The Ghana Health Service (GHS), is responsible for hospital laboratories in ten regional and 170 district hospitals. It also includes the public health laboratory system, comprised of one National Public Health Reference Laboratory (NPHRL) and three zonal public health laboratories.

A national health insurance bill was passed into law by the parliament of Ghana which set up a National Health Insurance Scheme (NHIS), that would enable residents in Ghana to obtain basic healthcare services. NHIS has made it mandatory for laboratories to obtain accreditation/certification or risk losing the privileges provided by NHIS. Thus, MOH has shown strong commitment towards laboratory accreditation.

The Global Fund is a key donor in the area of laboratory services for screening, treatment, and monitoring of HIV/AIDS patients. Though these services exist, the provision of quality laboratory services and the conduct of reliable diagnostic testing are still challenges in Ghana. The quality management systems (QMS) in the pre-analytical, analytical and post analytical process for laboratories has not been addressed as a whole. In order to leverage and coordinate donor laboratory efforts, USG support will be targeted to reinforce the basic scale-up assistance coming from the Global Fund and from PMI. USG support will build national capacity for QMS, trainings and the monitoring of laboratory quality using the tools of external quality assessment (EQA), including Proficiency Testing (PT) programs.

CDC Ghana through its implementing partners will support cost-effective, quality laboratory practices to promote reliable and accurate results, thus contributing to effective patient care. This will in turn build a positive attitude by patients towards testing. It will work closely

The Ghana Health Service will continue to support the development and dissemination of the National Laboratory Strategic Plan and policy documents. GHS will also continue to support the cost of training of laboratory professionals on quality management systems (QMS). These trained laboratory professionals will continue to transfer skills, knowledge and capacity, ensuring a sustained impact.The GHS will continue to work towards strengthening laboratory capacity for monitoring trends in HIV and Tuberculosis (TB) resistance. Funds will support the salaries of a Quality Manager for TB and ten Regional Supervisors responsible for EQA for TB AFB smear microscopy.The GHS will ensure that new algorithms for HIV diagnostics are validated and properly used. GHS will purchase HIV rapid test kits and required consumables to conduct national HIV testing algorithm validations. Funds will be used to provide technical support to HIV surveillance activities (including incidence studies).GHS will continue to develop and strengthen the national sample referral system and results reporting. Resources will go to ensure specimens are appropriately transported to maintain their integrity, ensuring testing and return within specified turnaround times for appropriate interventions.

CDC provided teachnical assistance to the Ghana Health Services (GHS) in implementing a new aggregate data capture system. CDC will continue to work on this system to incorporate additional aggregates currently being captured by parallel systems, with a special emphasis on laboratory and HIV aggregates; to create additional reports; to improve data use and data quality; and to provide supportive supervision to sites which experience implementation difficulties. In addition, work will continue on other partnership framework tasks, such as creating a help desk and improving the ART monitoring software so as to work with the new aggregate system. During the year, the target is to train 200 people to use the new system; much of this training comes from USG budgets other than PEPFAR. If work with the aggregate system progresses sufficiently, resdesign efforts on the NACP HIV tracking system will be undertaken.

CDC will work with the GHS to implement a multi-focal plan to strengthen blood services in Ghana.Current efforts to increase donor mobilization and retention, particularly of volunteer, non-remunerated donors from low risk populations, are constrained by lack of reliable, adequate and appropriate transport for donor education, mobilization and outreach services. The primary strategy will be to determine the most cost-effective, reliable, safe and durable methods of improving transport to increase the reliability and accessibility of blood services.Volunteer donors only account for 28% of the approximately 140,000 units of blood collected in Ghana in 2008. PEPFAR support will be used to develop a comprehensive, direct public social marketing campaign to increase the number of volunteer, uncompensated blood donors. This cost-effective proposal would utilize posters, flyers, billboards and public service messages to reach potential volunteer donors.Most of the blood services staff have not had any recent or ongoing in-service training. Newly hired staff are not presently given an orientation and do not receive adequate pre-service training to perform their jobs. The goal for PEPFAR funding is to increase the quality, frequency, sustainability and capacity to conduct targeted training for blood procurement, laboratory technicians and clinicians involved in blood services. Training will include topics on quality, safety, appropriate clinical use of blood and blood products, laboratory testing, component processing, storage, distribution and supply, and waste disposal.Currently there is inadequate cold storage capacity to ensure the safety, reliability and accessibility of blood products at the ten regional and 170 district hospitals. PEPFAR will support the purchase of blood storage refrigerators to improve storage capacity at a network of geographically dispersed priority hospitals. The appropriate type, size, and specifications of the units will be determined by GHS to ensure cost-efficiency, durability and reliability for optimum performance.