Original Research

Innovative strategies for a successful SLMTA country programme: The Rwanda story

Innocent Nzabahimana, Sabin Sebasirimu, John B. Gatabazi, Emmanuel Ruzindana, Claver Kayobotsi, Mary K. Linde, Jean B. Mazarati, Edouard Ntagwabira, Janvier Serumondo, Georges A. Dahourou, Wangeci Gatei, Claude M. Muvunyi
African Journal of Laboratory Medicine | Vol 3, No 2 | a217 | DOI: https://doi.org/10.4102/ajlm.v3i2.217 | © 2014 Innocent Nzabahimana, Sabin Sebasirimu, John B. Gatabazi, Emmanuel Ruzindana, Claver Kayobotsi, Mary K. Linde, Jean B. Mazarati, Edouard Ntagwabira, Janvier Serumondo, Georges A. Dahourou, Wangeci Gatei, Claude M. Muvunyi | This work is licensed under CC Attribution 4.0
Submitted: 25 July 2014 | Published: 03 November 2014

About the author(s)

Innocent Nzabahimana, Rwanda Biomedical Center/National Reference Laboratory, Rwanda
Sabin Sebasirimu, Rwanda Biomedical Center/National Reference Laboratory, Rwanda
John B. Gatabazi, Rwanda Miltary Hospital, Rwanda
Emmanuel Ruzindana, Rwanda Biomedical Center/National Reference Laboratory, Rwanda
Claver Kayobotsi, Single Project Implementation Unit (SPIU)/Ministry of Health, Kenya
Mary K. Linde, American Society for Clinical Pathology(ASCP), United States
Jean B. Mazarati, Rwanda Biomedical Center/National reference Laboratory, Rwanda
Edouard Ntagwabira, Rwanda Biomedical Center/National reference Laboratory, Rwanda
Janvier Serumondo, Rwanda Biomedical Center/National reference Laboratory, Rwanda
Georges A. Dahourou, US Centers for Disease Control and Prevention (CDC), Rwanda
Wangeci Gatei, US Centers for Disease Control and Prevention (CDC), Rwanda
Claude M. Muvunyi, Rwanda Biomedical Center/National reference Laboratory, Rwanda


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Abstract

Background: In 2009, to improve the performance of laboratories and strengthen healthcare systems, the World Health Organization Regional Office for Africa (WHO AFRO) and partners launched two initiatives: a laboratory quality improvement programme called Strengthening Laboratory Management Toward Accreditation (SLMTA), and what is now called the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA).

Objectives: This study describes the achievements of Rwandan laboratories four years after the introduction of SLMTA in the country, using the SLIPTA scoring system to measure laboratory progress.

Methods: Three cohorts of five laboratories each were enrolled in the SLMTA programme in 2010, 2011 and 2013. The cohorts used SLMTA workshops, improvement projects, mentorship and quarterly performance-based financing incentives to accelerate laboratory quality improvement. Baseline, exit and follow-up audits were conducted over a two-year period from the time of enrolment. Audit scores were used to categorise laboratory quality on a scale of zero (< 55%) to five (95% – 100%) stars.

Results: At baseline, 14 of the 15 laboratories received zero stars with the remaining laboratory receiving a two-star rating. At exit, five laboratories received one star, six received two stars and four received three stars. At the follow-up audit conducted in the first two cohorts approximately one year after exit, one laboratory scored two stars, five laboratories earned three stars and four laboratories, including the National Reference Laboratory, achieved four stars.

Conclusion: Rwandan laboratories enrolled in SLMTA showed improvement in quality management systems. Sustaining the gains and further expansion of the SLMTA programme to meet country targets will require continued programme strengthening.


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