Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012

Details for Mechanism ID: 10103
Country/Region: Nigeria
Year: 2011
Main Partner: Axios Foundation
Main Partner Program: NA
Organizational Type: Implementing Agency
Funding Agency: HHS/CDC
Total Funding: $548,457

Over the last six years PEPFAR Implementing Partners have refurbished and equipped more than 375 laboratories throughout Nigeria for the diagnosis and treatment of HIV/AIDs patients. The volume of laboratory testing and diversity of laboratory settings results in a need for a mechanism for the management and evaluation of the consistency of the results produced by these laboratories. Additionally, a process for identifying and developing remediation plans for under-performing facilities is required to facilitate the effective strengthening of the laboratory facilities. Such sustainable laboratory systems strengthening is imperative to maintain and improve the laboratory expertise that has been built over the years in the country through implementation of quality control and quality assurance support functions.

Accordingly, the Axios Foundation, in cooperation with the CDC, PEPFAR Implementing Partners and the Government of Nigeria is developing an External Quality Assessment (EQA) process for PEPFAR laboratories to address these needs. The objectives of the EQA process are to:

Assess quality of laboratory performance among all PEPFAR laboratories

Provide assurance to consumers (physicians as well as patients) that results are reliable

Identify possible deficiencies in laboratory practices and guiding participants in corrective action towards improvement

Build and strengthen the capability of the national Medical Laboratory Science Council (MLSC) to provide quality assurance and over sight for laboratory services in the country

in a sustainable manner

Encourage good laboratory practice

Collect information on the reliability characteristics of particular methods, materials and equipment and taking corrective actions as appropriate

Encourage implementation of quality assurance and control measures within laboratories

Collect information on performance of measurement principles in order to guide professionals and/or Government bodies towards achieving harmonization

Identify laboratories of excellent performance for their involvement in training and education

Stimulate information exchange and networking among PEPFAR laboratories

Provide updated information on new developments in HIV diagnostics.

The focus of the project is creation of a national laboratory quality assurance process that is sustainable and scalable so that the EQA objectives can

be applied to all PEPFAR laboratories.

Over the last six years PEPFAR Implementing Partners have refurbished and equipped more than 375 laboratories throughout Nigeria for the diagnosis and treatment of

HIV/AIDs patients. The volume of laboratory testing and diversity of laboratory settings results in a need for a mechanism for the management and evaluation of the

consistency of the results produced by these laboratories. Additionally, a process for identifying and developing remediation plans for under-performing facilities is

required to facilitate the effective strengthening of the laboratory facilities. Such sustainable laboratory systems strengthening is imperative to maintain and improve the

laboratory expertise that has been built over the years in the country through implementation of quality control and quality assurance support functions.

Accordingly, the Axios Foundation, in cooperation with the CDC, PEPFAR Implementing Partners and the Government of Nigeria is developing an External Quality Assessment

(EQA) process for PEPFAR laboratories to address these needs. The objectives of the EQA process are to:

Assess quality of laboratory performance among all PEPFAR laboratories

Provide assurance to consumers (physicians as well as patients) that results are reliable

Identify possible deficiencies in laboratory practices and guiding participants in corrective action towards improvement

Build and strengthen the capability of the national Medical Laboratory Science Council (MLSC) to provide quality assurance and over sight for laboratory services in the country

in a sustainable manner

Encourage good laboratory practice

Collect information on the reliability characteristics of particular methods, materials and equipment and taking corrective actions as appropriate

Encourage implementation of quality assurance and control measures within laboratories

Collect information on performance of measurement principles in order to guide professionals and/or Government bodies towards achieving harmonization

Identify laboratories of excellent performance for their involvement in training and education

Stimulate information exchange and networking among PEPFAR laboratories

Provide updated information on new developments in HIV diagnostics.

The focus of the project is creation of a national laboratory quality assurance process that is sustainable and scalable so that the EQA objectives can be applied to all PEPFAR

laboratories.

Funding for Laboratory Infrastructure (HLAB): $548,457

This narrative describes Axios Foundation's continuing activities in Health Systems Strengthening through the development of an External Quality Assessment (EQA) scheme for PEPFAR laboratories in Nigeria for COP10.

REDACTED.

Axios will build on and strengthen partnerships with WHO, Medical Laboratory Science Council (MLSC) and NBTS with an emphasis of inexpensive partnerships to guarantee the sustainability of EQA activities in country. As part of the focus on system strengthening in COP10, Axios will establish a partnership for mentoring and coaching to be provided by key technical staff within the EQA supply partners of NHLS/NICD in South Africa to Zaria staff and its in-country partners.

This relationship will include a tailored training session by a team of experts from NHLS and will include not only the staff at

Zaria, but selected key individuals from the Medical Laboratory Science Council of Nigeria (MLSCN) and the Center for

Disease Control as well. This training session will either take place in Zaria or South Africa

In COP10, the educational component of the EQA scheme will be refined; high and low performing laboratories will be

identified and mentoring relationships with appropriate training sessions and field visits from Zaria staff to supporting

laboratories will take place.

Building on the initial partnerships established in COP09, Axios will arrange with panel supply partners for the shipments of

HIV serology and CD4 panels for a selected group of USG/PEPFAR laboratories who will form the initial pilot group of the

scheme with a planned phased approach to include all USG/PEPFAR labs by the end of COP10.

Following the initial rounds of panel testing and results submission in COP10, Axios will conduct a brief assessment in to

track improvements in the quality of testing among participating laboratories. Significant challenges will be identified and

the means to address these challenges will be explored in collaboration with the PEPFAR partners. As part of an internal

quality assurance (QA) process, Axios will also assess the feedback loop between the IPs and Zaria EQA center as well

as a feedback loop between the participating laboratories and the IPs. This analysis will be used to identify strengths,

weaknesses, opportunities and threats to the operation of the EQA scheme. Lessons learned and challenges overcome

will be documented and shared through regular written communication such as newsletters with all USG/PEPFAR IPs as

well as all members of the USG partners.

As part of the focus on Health Systems Strengthening in COP10, Axios will identify new partnerships and links to source

hematology & chemistry EQA panels for Zaria EQA center, followed by an evaluation of the potential to introduce real time

polymerase chain reaction (PCR) techniques such as Viral Load Testing and HIV pediatrics (DBS) EQA schemes. To

enable such services, a suitable structure within the compound of the National Tuberculosis and Leprosy Centre in Zaria,

Kaduna State will need to be identified. REDACTED.

When the Zaria EQA center is operating, it will systematically gather all relevant operational data to provide an evidence

base for replicating and expanding the Zaria model into another region in Nigeria.