CLSI’s Training Partnership in Tanzania

CLSI’s Joanne Christopher sat down with her colleague, Emily Anderson, who is a program manager with CLSI’s Global Health Partnerships working with our partners in laboratories in Tanzania. She wanted to find out more about how CLSI works with laboratories in Tanzania to help them improve patient care and achieve their accreditation goals.

What does a typical day look like for you when you’re working in Tanzania?

Primarily I’ve been working behind the scenes to ensure our regional contract managers who are currently conducting mentorships in labs across Tanzania are equipped for success. This also includes making sure the workplan is in place, monitoring and reporting on their progress and a lot of logistics— ensuring arrangements are set for accommodation and transportation. When I do get to travel to Tanzania, typically, we will meet with our partners to strategize on our activities and visit some of our lab sites to conduct supportive supervision.

CLSI works in partnership with other public health and governmental organizations to improve laboratories throughout the world. Who are our partners in Tanzania and how, specifically does CLSI partner with them?

Our partners in Tanzania include Ministry of Health, the Lab Branch at the local CDC PEPFAR office, MDH and other PEPFAR implementing partners. We work closely with these partners to coordinate workshops and mentorships in labs equipped with analyzers for HIV viral load and labs enrolled in the SLMTA program.

I’ve heard about the “train the trainer” model quite a bit when talking to CLSI’s Global Health staff. Can you go into a little detail about the specifics of that model?

The train the trainer workshops are delivered in a way so that when participants complete the workshop they’re able to go back and deliver the information to their colleagues. We also hold mentor trainings which cover information on the ISO 15189 standard, which is the standard primarily used for medical lab accreditation. The mentors in Tanzania have been trained by CLSI’s regional contract managers who have many years of mentoring experience. The newly trained mentors are local laboratorians who are employed at various labs, but are able to take time off to visit other laboratories to conduct mentorship, which includes training on aspects of ISO 15189. Even after the training of trainers is finished, the regional contract managers are in touch with the local mentors to offer advising and support.

Is there a specific health care problem or testing method that CLSI’s training partnership in Tanzania is focused on? Can you talk a little about what the specific problem is and the strategy for improvement?

Laboratories that can produce reliable, accurate, and timely results are a critical component of universal health coverage. Currently, we are primarily focused on HIV viral load testing, early infant diagnosis of HIV, and TB testing. Expanding coverage of these tests to more people is the goal and it’s critical that the results that are produced are of high quality. HIV viral load testing is critical in the monitoring of viral load suppression. HIV treatment is working in patients with suppressed viral loads and from a public health perspective, patients who maintain a suppressed viral load have effectively no risk of passing the virus to their partner. Time is of the essence in early infant diagnosis of HIV to determine the course of treatment for an infant born to a mother with HIV. Likewise, access to an accurate TB test is also important to ensure proper treatment and management of the disease.

The ultimate achievement for many laboratories throughout the world is to attain and maintain accreditation. Can you tell me about a lab in Tanzania that has gone through the accreditation process? What specific steps did they need to take to achieve the goal of accreditation?

A number of labs have achieved and maintained their international accreditation in Tanzania. Preparing for accreditation takes months up to a couple of years and labs which have been successful have a committed lab management team who are vigilant and dedicated and engage the staff laboratorians in the process. Designated personnel attend workshops to gain knowledge about various aspects of the 12 quality system essentials, such as root cause analysis and corrective action and internal audits. Labs are often aided by seasoned mentors who support the process of developing a strong quality management system aligned to ISO 15189. Preparations include developing the quality manual, writing procedures, ensuring analyzers are functioning through maintenance and quality assurance, and maintaining records.