programme design and intervention and strategic partnership, national laboratory health systems can be greatly enhanced to support programme implementation. Continued collaboration and country leadership is critical to create an integrated and sustainable laboratory network in the Caribbean.

Strengthening national health laboratories in sub‐Saharan Africa: a decade of remarkable progress

“…There are indications that this disease-specific (vertical) approach to operating laboratories overwhelmed many public health laboratory services already burdened with human resource shortages, an ageing and inadequate infrastructure, and a lack of quality systems (Annex 2009;Nkengasong et al 2010). Implementing strategies where possible that ensure leveraging resources to strengthen the entire health system and not specific diseases is beneficial and cost effective (Alemnji et al 2012;Parsons et al 2012).…”

“…Implementing strategies where possible that ensure leveraging resources to strengthen the entire health system and not specific diseases is beneficial and cost effective (Alemnji et al . ; Parsons et al . ).…”

Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation

“…This includes the lack of advocacy, weak laboratory infrastructure and workforce, inadequate financial resources, and the complexity of the entire accreditation process. 8,9 However, there are indications that using the stepwise approach, together with other evidence-based laboratory improvement tools in implementing QMS, could lead to more realistic results with minimal resources. For example, in 1994 the Argentine Biochemical Foundation created an accreditation programme for clinical laboratories that used a stepwise approach, starting from minimum requirements up to higher standards, that allowed laboratories to slowly begin the process of quality improvement and eventually reach the desired result.…”

“…Six of these were medical laboratories. 9 All of the accredited laboratories were either private or faith-based health facility laboratories. Thus, although more than 90% of the population utilises public or government laboratory services, none of these services were accredited.…”

Strengthening laboratory capacity through the surveillance of rotavirus gastroenteritis in Central Africa: the Surveillance Épidémiologique en Afrique Centrale (SURVAC) Project

“…Reagents and supplies were not always available and this severely affected laboratory analyses. This situation is common in many developing countries and has been described in Africa [10,11] and the Caribbean [12].…”