A TBD partner will utilize South to South (S to S) collaboration, taking advantage of Portuguese language proficiency and experience developing laboratory capacity in resource limited settings. The goal is to provide laboratory expertise to the MOH to improve national laboratory service capacities through implementation of the National Laboratory Strategic Plan and in accordance with the USG-GOM Partnership Framework Support is aligned with the Partnership Framework goal "To strengthen the Mozambican health system, including human resources for health" through increasing the number of health care and social workers in Mozambique and improving the capacity and quality of pre-service, in- service training, faculty development and post-graduate training and the goal "To strengthening laboratory support for HIV diagnosis and management".

IM Objectives: 1) Develop capacity in laboratory staff to perform quality assured diagnostic tests through in-service training and mentorship; 2) Establish and support the implementation of a Quality Management Program including support for EQA programs for Hematology and Biochemistry and site supervision and coaching; 3) Strengthen pre-service training through provision of faculty (in the short-term) and strengthening of existing faculty and library strengthening through provision of laboratory reference books and journals; 4) Ensure the implementation and review of the National Laboratory Strategic Plan; 5) Strengthen TB diagnosis through mentorship and TB biosafety training; 6) Implement a general laboratory biosafety program. The TBD partner will operate at a national scale and training will be aimed at staff working in clinical laboratories. Through strengthening and supporting pre-service training of laboratory personnel, this IM supports the cross-cutting area of human resources for health. USG funds will support both directly and indirectly the capacitation of 50 new laboratorians in COP year 2010. TA will be provided to central level MOH Laboratory Section in the development of yearly implementation plans and in the roll out of activities in the National Strategic Plan. Mentorships will be targeted mainly at Provincial Hospital Laboratories, with targeted district labs receiving short term mentoring.

Significant contributions will be made to build the management capacity of the Laboratory Section Staff in oversight of the laboratory network and in the implementation of the Strategic Plan. In addition all activities are human capacity development activities covering both in-service and pre-service training. The partner will contribute to strengthening Faculty at the Health Science Institutes.

The TBD partner will collaborate with other USG Partners to make use of available resources thus leveraging resources and preventing duplication of activities. The mentorship program aims to build capacity in Mozambicans to manage their own resources through improved planning. Finally, human capacity building efforts will ensure transfer of expertise to a large number of local Mozambicans and eventually eliminate the dependence on external experts.

For on-going monitoring and evaluation, the partner will conduct one pre- and two post-mentorship assessments (one immediately after and one 6 months after) to measure improvements in laboratory operations and adherence to set standards after mentorship training. To measure sustained impact of mentorship program relative to investment, the partner will facilitate an external evaluation of the program (over the past 3 years) in FY 2010.

This support will utilize partnership through South to South (S to S) collaboration, taking advantage of Portuguese language proficiency and experience in developing laboratory capacity in resource-limited settings. The South to South partner will support the MOH in its efforts to build capacity of future clinical laboratory technologists. A key component of this activity is successful pre-service programs for Faculty development. With FY 2009 funding the South to South partner will hire experienced Laboratory Technology Faculty to be placed at the Insituto Superior de Ciencas de Saude (ISCISA). Faculty will have three distinct roles: assist with the organization of the laboratory program, provide lectures and mentor current faculty at the institute. Organization of the Laboratory program will include assisting with planning and scheduling of lectures. Partner will also conduct lectures in identified areas of weakness namely biochemistry and hematology. Faculty Mentorship will focus on teaching methods, lesson plan development and implementation of new curriculum revised through ASCP support. New curriculum will include modules on Laboratory Management, Quality Assurance and Logistics. Key elements in the implementation of a Quality Management System will therefore be addressed by the curriculum, hence students will be better equipped not only to implement but to manage and maintain quality systems.

It is anticipated that support to strengthening local faculty will contribute to a self-sustained education system for lab scientists within Mozambique. In turn adequately trained staff will be released into the laboratory network with understanding of quality laboratory practices and standards. These well trained laboratory scientists would contribute significantly to improved quality laboratory services.

The South to South partner will support the MOH in its efforts to build capacity of lab technicians within the lab network according the the National Strategic Plan

1) Four month technical/practical training in Brazil in immunology, biochemistry, hematology, microbiology, as well as laboratory and quality management training for 6 (superior and medium level) Mozambican Lab technicians;

2 ) Technical assistance (TA) to the National HIV Reference Laboratory (INS) to maintain and expand the HIV serology External Quality Assurance (EQA) Program. TA to INS in implementation of ISO standard to achieve international accreditation. Biochemistry EQA program for all provincial and some district labs;

3) In Country Program Managers (ICPMs)to: liaise between MOH and USG, to ensure activities are implemented and results are being achieved; organize lab mentorships; supervise to monitor performance of staff trained in Brazil or mentored through the mentorship program; and support to MOH lab section in implementation of National Strategic Plan;

4) Four 6 month lab mentorships with 60 people trained. The goal of this program is to build capacity in technical skills, biosafety, quality assurance processes, communication, work flow organization, equipment maintenance, and inventory and information management;

5) Workshop to promote improved communication, collaboration and respect among Mozambican lab and clinical professionals;

6) Faculty to teach superior level lab course for one year. Teachers will utilize MOH curriculum and 50 people will be trained;

7) Technical advisor to the MOH Lab Section (LS) to build capacity in strategic planning and implementation; program management, communication, and leadership;

8) Establishment of capacity to prepare microbiological media in country;

9) Biosafety training curriculum development and support for national roll out.

This support will utilize partnership through South to South (S to S) collaboration, taking advantage of Portuguese language proficiency and experience to develop laboratory capacity in resource-limited settings. The goal of this activity is to provide laboratory expertise to the MOH to improve national TB

laboratory service capacities. Activities will be implemented through a Cooperative Agreement to a "To Be Determined" South to South Collaboration Partner. FY 2010 funding will support the following activities:

1) Laboratory Mentorship will be provided in the regional TB Laboratories in Beira and Nampula., for a period of 2 months, with 15 people trained. The goal of this program is to build capacity through on-the- job training in technical skills, biosafety, quality assurance processes, communication skills, organization of work flow, lab inventory management, lab information management, daily equipment maintenance and troubleshooting, time management and professionalism. Mentors will give weekly seminars on relevant laboratory topics and encourage lab staff to participate in discussion and debate.

2) The TBD partner will conduct centralized training for staff working in the 3 regional TB culture laboratories in Maputo, Beira and Nampula in TB biosafety. Laboratory safety is an integral component to quality assured laboratories and this activity is therefore significant in the process towards accrediatation. This training will utilize curriculum developed by FUJB in FY 2008 covering use of personal protective equipment, handling of detergents, cleaning, waste management and sterilization. The training has also adapted relevant portions from the biosafety manuals developed by JHPIEGO for Hospital Safety to standardize biosafety training where relevant. Through the mentorship program a biosafety program will be implemented in the laboratories based on this training.