global health
Participants receive their certificates after completing a SLMTA Workshop
in Mutare, Zimbabwe
Documentation and records
A process
are mapping
clearly marked
posterfor
helps
reference
laboratorians check their progress
Improving QMS in Zimbabwe
by Lucy Atieno, PhD, laboratory and quality management system consultant, Global Health and Sadaf Chaudhry,
manager, Global Health
I
mplementation of laboratory quality management systems (QMS) is
moving forward in Zimbabwe under APHL’s leadership. A September 2016
audit conducted by the African Society of Laboratory Medicine (ASLM)
found significant, overall improvement at all 12 Ministry of Health and Child
Care (MoHCC) laboratories audited, with some indicators advancing to double
or triple the baseline score. ASLM and internal audits performed in 2014
provided the baselines for the audit.
Over the last two years, APHL has provided training and mentorship to
support QMS implementation at 30 Ministry of Health and Child Care (MoHCC)
laboratories in Zimbabwe. Working in partnership with the Centers for Disease
Control and Prevention, APHL has led Strengthening Laboratory Management
Toward Accreditation (SLMTA) workshops and directed the embedded
mentorship program.
Additional Findings
All 12 laboratories audited achieved at least a one-star rating, with scores
ranging between one and four stars with a one-star cut-off of 55% (see Table 1).
Specifically, all laboratories improved across the 12 SLIPTA quality essentials
(see Table 2) although some areas will require further attention. These include:
• Management Review
• Evaluation and Audits
• Identification of Non Conformities, Corrective and Preventive Actions
APHL will continue to implement QMS projects in targeted countries under
the Global Health Security Agenda (GHSA) National Laboratory Systems Action
Package. This GHSA package aims to implement measures to improve handling
and containment of dangerous biological agents.
Table 1: Audit Scores and Star Rating (2012 – 2016)
Location
ASLM Audit
Score (2012)*
ASLM Audit
Score 2014*
Lab 1
202/258 (78.3%)
Three Stars
Lab 2
Lab 3
Lab 4
In SLMTA/
Mentorship
program since
2010
SLIPTA Checklist Section
171/258 (66.3%)
238/269 (88.5%)
Four Stars
1: Documents & Records
171/258 (66%)
One Star
193/258 (75%)
Three Stars
207/267 (77.5%)
Three Stars
N/A
179/258 (69%)
Three Stars
204/267 (76%)
Three Stars
N/A
N/A
104/269 (38.7%)
No Star
164/269 (60%)
One Star
144/269 (53.5%)
No Star
148/267 (55.4%)
One Star
46/265 (17.4%)
No Star
146/265 (55%)
One Star
N/A
64 (23.9%)
No Star
154/267 (57.7%)
One Star
N/A
84 (31.5%)
No Star
N/A
Lab 10
Lab 11
Lab 12
Did not go
through SLMTA
program, but
have been under
mentorship since
September 2015
LAB MATTERS Fall 2016
50
70.9
34
80
34.6
67.7
50
8: Process Control
40.6
68.1
9: Information Management
55.3
74.7
10: Identification of Non Conformities, Corrective
and Preventive Actions
7.9
44.7
75/267 (65.5%)
One Star
11: Occurrence/Incident Management & Process
Improvement
26.7
73.3
41 (15.2%)
No Star
226/269 (84%)
Three Stars
12: Facilities and Biosafety
51.6
79.8
N/A
58 (21.6%)
No Star
196/269 (73%)
Two Stars
N/A
69 (25.7%)
No Star
199/269 (74%)
Two Stars
N/A
50 (18.7%)
No Star
152/267 (57%)
One Star
N/A
6: Evaluation and Audits
25
29.1
80.4
*Results obtained under ZINQAP Mentorship
16
5: Equipment
63.6
57.5
N/A
Lab 9
4: Client Management & Customer Service
26.8
Average Score September 2016 (%)
7: Purchasing & Inventory
Lab 6
Lab 8
2: Management Reviews
3: Organization & Personnel
Average Score September 2014 (%)
6
163/253 (64%)
One Star
In SLMTA/
Mentorship
program since
September 2014
Table 2: Average Percentage Scores for the 12 audited facilities
ASLM Audit
Score 2016**
Lab 5
Lab 7
APHL Baseline Audit
Scores 2014
**Results obtained under APHL Mentorship
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