Lab Matters Spring 2025 | Page 23

GLOBAL HEALTH

By Jully Okonji , senior laboratory specialist , APHL Kenya ; Michael Ikuro , medial laboratory scientist , Kakuma Ammusait Refugee Camp Laboratory ; Romeo Kithuka , laboratory specialist , APHL Kenya ; Benson Kiptoo , medical laboratory technologist , Kakuma Ammusait Refugee Camp Laboratory ; Peter Mundia , Kakuma Ammusait Refugee Camp Laboratory ; Felix Shikomera , laboratory technician , Kakuma Ammusait Refugee Camp Laboratory ; Sila Monthe , health manager , Kakuma Ammusait Refugee Camp Laboratory ; Edwin Ochieng , country director , APHL Kenya ; and B . Wailuba , Kakuma Ammusait Refugee Camp Laboratory

The Kakuma Refugee Camp , the largest refugee camp in the world , was established in 1992 in northern Kenya following the civil war in Somalia and Sudan . Operated by the United Nations High Commissioner for Refugees ( UNHCR ), Kakuma is bordered by Uganda to the west , South Sudan to the north , and Ethiopia to the northeast . The camp hosts the Ammusait Hospital where both refugees and host communities seek healthcare services . The Ammusait Hospital is the largest referral hospital within a 300-kilometer ( 186 mile ) radius .

In 2020 , APHL , in collaboration with CDC , UNHCR and its implementing partner , the International Rescue Committee ( IRC ), established high-quality assured molecular testing capacity so that Ammusait Hospital could respond to the needs of refugees and local communities for SARS-CoV-2 testing during the COVID-19 pandemic . The establishment of the SARS-CoV-2 laboratory resulted in the elevation of the laboratory status and the request from the hospital ’ s health management team to aspire for international accreditation status .

Figure 1 . End-term assessments based on the WHO / AFRO-revised SLIPTA-2023 . There were improvements in many of the quality essential areas resulting in a strong STAR 4 performance . This assessment was conducted prior to the KENAS accreditation assessment .

APHL trained laboratory staff in quality management systems ( QMS ), the ISO 15189:2022 guideline , internal audit and risk management practices . The laboratory QMS implementation used a phased approach with a facility-focused mentorship strategy based on the World Health Organization Regional Office for Africa ’ s ( WHO / AFRO ’ s ) Stepwise Laboratory Quality Improvement Process Towards Accreditation ( SLIPTA ). SLIPTA was established to support laboratories in the African region in improving their quality services at a time when very few laboratories were accredited in the region , and many countries did not know the best approach for implementation .

continued on page 22

Figure 2 . Percentage improvement in the laboratory score from baseline to end terms compared to the expected outcome . Results are presented in shows improvement in the laboratory scores in the implemented QSEs . An improvement from the baseline timepoint of 38 % ( STAR 0 ), Midterm of 66 %, 2 STAR , and an end-term score of 88 %.