Sustaining the Gains made in Laboratory Strengthening in Resource Constraint Settings in Kenya: A Laboratory Mentor’s Perspective

Background
The Association of Public Health Laboratories (APHL), in collaboration with the U.S. Centers for Disease Control and Prevention (CDC) provided mentorship to the Regional Laboratories by ensuring quality of laboratories were upheld to be able to offer quality assured SARS-CoV-2 results for the populations. The APHL used a mentorship approach tailored to facility needs or Facility Focused Mentorship (FFM) to support seven laboratories in Kenya to strengthen laboratory services. Here, the findings and experience of Quality Management System (QMS) implementation in medical laboratories using FFM approaches in Kenya, are presented.

Objective

To share experience on the processes of laboratory strengthening and sustainability practices suitable for laboratories in resource constraint areas.

Method

The FFM approach was employed in the mentorship scheduled. Objectives of the mentorship schedules were shared with the facility laboratory management and the hospital management. Laboratory assessments were conducted at intervals as a monitoring tool. Three of the seven laboratories had not achieved their ISO 15189:2012 accreditation status. The assessment looked at reagents, equipment procurement and management, and resource management. Laboratory staff trainings were done on schedule. Laboratory-clinical interface was initiated, and review of test menu and service utilization was done.

Results

Molecular laboratory setup was successfully done in six out of the seven laboratories supported by APHL. QMS Improvements of >30% was documented from baseline to end term period. Improvements in laboratory planning and budget allocation was seen in two of out of the three laboratories that previously did not have laboratory budgets. Increase in the tests’ menu and utilization of the laboratory services was documented.

Conclusion

Laboratory quality assured testing processes is possible in a resource limited setting and quality indicators of measure established to ensure quality assured results are released. The outcome of this process has significantly eased the demand for SARS-CoV-2 testing along other available laboratory tests services by ensuring results are quality assured and accessible to patients and clinicians. Laboratory FFM does allow for an in-depth gap analysis and thus ensures consistency in closure of such gaps.