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* * * Home: What MSH Does: TB: Strengthening Laboratory Systems, Services, and Networks

Strengthening Laboratory Systems, Services, and Networks
TB sputum microscopy is a critical step in diagnosing and treating patients. MSH is working to ensure that TB technicians have fully functioning TB laboratories. Photo by Catherine Mundy.
Clinical laboratories play a pivotal role in health care delivery to ensure early and accurate diagnosis, in monitoring treatment progress, and in determining drug resistance. MSH works with MOHs, national TB and HIV/AIDS programs, NGOs, and other partners to develop laboratory policies, strategies, and procedures that will strengthen laboratory systems and services and improve the management of human resources, laboratory equipment, and commodities. We assist in adapting quality-assurance systems and laboratory standard operating procedures to local contexts, using capacity building packages designed to improve management and leadership practices in laboratory settings.

Sputum microscopy is the cornerstone of diagnosis for the vast majority of TB patients in resource–poor settings. To provide this simple test in a routine program setting, systems need to be in place to ensure appropriate collection, storage, transportation, accurate registration, and quality-controlled examination of specimens. Timely recording and reporting of results to both the health care provider and the patient are essential links to care and treatment.

Related Country Work:

MSH is helping to strengthen laboratory systems and networks in Ethiopia, Kenya, Namibia, Rwanda, South Africa, Uganda, and Zambia.

In collaboration with the Global TB Drug Facility, MSH is providing assistance for the development, testing, and evaluation of diagnostic kits in Congo-Brazzaville, Nigeria, and Tajikistan.
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Highlights
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* arrow * Congo-Brazzaville:
The Unsung Heroes of Tuberculosis Control		 *
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* arrow * Uganda:
Strengthening Laboratories in Uganda: Expediting the Roll-Out of TB and HIV/AIDS Programs		 *
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Uganda

In Uganda, MSH has been working with the Joint Clinical Research Centre and the MOH to design and implement a Laboratory Performance Improvement Program, focusing on strengthening systems and building the management and leadership capacity of laboratory management teams from selected MOH regional referral hospitals that are supporting the national ART rollout program.

This is a new approach to improving the performance of laboratories, in a setting where efforts to improve laboratory support for TB and HIV/AIDS have traditionally focused on providing equipment and supplies and training laboratory staff in test methods, but has ignored underlying management issues. Prior to this program, many regional hospital laboratories in Uganda were unable to provide quality assured basic services for comprehensively managing and caring for those infected with TB and HIV/AIDS.

MSH assisted in bringing together multidisciplinary laboratory management teams composed of medical superintendents, hospital administrators, doctors, nurses, and laboratory staff. These teams worked together to identify challenges in laboratory services, clarify roles and responsibilities, develop action plans to initiate changes within their reach, and use a standards-based monitoring tool to measure progress.

Among their improvements are the first hospital monthly budget for laboratory supplies, additional space for key laboratory functions, improved laboratory staff morale, and increased productivity so that essential tests are performed in a timely manner.
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