Continuing activity - FY08: The ministry of health conducts within its Science Institutes training for basic

level and medium level technicians. These institutes are failing to meet the needs of the expanding

laboratory network as few students are trained and the capacity of the training institutes requires

strengthening.

Funding provided aims at improving the quality of laboratory technicians graduating from these institutes, as

well as supporting the training institutes to operate at their full potential, through implementation of the

following activities:

Conduct a training needs assessment in training institutes, evaluate existing curriculum, developing a

training plan and ensure its implementation. In addition funding will be provided to develop and implement

monitoring and evaluation tools to assess the success of training efforts being implemented within the

network and identifying areas of possible improvement.

In addition funding is provided to identify and support a suitable partner in Mozambique to set up an EQA

program for biochemistry and hematology.

FY07: Plus-up: This activity is related to laboratory activity number 8549 and involves provision of

Technical assistance to the MoH to develop and implement systems for the improved diagnosis of

cryptococcal meningitis and other common opportunistic infections through laboratory infrastructure

improvement and training of laboratory personnel. The main activities include feasibility assessment of

laboratory needs with respect to OI diagnosis; development of an implementation plan; training of staff at

selected sites procurement and distribution of supplies and equipment.

Original COP: This activity is related to activities 8632, 8546 and 8581 and contributes to the strengthening

of the laboratory network in Mozambique.

There are several continuing and new components to this activity which will be implemented by various

partners through new and existing cooperative agreements (including from the centrally funded laboratory

consortium of APHL, American Society of Clinical Pathology-ASCP, American Society for Microbiology-

ASM, and Clinical and Laboratory Standards Institute-CLSI, and possibly a South-to-South Brazilian

partner). The appropriate partners will be identified based on their area of expertise to undertake the

following activities:

1) Train laboratory technicians and scientist in standard lab practice in the field of hematology, biochemistry,

CD4 testing and microbiology;

2) Develop and implement a training and mentorship program for laboratory technicians in all provincial and

district hospital laboratories that have been rehabilitated and provided with laboratory equipment through

efforts of other Emergency plan funded partners. This component will support training of 60 laboratory

technicians from all provinces in the country.

3) Provide technical assistance in curriculum development, training center renovation including placement

of equipment and faculty, for the development of one laboratory training centre. This will increase the

support both pre-and in-service training of laboratory technicians to provide services in the country. The

outcome of this activity will be the development of one equipped laboratory centre for clinical microbiology

with appropriate staff needed to deliver training.

4) Develop and disseminate standard laboratory operating procedures for hematology, biochemistry, CD4

and immunology and definition of services to be offered at the various levels of laboratories in the health

system.

5) Assist the MoH to strengthen the TB and microbiology reference laboratories in support of diagnosis of

opportunistic infections through training, procurement of commodities, development and implementation of

standard procedures and quality assurance programs

6) Develop infant laboratory testing algorithms and pilot DBS testing: This activity will support travel and

technical assistance (TA) provided by a Brazilian Laboratory expert. In FY06 the laboratory expert has

helped the MOH NIH, PMTCT and pediatric treatment staff to develop the algorithm for infant testing for

Mozambique, using Dried Blood Spot (DBS) samples for PCR laboratory diagnosis. The Brazilian expert

helped to train Mozambican laboratory staff on the use of the first PCR machine installed in Mozambique at

the NIH laboratory and conducted a first training for pediatricians on DBS collection for infant diagnosis. The

in-country MOH and CDC technical staff have since developed a DBS/PCR roll-out plan for PMTCT service

sites, with DBS samples collected from HIV exposed infants, and sent to the NIH laboratory for PCR.

Services will be offered to first PMTCT pilot sites in Maputo City for three months, after which services will

gradually be expanded to serve PMTCT and pediatric treatment sites where exposed infants are seen in

other provinces. FY07 funds will support up to two visits from the Brazilian laboratory expert to provide

technical assistance during the pilot phase, to help refine the roll-out plan according to lessons learned from

the first phase and help review training materials as needed.

All selected partners will work in coordination with other Emergency Plan funded partners to ensure the

integration of laboratory logistics management into systems developed for other health-related commodities

that are being procured in partnership with the Supply Chain Management System.