Implementation of the world health organization regional office for africa stepwise laboratory quality improvement process towards accreditation

Background: The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis; management and treatment of diseases. In response; the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program.SLIPTA implementation process: WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1-5 stars were issued. Preliminary results: By March 2015; 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries; competent in the Portuguese (3); French (12) and eng (83) languages; were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62-77). Of these audited laboratories; 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action); which both had mean scores below 50%.Conclusion: The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment; ownership and investment in continuous quality improvement are integral components of the process

The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa: Achieving better Health for Africa in the New Millennium

The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa focuses on nine major priority areas: 1) leadership and governance for health; 2) health services delivery; 3) human resources for health; 4) health financing; 5) health information systems; 6) health technologies; 7) community ownership and participation; 8) partnerships for health development; and 9) research for health. This paper describes a framework constructed for implementing the necessary activities in each of these priority areas; and proposes recommendations for consideration by Member States in the development of their own country frameworks. The frameworkfor implementing activities related to health information and research for health which have been taken into account in the Algiers Framework are discussed separately elsewhere in this issue

Strengthening public health laboratories in the WHO African Region: a critical need for disease control

Despite the progress and efforts being made to strengthen laboratory capacities in the Region; challenges remain. The purpose of this document is to raise awareness on the need to strengthen public health laboratory services and propose actions for building national laboratory capacity

Laboratory Capacity in 2012 for Diagnosis of Epidemic Prone Diseases in the Context of Integrated Disease Surveillance and Response in the WHO African Region

This paper provides the status of laboratory capacity for diagnosis of epidemic prone diseases in the context of Integrated Disease Surveillance and Response (IDSR) in 46 countries in the WHO African Region as of end of 2012 through self-assessment questionnaires. The findings from this assessment revealed that 98 (45/46) of the countries have the capacity for isolation; identification and antimicrobial susceptibility testing of common bacterial causes of enteric diseases and meningitis in the Region. Forty three countries performed standard enzyme-linked immunosorbent assay (ELISA) for confirming suspected cases of pathogens such as Morbillivirus responsible of measles through the detection of specific immunoglobulin M (IgM) and 30 countries had at least polymerase chain reaction (PCR) capacity for detection of influenza viruses. However; the number of countries with an appropriate department of virology providing comprehensive diagnostic services is still limited especially for dangerous viral pathogens requiring high-level containment facilities. The collection and analysis of critical information on the existing diagnostic capacity were used to propose key recommendations for strengthening the laboratory confirmation of outbreaks in line with the IDSR Strategy and the International Health Regulations (IHR; 2005). The proposed key actions were focused in the following areas: high-level advocacy for country ownership; human resource development; laboratory space and equipment; quality assurance and laboratory networking