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Original Research
Building local human resources to implement SLMTA with limited donor funding: The Ghana experience
Submitted: 15 July 2014 | Published: 03 November 2014
About the author(s)
Bernard Nkrumah, US Centers for Disease Control and Prevention, US Embassy, GhanaBeatrice van der Puije, Global Health Systems Solutions, C75/20 Amanfro Street, Abelenkpe, Ghana
Veronica Bekoe, National AIDS Control Program, Ghana Health Service, Ghana
Rowland Adukpo, National Public Health Reference Laboratory, Ghana Health Service, Ghana
Nii A. Kotey, Global Health Systems Solutions, C75/20 Amanfro Street, Abelenkpe, Ghana
Katy Yao, US Centers for Disease Control and Prevention, Atlanta, United States, United States
Peter N. Fonjungo, US Centers for Disease Control and Prevention, Atlanta, United States, United States
Elizabeth T. Luman, US Centers for Disease Control and Prevention, Atlanta, United States, United States
Samuel Duh, Global Health Systems Solutions, C75/20 Amanfro Street, Abelenkpe, United States
Patrick A. Njukeng, Global Health Systems Solutions, Cameroon
Nii A. Addo, National AIDS Control Program, Ghana Health Service, Ghana
Fazle N. Khan, US Centers for Disease Control and Prevention, Côte d'Ivoire
Celia J.I. Woodfill, US Centers for Disease Control and Prevention, US Embassy, Ghana
Abstract
Background: In 2009, Ghana adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme in order to improve laboratory quality. The programme was implemented successfully with limited donor funding and local human resources.
Objectives: To demonstrate how Ghana, which received very limited PEPFAR funding, was able to achieve marked quality improvement using local human resources.
Method: Local partners led the SLMTA implementation and local mentors were embedded in each laboratory. An in-country training-of-trainers workshop was conducted in order to increase the pool of local SLMTA implementers. Three laboratory cohorts were enrolled in SLMTA in 2011, 2012 and 2013. Participants from each cohort attended in a series of three workshops interspersed with improvement projects and mentorship. Supplemental trainingon internal audit was provided. Baseline, exit and follow-up audits were conducted using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. In November 2013, four laboratories underwent official SLIPTA audits by the African Society for Laboratory Medicine (ASLM).
Results: The local SLMTA team successfully implemented three cohorts of SLMTA in 15 laboratories. Seven out of the nine laboratories that underwent follow-up audits have reached at least one star. Three out of the four laboratories that underwent official ASLM audits were awarded four stars. Patient satisfaction increased from 25% to 70% and sample rejection rates decreased from 32% to 10%. On average, $40 000 was spent per laboratory to cover mentors’salaries, SLMTA training and improvement project support.
Conclusion: Building in-country capacity through local partners is a sustainable model for improving service quality in resource-constrained countries such as Ghana. Such modelspromote country ownership, capacity building and the use of local human resources for the expansion of SLMTA.
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